BCOM2016-003478-495 CALLE TAMPICO D VOICE (760) 777-7125
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 DESIGN & E RTM INSPECTIONS (760) 777-7153
B DINg�RMI�
201
Date: 10/27/2016
Application Number: BCOM2016-0034 _ OCT 2 wner:
Property Address: 78825 HIGHWAY 111 STE '2 M LA QUINTA
TA
APN: 643020065 i CIT(�FLAQN70EPARTIAENT 319 UNIVERSITY STE 236
Application Description: ULTA / 12,602SF TENANT IMPROVEMENT IRVINE, CA 92253
Property Zoriing:
Application Valuation: $550,000.00
Applicant: Contractor:
CHIPMAN DESIGN ARCHITECTURE THREE RIVERS CONSTRUCTION & DEVELOPMENT
2700 S RIVER RD 4TH FL 7777 RUSTLER CT
DESPLAINES, IL 60018 SPARKS, NV 89436
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: B License No.: 896569 a
Date: Z `, hContract
OWN ER-BUI ECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair
any structure, prior to its issuance, also requires the applicant for the permit to file a
`signed statement that he or she is licensed pursuant to the provisions of the
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
3 of the Business and Professions Code) or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
(_) I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for sale.
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not'.
apply to an owner of property who builds or improves thereon, and who does the work
himself or herself through his or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the building or improvement is sold
within one year of completion, the owner -builder will have the burden of proving that
he or she did not build or improve for the purpose of sale.).
(_) 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
(_) I am exempt under Sec. B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency For
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
(775)825-5248
Llc. No.: 896569
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
Carrier: ARGONAUT INSURANCE COMPANY Policy Number: WC9280SS375104
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions. `
D II 7_4 IbA�Applicant,_AVZ_--
WARNING: FAILURE TO SECURE WORKfRS�fUPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Date: ATU Sign - nature (Applican-- t oT or,,Ag
Date: 10/27/2016
Application NLmber;. BCOM2016-0034 Owner: .
Property Address:' 78825 HIGHWAY 111 STE 2 RM LA QUINTA
APN: 643020065 5319 UNIVERSITY STE 236
Application Description: ULTA•/ 12,602SF TENANT IMPROVEMENT/VB/M-OCC/322-OL/SPRINKLED IRVINE, CA 92253
Property Zoning:
Application Valuation: $550,000.00
Applicant: Contractor:
CHIPMAN DESIGN ARCHITECTURE THREE RIVERS CONSTRUCTION & DEVELOPMENT
2700 S RIVER RD 4TH FL . 7777 RUSTLER CT
DESPLAINES, IL 60018 SPARKS, NV 89436
(775)825-5248
Llc. No.: 896569
Detail: 12,6025E MERCANTILE TENANT IMPROVEMENT/VB/M-OCC/322-OL/FULLY SPRINKLED [ULTA BEAUTY] THIS PERMIT DOES NOT INCLUDE
ALTERATIONS TO THE BUILDING FRONT FACADE, BUILDING SIGNAGE, CANOPIES, OR RACKING/SALES FIXTURES. 2013 CALIFORNIA BUILDING CODE.
FINANCIAL INFORMATION
=:DESCRIPTION ACCOUNT QTY AMOUNT
ART IN PUBLIC PLACES - COMMERCIAL REMOD
270-0000-43201 0 $2,250.00
Total Paid for ART IN PUBLIC PLACES - AIPP: $2,2S0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$22.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $22.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
NON-RESIDENTIAL, EA ADDITION 2,000SF
101-0000-42403
0
$217.56
DESCRIPTION
ACCOUNT
QTY
AMOUNT
NON-RESIDENTIAL, EA ADDITION 2,000SF, PC
101-0000-42600
0
$58.02
DESCRIPTION
ACCOUNT
QTY
AMOUNT
NON-RESIDENTIAL, FIRST 2,000SF
101-0000-42403
0
$108.77
DESCRIPTION
ACCOUNT
QTY
AMOUNT
NON-RESIDENTIAL, FIRST 2,000SF, PC
101-0000-42600
0
$84.12
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $468.47
DESCRIPTION
ACCOUNT
QTY
AMOUNT
AIR HANDLER
101-0000-42402
0
$145.04
DESCRIPTION
ACCOUNT
QTY
AMOUNT
AIR HANDLER PC
101-0000-42600
0
$48.36
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR
101-0000-42402
0
$145.04
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$96.68
DESCRIPTION
ACCOUNT
QTY
AMOUNT
VENT FAN
101-0000-42402
0
$24.18
DESCRIPTION
ACCOUNT
QTY
AMOUNT
VENT FAN PC
101-0000-42600
0
$9.66
Total Paid for MECHANICAL: $468.96
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP
101-0000-42401
0
$193.44
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP PC
101-0000-42600
0.
$193.44
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$12.09
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$24.17
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER HEATER/VENT
101-0000-42401
0
$12.09
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER HEATER/VENT PC
101-0000-42600
0
$7.25
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER SYSTEM INST/ALT/REP
101-0000-42401
0
'$12.09
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER SYSTEM INST/ALT/REP PC
101-0000-42600
0
$12.09
Total Paid for PLUMBING FEES: $466.66
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF
101-0000-42400
0
$565.50
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$452.40
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 100 SF
101-0000-42400
0
$49.31
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 500 SF PC
101-0000-42600
0
$134.88
Total Paid for REMODEL: $1,202.09
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI -COMMERCIAL
101-0000-20308
0
$154.00
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $154.00
I U I ALS: ",U3Z.18
Bin. #
ff 11
Qty. of, La Quinta
Building & iy Division
r Safe
P.O. Box 1504,78-495 Calle Tampico
L; -Quinta, CA 92253 -:(760) 777V012
39 Building Permit Application and Tracking Sheet
Permit #
bbd M 1
Project Address: e
Z.
Owner's Name:.
A. P. Number:
Address: U D
Legal Description:
City, ST, Zip:
Contractor: T
Telephone: 50-U- OZI/-7
Address:
Project Description:
City, ST, Zip:
Telephone:
State Lie. #: City Lie.
Arch, Engr., Designer:c,�xs'k'c\ R Nck,kdw
Address: 14 � IR
City., ST, Zip: ,\ L
Tekphone:6429OUL). Construction Ty Occ'upancy: S,
StateLic.#: Project type (circle one): Add'n. Alter Repair Demo'
Name of Contact Person: 'U*Qi Sq. Ft.: 2— 6 0� I # Stories:I
Telephone 4 of Contact Person: M - 7199" 6100
1 Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
9
Submittal
Req1d
Reed
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit.
Truss C21cs.
Called Contact Persoz
Plan Check Balance
Tide 24 Cales.
Plans picked up
Construction
Hood plain plan
Plans resubmitted
Mechafiical
Grading plan
2'° Review, ready for correctionstissue
Electrical
Subcontattor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SZVLL
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
Review; ready for corrections/issue
Developer Impact Fee
Planning Approval.
Called :- Contact Person
A.I.P.P
Pub. Wks. Appr
Date of permit Issue
School Fees
EE
I
I Total Permit Fees
JQG (ZiP 5&4 1y« &A—A-LA.-
.. . . ...........
Permit Number: BCOM2016-0034
Applied: 7/26/2016' Approved:
Issued: Finaled:
Status: UNDER REVIEW
Parent Permit:
Parent Project:
Details
Description: ULTRA BEAUTY / TI REMODEL INPROVMENT
Site Address: 78825 HIGHWAY 111
City, State Zip Code: LA QUINTA, CA 92253
Applicant: CHIPMAN DESIGN ARCHITECTURE
Owner: RM LA QUINTA
Contractor: TBD
Printed: Tuesday, 26 July, 2016 1 of 1
M—w— srsreMs
LIST OF
IRETURNED
SENT DATE
DUE DATE
TYPE
CONTACT
STATUS REMARKS
DATE .
Review Group: AUTO
7/26/2016
8/9/2016
IST BLDG NS (2 WK)
BUILDING BUCKET
n
Notes
s y i •� r�\ p� two : l a A�. f f z �.
7/26/2016
8/9/2016
1ST PLANNING (2 WK)
PLANNING BUCKET
'Notes
, -} r d • ` ct +
Printed: Tuesday, 26 July, 2016 1 of 1
M—w— srsreMs
Building Permit Number:
Project Description: Tenant Improvement
Exempt: 0
(Materials may contain hazardous wastes and
are not subject to recycling provisions)
Construction Debris Management Plan
Plan Submittal Date 9/13/2016
Job Site
Owner's
Number, Street, or PO
City, State, Postal C
Owner's Phone Nur
Owner's E -Mail Add
Project Manager's
Project Manager's Phone N
Project Manager's E-mail A
Builder / Contn
Number, Street or PO
City, State, Postal C
Project Square
78-825 Highway 111
La Quinta, CA. 92253
ULTA
1135 Arbor Drive
Romeoville, IL 60446
510 868-0247 (ULTA Project Manager)
ourathAcomcast.net
Morgan Gurath
Jim McCall
775 825-5248
imccal I(Wriversinc.com
Three Rivers Construction & Development
155 Design Place #101
Sparks, NC. 89441
12,626 square feet
City Approval
Date of City Approval •
Materials To Be Discarded:
Product
Tons
Trash
11.00 Not recyclable
Product
Tons
Asphalt
0.00 Recyclable
Masonry (broken)
0.00
Brick/Block
0.00 Recyclable
Plaster
0.00
Cardboard
0.00 Recyclable
Scrap Metal
5.00
Commingled
0.00 Recyclable
Tile (floor)
1.00
ConcreteAO.00
Recyclable
Tile (roof)
0.00
DrywallRecyclable
Wood
2.00
Donated / Reuse"Recyclable
Landscape Debris
0.00
*Describe Items
Totals: Rec cie Trash
13.5 11.0
Projected Diversion:
55.10%
I understand It is the property ownees responsibility to submit copies of weight tickets or receipts to the District
Environmental Coordinator as these hauls occur. I hereby certify that completion, implementation and adherence of the
Debris Management Plan (DMP) for the above named project shall guarantee that at least 50% of the jobsite waste Is
diverted from landfilling. The remaining material will be recycled or reused. I will divert, for recycling or re -use, remaining
materials generated from the first day of the project through the completion of the project in accordance with this plan. This
DMP is issued in the name of the property owner(s) and shall remain their property throughout the construction and/or
demolition project. A contractor serving as agent of the owner may obtain a DMP for the owner. However, the DMP is still
Issued in the name of the property owner(s) and the owner retains legal responsibility for ensuring that the provisions of the
DMP are adhered to. The property owner(s) and general contractor shall be kept informed of the diversion progress through
bi-monthly reports. if self -hauling, all -refuse material from this project site must be taken to an approved recycler or transfer
Owner/ Developer/ Project Manager/ Superintendant Date
Plan Submittal
Building Permit Number:
Project Description: Tenant Improvement
Exempt: ❑
(Materials may contain hazardous wastes and
are not subject to recycling provisions)
Construction Debris Management Plan
Job Site Address
z
9/7/2016
78825 Hwy 111
Owners Namel Ian Hafner/Spirit Investment Partners
Number, Street; or PO Box1 302 N. EI Camino Real suite 212-D
City, State, Postal Code San Clemente, CA. 92672
Owner's Phone Number 949-481-6204
Owner's E -Mail Address
Project Manager's Name
Project Manager's Phone Number
Project Manager's E-mail Address
Builder / Contractor
Number, Street or PO Box
City, State, Postal Code
Ian @soiritinvestors.com
Jim Weaver
408-477-7617
iim weaver@bdavisinc.com
B. Davis Inc
1441-A Terminal Ave
San Jose, CA. 95112
Project Square Footage 31,000 square feet �"
City Approval B _b EL— ,C,X.lk Vt(a�2
Date of City Approval o9 /,0 ( (o
Materials To Be Discarded:
Product
Trash
Asphalt
Brick/Block
Cardboard
Commingled
Concrete
Drywall
Donated / Reuse"
'Describe Items
Tons
28.00 Not recyclable
0.00 Recyclable
0.00 Recyclable
0.00 Recyclable
0.00 Recyclable
1.50 Recyclable
14.00 Recyclable
0.00 Recyclable
Totals: Rec cle Trash
37.5 28.0
Product
Masonry (broken)
Plaster
Scrap Metal
Tile (floor)
Tile (roof)
Wood
Landscape Debris
Tons
0.00 Recyclable
0.00 Recyclable
14.00 Recyclable
3.00 Recyclable
0.00 Recyclable'
5.00 Recyclable
0.00 Recyclable
Projected Diversion:
57.25%
I understand it is the property owner's responsibility to submit copies of weight tickets or receipts to the District
Environmental Coordinator as these hauls occur. I hereby certify that completion, implementation and adherence of the
Debris Management Plan (DMP) for the above named project shall guarantee that at least 50% of the jobsite waste is diverted
from landfilling. The remaining material will be recycled or reused. I will divert, for recycling or re -use, remaining materials
generated from the first day of the project through the completion of the project in accordance with this plan. This DMP is
issued in the name of the property owner(s) and shall remain their property throughout the construction and/or demolition
project. A contractor serving as agent of the owner may obtain a DMP for the owner. However, the DMP is still issued in the
name of the property owner(s) and the owner retains legal responsibility for ensuring that the provisions of the DMP are
adhered to. The property owner(s) and general contractor shall be kept informed of the diversion progress through bi-monthly
reports. If self -hauling, all refuse material from this project site must be taken to an approved recycler or transfer station.
Owner / Developer / Project Manager / Superintendant
Date