BSPN2016-005678-495 �ALLE TAMPICO D "i
LA QOINTA,'CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BSPN2016-0056
Property Address: 78987 HIGHWAY 111
APN: 643020050
Application Description: HALLOWEEN CITY / INSPECTION FOR TEMPORARY STORE
Property Zoning:
Application Valuation:
Applicant:
JOE MOTTOLA
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: _ License No.:
Contractor:
OWNER -BUILDER DECLARATION
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).:
(1 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.).
( ) I, 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
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/2/2016
Owner:
OD LA QUINTA
80618 DECLARATION AVE
INDIO, CA 92253
Contractor:
Llc. No.:
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 rk for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Se ion
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:_ Polity Number: _
_ 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,te� / Z Applicant
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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. �,..
Da Z Si nature_(A IieancorAent
Date: 9/2/2016
Application Number:
BSPN2016-0056
Owner:
Property Address:
78987 HIGHWAY 111
OD LA QUINTA
APN:
643020050
80618 DECLARATION AVE
Application Description:
HALLOWEEN CITY/ INSPECTION FOR TEMPORARY STORE
INDIO, CA 92253
Property Zoning:
Application Valuation:
Applicant:
Contractor:
JOE MOTTOLA
Llc. No.:
----------------------------------------
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i.
Detail' WtiCAL COMPLIANCE
INSPECTON FOR TEMPORARY STORE "HALLOWEEN CITY" 2013'CALIFORINA BUILDING CODES.
DESCRIPTION
INFORMATIONFINANCIAL
ACCOUNT QTY
AMOUNT
SPECIAL INSPECTION
101-0000-42404 0
$72.52
DESCRIPTION
ACCOUNT QTY
AMOUNT
SPECIAL INSPECTION PC
101-0000-42600 0
$181.29
Total Paid for COMPLIANCE SURVEY/SPECIAL INSPECTION:
$253.81 .
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A. P. Naunber.
l ,, .ter ees Name' , �t '
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Clty•of La Quinta
-Building tK Safety Division
50
' . P.O. Bo104,78-49S Calle Tampico
4.Quinta, CA 92253 • (760) 777.7012
Building Permit Application'and Tracking Sheet
Permit*
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A. P. Naunber.
l ,, .ter ees Name' , �t '
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Legal Description:
_City, ST, Zip: t"4, u.$' •�O
Contractor:
1'ei hone:
Address:PrpjacfDeseription:�,;,
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City, $T, Zip.
Telephone:'
City Lia k ,
State Lic. # :
Arch., 13W•, Designer
Address:
City, ST, zip;
Telephone:
State Lia M
tome of Contact Person:
p Q
Construction'lyrpe: , Occupancy:
Project type (circle one): New Add'n Alter Repair Demo"
. Sq. Ft.:
# Stories:
# Unity:
fielephone # of Contact Pe%son:
— 67 •- '2 $ 4
fi�t� ted Value of Project:
PPLICANTc DO NOT WRITE BELOW THIS UNE
# Submittal Req'd Recd TRACKING PERMIT FEES
Plan Sets
Plan Cheek submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calce.
Called Contact Person
Plan Check Balance.
Title 24 Gales.
Plans pickid up
Construction
Flood phis plan
Plans resubtnithd
Mechanical
Grading plan
2`! Review, ready for correationsfusue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resabmitted
Gradlog '
IN HOUSE%- '
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Caked Contact Person
A.I.P.P.
Pub. Wks. Appr •
Date of permit Issue
School Fees
•
Notal Permit Fees
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RISER
B.S.
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CITY OF LA QUINTA
BUILDING DIVISION
APPROVED
FOR CONSTRUCTION
DATE: BY:
i
rDING INSPECTOR TO FIELD VERIFY:
V INIMUM OF TWO EXITS TO THELIC WAY FROM MAIN RETAIL AREA
LUMINATED EXIT SIGNAGE INCH MINIMUM CLEAR•MAIN AISLES
CCESSIBLE TRANSACTION COUNTER
ROPER ANCORAGE OF STORAGE
KS
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enspk z0vo 10 0056
PROUDLY SERVING THE
UNINCORPORATED AREAS
OF RIVERSIDE COUNTY
AND THE CITIES OF:
BANNING
BEAUMONT
CALIMESA
CANYON LAKE
COACHELLA
DESERT HOT SPRINGS
EASTVALE
INDIAN WELLS
INDIO
JURUPA VALLEY .
LAKE ELSINORE
LA QUINTA
MENIFEE
MORENO VALLEY
NORCO
PALM DESERT
PERRIS
RANCHO MIRAGE
RuBIDOUx CSD
SAN JACINTO
TEMECULA
WILDOMAR
BOARD OF
SUPERVISORS:
KEVIN JEFFRIES
DISTRICT 1
JOHN TAVAGLIONE
DISTRICT 2
JEFF STONE
DISTRICT:
JOHN BENOIT
DISTRICT 4
MARION ASHLEY
DISTRICT 5
CAL FIRE — RIVERSIDE UNIT c
RIVERSIDE COUNTY FIRE DEPARTMENT
OFFICE OF THE FIRE MARSHAL
77-933 Las Montanas Rd., Ste. #201, Palm Desert, CA 92211-4131 • Phone (760) 863-8886
• ,Fax (760) 863-7072
www.rvcfire.org
September 2"d, 2016
Joe Mahola-Halloween City
35901 Veronica
Livonia, MI 48150
Re: Building Temporary Use Permit — Halloween. Qty
LAQ-I6-MISC-026 78987 Highway 111, La,Quinta, CA
Fire Department personnel have reviewed and have approved the plans you submitted for the
above referenced project. Please be advised the following conditions apply as a part of the
conditions for the issuance of a,building permit..
Buildings/facilities
f
1) Fire Sprinkler — Temporary tenant will provide maintenance records for Riverside
County Fire Department (5 year certification). 640060--W^6e.D
2) Fire Alarm — Temporary tenant will provide maintenance records for Riverside County
Fire Department. twtuGr-1 L>rt t C&Zb
3) . Install Knox Key Lock box, mounted per recommended standard of the Knox Company.
If the building/facility is protected with a fire alarm system or burglar alarm system, the
lock boxes will require "tamper" monitoring. Special forms are available from this office
for the ordering of the Key Switch. This form must be authorized and signed by this
office for the correctly coded system to be purchased:
4) Provide keys to the tenant space for inclusion in the main building Knox Box. Key(s)
shall have durable and legible tags affixed for identification of the correlating tenant
space. �ww�2�LLorr21�
5) Approved building address shall be placed in such a position as to be plainly visible and
legible from the street and rear access if applicable. Building address numbers shall be a
minimum of 12". Minimum 6" tall suite addressing shall be provided to both the. front and
rear.entrances. All addressing must be legible and.of a contrasting color with the background
and adequately illuminated to be visible from the street at all hours. owt162�L►a�.►yLQ�
Other requirements:
1) Install portable fire extinguishers per Title 19, but not less than 2AlOBC in rating. All new
and existing portable fire extinguishers shall have current annual servicing performed and
tagged.
2) All fire -rated drop door assemblies are required to have a current annual certification at time
of final inspection.