05-3264 (CSCS)tr
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Td�p 4 4 a"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 05-00003264
Property Address: 79680 HIGHWAY 111
APN: 649-020-014-4 -31143 -
Application description: NEW COMML - STORES & CUSTOMER SERVICE
Property Zoning: REGIONAL COMMERCIAL
Application valuation: 435120
Applicant:
I.l
V
Architect ^or Engineer:
N V\
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 fessionals Code, and my License is in full force and effect.
License Class: B se No.: 801773
Dat �6 OSP Contractor:
OWNER -BUILDER DE RA N
I hereby affirm under penalty of perjury that I am exempt from the Con or'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 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.).
(_ 1 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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
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
ii Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 01641941-2005
_ 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 haborEede'J-,i�all aoJuuth caEnply with those pyovisions.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CO AGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FIN UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001 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 Director of Building and Safety 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 rela ' constrdI!Vt7rr, ea ereby authorize representatives
of this co (/ty to//enter upon thea ove-mentioned er spection pur oses.
D DIY 1�Y
Sig,
ig re (Applicant or Agent):
Date: 6/16/06
Owner:
DUNES BUSINESS PARK LLC,
THE -ems
3550 W 6TH ST STE 400
LOS ANGELES, CA 90020
Lr��
JUN 2
0 20'J6
Contractor:
BISHOP BUILDERS INC
CITY OF LAi1t%1lb�
P.O. BOX 1746
FINANCEifE�i
__
KETCHUM, ID 83340
(760)218-5801
Lic. No.: 801773
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
ii Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 01641941-2005
_ 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 haborEede'J-,i�all aoJuuth caEnply with those pyovisions.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CO AGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FIN UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001 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 Director of Building and Safety 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 rela ' constrdI!Vt7rr, ea ereby authorize representatives
of this co (/ty to//enter upon thea ove-mentioned er spection pur oses.
D DIY 1�Y
Sig,
ig re (Applicant or Agent):
Application Number . . . . . 05-00003264
- Permit
. . .
BUILDING PERMIT
Additional
desc .
Permit Fee
. . . .
1815.50 Plan Check Fee
1180.08
Issue Date
. . . .
Valuation . . . .
435120
Expiration
Date
12/13/06
Qty Unit Charge
Per
Extension
BASE FEE
639.50
336.00
----------------------------------------------------------------------------
3.5000
THOU BLDG 100,001-500,000
1176.00
Permit
. . .
MECHANICAL
Additional
desc .
Permit Fee
105.00 Plan Check Fee
26.25
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
12/12;06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
5.00
9.0000
EA MECH FURNACE <=100K
•45.00
5.00
----------------------------------------------------------------------------
9.0000
EA MECH B/C <=3HP/100K BTU
45.00
Permit
. . .
ELEC-NEW COMMERCIAL
Additional
desc .
Permit Fee
. . . .
190.00 Plan Check Fee
47.50
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
12/13/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
8750.00
----------------------------------------------------------------------------
.0200
ELEC GARAGE OR NON-RESIDENTIAL
175:.00
Permit
. ._.
PLUMBING
Additional
desc . .
Permit Fee
. . . .
184.50 Plan Check Fee
46.13
Issue Date
. . . .
Valuation
0
Expiration
Date
12/13/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00
15.0000
EA PLB BUILDING SEWER
15.00
3.00
6.0000
EA PLB ROOF DRAIN
18.00
5.00
3.0000
EA PLB WATER INST/ALT/REP
15.00
1.00
9.0000
EA PLB LAWN SPRINKLER SYSTEM
9.00
5.00
7.5000
EA PLB OTHER BACKFLOW <=2 INCH
37.50
LQPERMIT
Application Number . . . . .. 05-00003264
Permit . . . . . . PLUMBING
Qty Unit Charge Per
Extension
5.00 15.0000 EA PLB GAS METER
----------------------------------------------------------------------------
75.00
Permit . . . GRADING PERMIT
Additional desc
Permit Fee . . . . 15.00 Plan Check Fee
.00
Issue Date Valuation . . .
. 0
Expiration Date 12/13/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
------------------------- --------------------------------------------------
Special Notes and Comments
SHELL BUILDING "C" 8,750 SF TYPE V -N
CONSTRUCTION, B/M PROPOSED USE. 2001
CODES.
ALLOWABLE AREA BY SPRINKLERS = 8,000 SF
X 3 = 24,000SF TOTAL ALLOWABLE
AREA PER 503.3 EXCEPTION.
**PERMIT DOES NOT INCLUDE TEMPORARY
POWER, BLOCK WALLS, TRASH ENCLOSURES,
COVERED PARKING AND SITE LIGHTING.**
REFER TO 05-3262 FOR APPLICATION
TRACKING NOTES.
Other Fees . . . . . . . . . ACCESSIBILITY PLAN REVIEW
118.01
ART IN PUBLIC PLACES -COM
2155.60
DIF CIVIC CENTER - COMM
831.25
ENERGY REVIEW FEE
118.01
DIF FIRE PROTECTION -COMM
280.00
STRONG MOTION (SMI) - COM
91.37
DIF STREET MAINT FAC -COMM
201.25
DIF TRANSPORTATION - COMM
15085.00
Fee summary Charged Paid Credited
-----------------
Due
----------------------------------------
Permit Fee Total 2310.00 .00 .00
2310.00
Plan Check Total 1299.96 900.00 .00
399.96
Other Fee Total 18880.49 .00 .00
18880.49
Grand Total 22490.45 900.00 .00
21590.45
LQPERMIT