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06-3805 (CSCS)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4ht 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number_: 06-00003805 Property Address: 79710 HIGHWAY' 111 APN: 649-020-014-3 -31143 - Application description: NEW COMML - STORES & CUSTOMER SERVICE Property Zoning: REGIONAL COMMERCIAL Application valuation: 545778 Applicant: Architect or Engineer: -------------------------------------------------- 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 ass and Professionals Code, and my License is in full force and effect. LicenseClasS: 13 — /gicedemo.: 876299 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 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 cdntractor(s) licensed pursuant to the Contractors' State License Law.). ( 1 I am exempt under Sec. , BAP.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: LQPE%NIIT Owner: Highland La Quinta LLC 1055 East Colorado Blvd Suite 5178 PASDENA, CA 91106 VOICE (760) 777-7012 . FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/05/07 Contractor: MARVEST t/ 42208 WASHINGTON STREET_P 1 C A o 6. BERMUDA DUNES, CA 92201-- /'A' (760)360-7061'Of Lic. No.: 876299QV/N7. ----------------------------------------------- WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _)!6._l 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 STATE FUND Policy Number 1846155 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 shouldbecome sub' ct to the workers' compensation provisions of Section 3700 of the Labor Code i ithpergply wg_Vthose provisions. 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 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 relating to building construction, and hereby a horize representatives of )his coun y to nter upon the above-mentioned property for ins a tion purpo s. Dat gnature (Applican Application Number . . . . . 06-00003805 --=--- Structure Information 10200 "RETAIL SHELL" BLDG #3 ----- Other struct info CODE EDITION O1BMP04E05EN FIRE SPRINKLERS YES MIXED-USE OCCUPANCY B/M SHELL OCCUPANT LOAD .00 PATIO SQ FTG 981.00 1ST FLOOR SQUARE FOOTAGE 10200.00 ---------------------------------------------------------------------------- 2ND FLOOR SQUARE FOOTAGE .00 Permit . . . BUILDING PERMIT Additional desc RETAIL SHELL BLDG #3 Permit Fee . . . . 2177.50 Plan Check Fee 1415.38 Issue Date Valuation . . . . 545778 Expiration Date 12/02/07 Qty Unit Charge Per. Extension BASE FEE 2039.50 46.00 3.0000 ----------------------------------------------- THOU. BLDG 500,001-1,000,000 ----------------------------- 138.00• Permit . . . ELEC-NEW COMMERCIAL Additional desc . Permit Fee . . . . 238.62 Plan Check Fee 59.66 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/02/07 Qty Unit Charge Per Extension BASE FEE 15.00 11181.00 .0200 ---------------------------------------------------------------------------- ELEC GARAGE OR NON-RESIDENTIAL 223.62 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 277.50 Plan Check Fee 69.38 Issue Date Valuation 0 Expiration Date 12/02/07 Qty Unit Charge Per Extension BASE FEE 15.00 8.00 9.0000 EA MECH FURNACE <=100K 72.00 8.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 132.00 9'.00 6.5000 ------------------------------=---------------------------------------------- EA MECH VENT FAN 58.50 Permit . PLUMBING Additional desc . LQPERMIT ' LQPERDIIT Application Number . . . . . 06-00003805 Permit . . . . . . PLUMBING Permit Fee . . 241.50 Plan Check Fee 60.38 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/02/07 Qty Unit Charge Per Extension BASE FEE 15.00 18:00 6.0000 EA PLB FIXTURE 108.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 3.00 6.0000 EA PLB ROOF DRAIN 18.00 8.00 7.5000 EA PLB WATER HEATER/VENT 60.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 1.00 7.5000 EA PLB OTHER BACKFLOW <=2 INCH 7.50 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS. 3.00 4.00 .7500 EA PLB GAS PIPE >=5 ---------------------------------------------------------------------------- 3.00 Permit . . . GRADING PERMIT Additional desc . Permit Fee 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/02/07 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments 10,200SF "RETAIL SHELL" BUILDING #31 TYPE V -N CONSTRUCTION. 2001 CBC,CMC,CPC, 2004 CEC, 2005 ENERGY CODES. **PERMIT DOES NOT INCLUDE TEMPORARY POWER, BLOCK WALLS, TRASH ENCLOSURE AND SITE LIGHTING.** Other Fees . . . . ._. . . . ACCESSIBILITY PLAN REVIEW 141.54 ART IN PUBLIC PLACES -COM 2700.55 'DIF CIVIC CENTER - COMM 3284.39 ENERGY REVIEW FEE 141.54 DIF FIRE PROTECTION -COMM 459.00 STRONG MOTION (SMI) - COM 117.35 DIF STREET MAINT FAC -COMM 1081.20 DIF.TRANSPORTATION - COMM 30997.79 Fee summary Charged Paid Credited ---------- Due ----------------------------------------------- Permit Fee -Total 2950.12 .00 .00 2950.12 ' LQPERDIIT Application Number. 06-00003805 Plan Check Total 1604.80 1200.00 Other Fee Total 38923.36 .00 Grand Total 43478.28 1200.00 00 404.80 00 38923.36 ` 00 4227.8.28 J b PO. BOX 1504 APPLICATION ONLY Building Iq— 71® gf1C-�Wr 11 LA QUINTA78-495 CCALIFORNIA 922253 Address ! �-I�r A��7�' ]EBUILDING: er 1n60tAW �aCPhIN �-F/• BUILDING: TYPE CONST�� OCC. GRP. Mailing �i �� T �►1 `O� Address 1 A.P. Numbe4ff 9r jy 2 �N�,Q 3W3, y> y� /� City Zip Tel. Legal Description pW a _14 M- 71 ✓l! 3 i DIS -ZJ& 4.1lot bz.�- Contra Project Description �L— TMf0. r Address City Zip Tel. State Lic. City Sq. Ft. /1 n I - i No. I No. Dw. & Classif. Lic. # Size 27 "'� Stories Units Arch., Enr New Add ❑ Alter El Repair ❑ Demolition ❑ Designer �ress I1.D6el.Iz Cite CA- Zi `D— I State V / Lic. #Ig LICENSED CONTRACTOR'S DECLARATION hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Secti 7 0) of Division 3 of the Business and Professions Code, and my license is in full force d eff I. SIGN TURE DATE OWNER -BUILDER DECLARATION Estimated Valuation I h reby affirm that I am exempt from the Contractor's License Law for a following reason: Sec. 7031.5, Business and Professions Code: Any city or county w h requires a permit to onstruct,alterimprove, demolish, or repair any structure, prior to issuance also PERMIT requires t applicant /or such permit to lila a signed statement that he is tic sed pursuant to AMOUNT the provisI s o/ the Contractor's License Law, Chapter 9 (commencing wi Section 7000) of Division 3 o he Business and Professions Code, or that he is exempt the r rom, and the basis Plan Ch k. Dep. for the allege exemption. Any violation of Section 7031.5 by any applica for a permit. subjects the applicant a civil penalty or not more than five hundred dollars ($ 0). Plan Chk. Bal. ❑ 1, as owner o the property, or my employees with wages as their s e compensation, will do the work, and th structure is not intended or offered for sale. (Sec. 44, Business and Profes- Const. sions Code: The ontractor's License Law does not apply to an o ner of property who builds or improves thereo and who does such work himself or through is own employees, provided Mech. that such improve nts are not intended or offered for sale. I , however, the building or im- provement is sold in one year o/ completion, the owner uilder will have the burden o/ Electrical proving that he did no uild or improve for the purpose o/ S" e). Plumbin ❑ I, as owner of the pro rty, am exclusively contracting w' licensed contractors to construct g the project. (Sec. 7044, smess and Professions Code he Contractor's License Law does S. M. 1. not appty to an owner o/ p party who builds or improv thereon, and who contracts for such projects with a contractor( licensed pursuant to the ntractor's License Law) Grading ❑ 1 am exempt under Sec. B. & P.C. f this reason Driveway Enc. t Date Owner Infrastructure U WORKER'S OMPE ATION DECLARATION I I hereby affirm that I have a cert 'tate consent to self -insure, or a certificate of Worker's �� / Compensation InsuraApermit a certifie co thereof. (Sec. 3800, Labor Code.) �Ll / — Policy No. Compan ❑ Copy is filed wcity. O C fed copy is hereby furnished. r ERTIFI ATE EXEMPTION FROM TOTAL FIN111�C.� �� ~n RKER COMP SATION INSURANCE (This section need nmpl ed i/ the pe it is /or one hundred dollars ($100) valuation REMARKS or less). I certify that in tr ante of the wor or which this permit is issued. I shall not employ any person inner so as to become ubject to Workers' Compensation Laws of California. Date O NOTICE TO APPLICafter making this Certi/ic o/ Exemption you should become subject to the Workmpensation Provisions of t Labor Code, you must forthwith comply with such pro or this permit shall be deem revoked. ZONE: BY: Minimum Setback Distances: CONSTRUCTION LENDING AG\valited, Front Setback from Center Line I hereby a rm that there is a construction lending agenrformance of the work Rear Setback from Rear Prop.Line for which thi ermit is issued. (Sec. 3097, Civil Code.) Lender's N a Side Street Setback from Center Line Lender's ddress Thi s a building permit when properly filled out, signeted, and is subject to Side Setback from Property Line expirat'n if work thereunder is suspended for 180 days. I ertify that I have read this application and state thatn rmation is correct. FINAL DATE INSPECTOR I ag a to comply with all city and county ordinances anlating to building cotruction, and hereby authorize representatives of this the bove-mentioned pr party for inspection purposes. Issued by: Date Permit Signature of applicant ate Mailing Address Validated by: City, State, Zip Validation: WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE