09-1003 (RC)P:U BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
-09-00001003
79710 HIGHWAY 111 STE 100
649-020-014-3 -31143 -
REMODEL - COMMERCIAL
REGIONAL COMMERCIAL
22000
Ta�/ 1 4 4 Qum&
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
HIGHLAND LA QUINTA, LLC
1055 E. COLORADO BLVD. #5178
PASDENA, CA 91106
LLII f
P E;
29 Contractor:
I MAR VEST
"��c ` 42335 WASHINGTON ST, STE F#424
I Ar„2i1nr3VZ,4 PALM DESERT, CA 92211
(760)360-7061
Lic. No.: 876299
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed un r provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Profe __._So,
al ode, and my License is in full force and effect.
Licensee Class: �B ol icense No.: 876299
,B,at e� �!,qelltractor•
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.).
1 _ 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.).
(_) I am exempt under Sec. i, 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:
LQPERMIT
Date: 9/30/09
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 STATE FUND Policy Number 1917303
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 subjec ers' compensation laws of California,
and agree that, if I should becomes }e o the workers' co pensation provisions of Section
3700 of the Labor Code, I sh rthwith comply with provisions.
aD te:y_�l� pplicant:
WARNING: FA UR�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 t—Fegre comply with all
city and co m ordinances and state laws relating to building construct nd hereby authorize rep entatives
of this unty to enter upon t above-mentioned property for insp purposes.
e: .✓ nature (Applicant or Agent):
Application Number 09-00001003
------ Structure Information STE 100 - 1308 SF T.I.
-----
Other struct info . .
. . . CODE EDITION
2007
FIRE SPRINKLERS
YES
MIXED-USE OCCUPANCY
B
OCCUPANT LOAD
14.00
1ST FLOOR SQUARE FOOTAGE
1308.00
----------------------------------------------------------------------------
2ND FLOOR SQUARE FOOTAGE
.00
Permit . . .
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . .
32.25 Plan Check Fee
8.06
Issue Date . . . .
Valuation
0
Expiration Date
3/24/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
20.00 .7500
PER ELEC DEVICE/FIXTURE 1ST 20
15.00
5.00 .4500
------------------------------
EA ELEC DEVICE/FIXTURE >20
---------------------------------------------
2.25
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . . . .
33.00 Plan Check Fee
8.25
Issue Date . . . .
Valuation . .
. . 0
Expiration Date
3/24/10
Qty Unit Charge
Per -
Extension
BASE FEE
15:00
2.00 4.5000
EA MECH VENT.INST/ DUCT ALT
9.00
1.00 9.0000
--------------------------------------------------
EA MECH APPL REP/ALT/ADD
--------------------------
9.00
Permit . .
BLDG POOL PERMIT - ADA INV FEE
Additional desc .
Permit Fee . . . .
450.00 Plan Check Fee
146.25
Issue Date . . . .
Valuation . .
. . 22000
Expiration Date
3/29/10
Qty Unit Charge
Per
Extension
BASE FEE
90.00 _
20.00 18.0000
-----------7----------------------------------------------------------------
THOU BLDG 2,001-25,000
360.00
Permit . . .
PLUMBING
-
Additional desc . .
r
Permit Fee . . .
24.00 Plan Check Fee
6.00.
LQPERMIT
i
LQPERMIT "
Application Number 09-00001003
Permit . . . . PLUMBING
Issue Date . . . . Valuation . . .
. 0
Expiration Date ". 3/24/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 6.0000 EA PLB FIXTURE
6.00
1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00
----------------------------------------------------------------------------
Special Notes and Comments
INTERIOR TENANT IMPROVEMENT - 1308 SF
"STOWE INSURANCE" OFFICE OCCUPANCY, TYPE
VB CONSTRUCTION, 14 OCCUPANT LOAD. 2007
CODES. INVESTIGATION FEE ASSESSED PER
1997 UNIFORM ADMINISTRATIVE CODE §304.5
FOR WORK BEGUN WITHOUT BUILDING PERMIT.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . ACCESSIBILITY PLAN REVIEW
14.63
BLDG STDS ADMIN (SB1473)
1.00
ENERGY REVIEW FEE
14.63
STRONG MOTION (SMI) - COM
4.62
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee Total 539.25 .00 .00
539.25
Plan Check Total 168.56 .00 .00
168.56
Other Fee Total 34.88 .00 .00
34.88
Grand Total. 742.69 .00 .00
742.69
i
LQPERMIT "
Bin #
2� City of Quinta
Building 8t Sa !ty Division
Permit # b�P.O. Box 1504, 78-495 Calle Tampico
l� La Quinta, CA 92253 - (760) 777-7012
l Building Permit Application and Tracking Sheet
Project Address: 79-7'/6 14-ji 0/ Owner's Nam :`
eo bl:e-t 546w e.
A. P. Number: Address: g) ) 9 (o 4W X11 *4
Legal Description: lit City, ST, Zip:
4,'o Lori 9AZ0/
Contractor: ry-0.(S I � Telephone:
Address:`7a
....:•.;;:.::.:<.:;;..r,;::.;..,:.:.
Project Description:
City, ST, Zip:,;,�Jvh 1Ja 5e r Cjc� q2a l l . Q
fri o r o -U S
Telephone: % (Od l00 - % U (o"�"�:;<:>�#�?•.`.`>#`:>s€3:3>>'>`' nn
>::;;:.;>: •::.:;<:;: •;:.;: :<<.:2:<:»><:»:«: �' Q S S=OT 4-J\& 'V-C�J
State Lie. # : '] (pa 9 % City Lic. #: i A
k
v 1v�JQ
Arch., Engr, Designer: d S
Address: ��(� 1 51 . EL"--1:oL!
IM 0 0� s }31AQQJ i4 �
f� F-33 s t D lta n of o.
City,, sT, Zip: eSe �� C. t4 9 a P. 1
�tN (.W � LJ or
Telephone:
hone:
D-
7 (O 101/ -a3 tf S >': ;> .:::.• >.«•> ::y:s.;; Construction T e:1'
#» .:;•::..:::.....:.. P V - Occupancy:
State Lic. #:
Project type (ci cle one): New Add'n Ite Repair Demo
Name of Contact Person: �.
�1 eAS F- 7(00- t.: i 3 # Stories: ( #Units:Telephone# of Contact Person:?(
II I Total Permit Fees 1517. Cpl?
WA
- Roe,
stmated Val e of Projec . -1 p o17.
APPLICANT:
DO NOT WRITE BELOW HIS LINE
#
Submittal
Req'd
R c'd
TRACKING
Plan Sets
PERMIT FEES
Plan Check submitted Item
Structural Calcs.
Amount
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
_2":eview, ready for correction issue 1i Electrical
Subcontactor List
Called Contact Person Z
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
.
'"' Review, ready for corrections/issue Developer Impact Fee
Called Contact Person
Planning Approval
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
I
II I Total Permit Fees 1517. Cpl?
WA
- Roe,
o�L01 Certificate of Occupancy
T4hfot4Oak&
OFTBuilding & Safety Department
This Certificate is issued pursuant to the requirements of Appendix Chapter 1 Section 110 of the
2007 California Building Code, certifying that, at the time of issuance, this structure was in
compliance with the provisions of the Building Code and the various ordinances of the City
regulating building construction and/or use.
BUILDING ADDRESS: 79-710 HIGHWAY 111 STE 100
Use classification: COMM: "STOWE INSURANCE" Building Permit No.: 09-1003
Occupancy Group: B Type of Construction: V=N Land Use Zone: CR
Sprinklers Installed: YES Sprinklers Required: YES Occupant Load: 14
Building Official
Owner of Building: HIGHLAND LA QUINTA LLC
Address: 1055 E. COLORADO BLVD #5178
City, ST, ZIP: PASDENA, CA 91106
By: STEVE TRAXEL
Date: NOVEMBER 2.2009