05-5542 (RC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
R Application Number:
Property Address:
APN:
Application desc
Property Zonir
Application vol l
Applicant:
e9_5=0 0 0 0 5 5 4 2
79740 HIGHWAY 111
649-02�04� -
14ITA
FEB 2 1
�A
CITY �F,� nF-PT.
VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 2/21/06
Owner:
99C ONLY STORES
C/O JEFF GOLD
4000 E UNION PACIFIC AVE
COMMERCE, CA 90023
Contractor:
or Engineer: JOHNSON - BENEDETTI CONST MGMT
333 N. PALM CANYON
PALM SPRINGS, CA 92262
(760)677-2053
Lic. No.: 810181
-----------------
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 Professionals Code, and my License is in full force and effect.
License Class: 1B -License No.: 810181
t
Date: 7► ZI Contract
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).:
(_) 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(sl 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
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 2290027197
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 agreethat, if I should ecome subject to the workers' compensation provisions of Section
700 of the Labor Co o ith comply with those provisions.
JDate: ' / 1 Applicant:
��_
_� ! �`
WARNING: F ILURE 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 authorize representatives
of this county to enter upon the above-mentioned pr p" purposhs. n
Date:G/ Gll D ; Signature (Applicant or Agent):
Application Number . . . . . 05-00005542
Permit . . . BUILDING PERMIT - ADA INV FEE
Additional desc .
Permit Fee . . . . 1587.00 Plan Check Fee
515.78
Issue Date . . . . Valuation . . . .
143640
Expiration Date 8/20/06
Qty Unit Charge Per
Extension
BASE FEE
1279.00
44.00 7.0000 THOU BLDG 100,001-500,000
----------------------------------------------------------------------------
308.00
Permit . . . ELECT - ADD/ALT/REM
Additional desc .
Permit Fee 118.34 Plan Check Fee
29.59
Issue Date . . . . Valuation . . .
0
Expiration Date 8/20/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
5167.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL
----------------------------------------------------------------------------
103.34
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 28.50 Plan Check Fee
7.13
Issue Date . . . . Valuation
0
Expiration Date 8/20/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
3.00 4.5000 EA MECH VENT INST/ DUCT ALT
------------------------------------------- --------------------------------
13.50
Permit . . . PLUMBING INV FEE
Additional desc .
Permit Fee . . . . 228.00 Plan Check Fee
28.50
Issue Date . . . Valuation . . . .
0
Expiration Date 8/20/06
Qty Unit Charge Per
Extension
BASE FEE
30.00
12.00 12.0000 EA PLB FIXTURE
144.00
1.00 30.0000 EA PLB"BUILDING SEWER
30.00
4.00 6.0000 EA PLB WATER INST/ALT/REP
24.00
---------------
Special Notes and Comments
t
"Vanilla" shell improvements in
LQPERMIT
Application Number . . . . . 05-00005542
-------------------------------------------
Special Notes and Comments
---------------------------------
preparation for future tenants. Scope
of work to include; T -bar celings,
mechanical, electrical lighting,
demising walls & bathrooms.
Investigation fee imposed for work
performed prior to obtaining a permit.
Project red -tagged with stop work
notice 2/14/06 with framing and
plumbing construction observed in
progress. Shell improvement Plumbing
Plans do not reflect scope of work
submitted in Floor Plan, approved
as -built Plumbing Plans will be
required at underground waste
inspection.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STRONG
MOTION (SMI) - COM 30.16
Fee summary Charged Paid
-------------------------------------
Credited Due
----------
Permit Fee Total 1961.84
----------
.00 .00 1961.84
Plan Check Total 581.00
.00 .00 581.00
Other Fee Total 30.16
.00 .00 30.16
Grand Total 2573.00
.00 .00 2573.00
LQPERMIT
TYPE OF INDATE
TEMPORARY POWER INSP.
SETBACKS'
U/G PLUMBING / WASTE
U/G ELECTRICAL / GROUNDING 3 3
FOOTINGS / STEEL
CONCRETE SLAB
ABOVE SIGNED
FRAMING (COMBI
ROUGH ELECTF
ROUGH PLUMBI
SEWER CONNECTION
SEPTIC / GRFARF INTGD
FOOTINGS / STEEL --
BOND BEAM
POOL / SPA / WATER FEATURE INSPECTIONS
PRE-GUNITE /SETBACKS
U/G PLUMBING
U/G GAS
U/G ELECTRICAL
PRE -PLASTER (ALARMS/ BARRIERS
FINAL INSPECTIONS
TEMP.. USE OF PERMANENT POWER
ELECTRICAL
PLUMBING
MECHANICAL
PUBLIC WORKS DEPARTMENT
COMMUNITY DEVELOPMENT DEPT.
FINAL / JOB CAMo1 FTcn . .
�rrnvVHLJ UL) NOT INCLUDE RIGHT TO
N ON UTILITIFS nR nrri iov D....
��. 14L;l OF LA QUINTA
#IL G SAFETY DEPARTMENT
1 ��. 777-7012
c)., ECTION REQUEST LINE
777-7153
O C STORES
Contrac )N N-13FNEDETTI CONST
Permit Numb "=*_ D,�Y3
POST ON JOB IN CONSPICUO(IS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 7')`' 00 14
.til:r: crrnl•:Ic slnl:
TEMPORAF
SETBACKS
U/G PLUME
rvun GUNUKETE UNTIL ABOVE SIGNED
ROOF NAIL / PRE -ROOF
OKAY TO WRAP
FRAMING COMBINATION
ROUGH ELECTRIC
ROUGH PLUMBING /r
ROUGH MECHANICAL
INSULATION I /
INTERIOR GYP. BD (DRl
EXTERIOR LATH
GAS TEST
SEPTIC ABANDONMENT
SEWER CONNECTION
NRY INSPECTIONS
BOND BEAM
POOL / SPA / WATER FEATURE INSPECTIONS
PRE GUNITE / SETBACKS
U/G PLUMBING
U/G GAS
U/G ELECTRICAL
PRE -PLASTER ALARMS /BARRIERS
FINAL INSPECTIONS
TEMP. USE OF PERMANE=POWER
ELECTRICAL
PLUMBING
MECHANICAL
PUBLIC WORKS DEPART
COMMUNITY DEVELOPMFINAL / JOB COMPL FTF
OV APPROVALS DO NOT INCLUDE RIGHT
CITY OF LA QUINTA
FyoFo
BUILDING & SAFETY DEPARTMENT
777-7012
O
INSPECTION REQUEST LINE
777-7153
Cont ct J
ki)u:rri CO MST
�o
'Permit
(-
S- N2v
PO
N C ICUOUS PLACE
INS EC
S
SI APPLICABLE SPACES
JOB ADDRESS)
Sl:lt O'I'III::R SIUI:
TYPE OF INDATE
TEMPORARY POWER INSP.
SETBACKS'
U/G PLUMBING / WASTE
U/G ELECTRICAL / GROUNDING 3 3
FOOTINGS / STEEL
CONCRETE SLAB
ABOVE SIGNED
FRAMING (COMBI
ROUGH ELECTF
ROUGH PLUMBI
SEWER CONNECTION
SEPTIC / GRFARF INTGD
FOOTINGS / STEEL --
BOND BEAM
POOL / SPA / WATER FEATURE INSPECTIONS
PRE-GUNITE /SETBACKS
U/G PLUMBING
U/G GAS
U/G ELECTRICAL
PRE -PLASTER (ALARMS/ BARRIERS
FINAL INSPECTIONS
TEMP.. USE OF PERMANENT POWER
ELECTRICAL
PLUMBING
MECHANICAL
PUBLIC WORKS DEPARTMENT
COMMUNITY DEVELOPMENT DEPT.
FINAL / JOB CAMo1 FTcn . .
�rrnvVHLJ UL) NOT INCLUDE RIGHT TO
N ON UTILITIFS nR nrri iov D....
��. 14L;l OF LA QUINTA
#IL G SAFETY DEPARTMENT
1 ��. 777-7012
c)., ECTION REQUEST LINE
777-7153
O C STORES
Contrac )N N-13FNEDETTI CONST
Permit Numb "=*_ D,�Y3
POST ON JOB IN CONSPICUO(IS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 7')`' 00 14
.til:r: crrnl•:Ic slnl:
TEMPORAF
SETBACKS
U/G PLUME
rvun GUNUKETE UNTIL ABOVE SIGNED
ROOF NAIL / PRE -ROOF
OKAY TO WRAP
FRAMING COMBINATION
ROUGH ELECTRIC
ROUGH PLUMBING /r
ROUGH MECHANICAL
INSULATION I /
INTERIOR GYP. BD (DRl
EXTERIOR LATH
GAS TEST
SEPTIC ABANDONMENT
SEWER CONNECTION
NRY INSPECTIONS
BOND BEAM
POOL / SPA / WATER FEATURE INSPECTIONS
PRE GUNITE / SETBACKS
U/G PLUMBING
U/G GAS
U/G ELECTRICAL
PRE -PLASTER ALARMS /BARRIERS
FINAL INSPECTIONS
TEMP. USE OF PERMANE=POWER
ELECTRICAL
PLUMBING
MECHANICAL
PUBLIC WORKS DEPART
COMMUNITY DEVELOPMFINAL / JOB COMPL FTF
OV APPROVALS DO NOT INCLUDE RIGHT
"Vanilla" shell improvements in preparation for future tenants.
Scope of work to include; T -bar celings, mechanical, electrical
lighting, demising walls & bathrooms. Investigation fee imposed for
work performed prior to obtaining a permit. Project red -tagged with
stop work notice 2/14/06 with framing and plumbing construction
observed in progress. Shell improvement Plumbing Plans do not
reflect scope of' work submitted in Floor -Plan, approved as -built
Plumbin', Plans will be required at underground waste inspection.
"Vanilla" shell improvements in preparation for future tenants.
Scope of wort: to include; T -bar celings, mechanical, electrical
lighting, demising walls & bathrooms. Investigation fee imposed for
work performed prior to obtaining,a permit. Project red -tagged with
stop worl< notice 2/14/06 with framing and plumbing construction
observed in progress. Shell improvement Plumbing Plans do not
reflect scope of work submitted in Floor Plan, approved as -built
Plumbing Plans will be required at underground waste inspection.
v