10-1047 (RC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN: 'r
Application descrjp&n:
Property Zoning:
Application valuation:
Applicant:
�AGTAAC
10-00001047'
79785 HIGHWAY 111 STE
600-020-034- -
REMODEL - COMMERCIAL
COMMERCIAL PARK
1200
Tdv14*4Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
101 KOMAR INV
- 23 CORPORATE PLZ STE 247
NEWPORT BEACH, CA 92660
Architect or Engineer:
TF..QA1T . ' Z754_Dd ��—Vorw S r
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.
Ijcense Class: B License No.: 932157
/
N
Date:LQ/f10 ontractor: 000, JISc
�-
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 1$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.).
( 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:
LQPERAIIT
Contractor:
GEIGER HOME REMODE
83270 PLAZA DE ORO
COACHELLA, CA 9223
(323)377-0320
Lic. No.: 932157
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/11/10
U
otcTl 2OCT 12:201]0
_j
VY OF IA QUINTA
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 EXEMPT Policy Number EXEMPT
_ 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 he Labor Code41h fo`rthwithcp-�ply with those provisions. _
Date: 41;L _ p A licant:
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 authorize representatives
of4his co my o enter upon the above-mentioned property for i action purposes._
Date: ignature (Applicant or Agent): X/-
Application Number . . . 10-00001047
Structure Information
Construction Type . .
. . . TYPE V, UNPROTECTED
Occupancy Type . .
. . . MERCANTILE
Other struct info . .
. . . CODE EDITION
2007/08 ENERGY
FIRE SPRINKLERS
YES
OCCUPANT LOAD
94.00
----------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
2824.00
Permit . . .
BUILDING PERMIT
Additional desc . .
2824 SF INT. T.I. "DADA BUGS"
Permit Fee . . . .
29.00 Plan Check Fee
18.85
Issue Date . . . .
Valuation . . .
. 1200
Expiration Date . .
4/09/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
7.00 2.0000
----------------------------------------------------------------------------
HND BLDG 501-2,000
14.00
Permit . . .
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . .
18.00 Plan Check Fee
4.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
4/09/11
• a
Qty Unit Charge
Per
Extension
BASE FEE
15.00
4.00 .7500
-
PER ELEC DEVICE/FIXTURE 1ST 20
3.00
----------------------------------------------------------------------------
Special Notes and Comments
2824 SF INTERIOR RETAIL
T.I. "DADA BUGS"
"M" OCCUPANCY TYPE V -B
CONSTR. 94
OCCUPANT LOAD. 2007 CODES
2008 ENERGY.
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . ACCESSIBILITY PLAN REVIEW
1.88
BLDG STDS ADMIN (SB1473)
1.00
ENERGY REVIEW FEE
1.88
Fee summary Charged
---------------------------
Paid Credited
---------------------------
Due
Permit Fee Fee Total.
47.00 .00 .00
47.00
Plan Check Total
23.35 .00 .00
23.35
Other Fee Total
4.76 .00 .00
4.76
Grand Total
75.11 .00 .00
75.11
LQPERAIIT
T-Vf 4 4QuIrw
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
To: Greg Butler, Building & Safety Manager To CDD:
From: Les Johnson, Director -Planning Due Date: A 5 4P
Permit #: Status: /66 C'.�
Rulldtnq flans ApprromaI
(This is an approval to issue a Building Permit)
The Planning Department has reviewed the Building Plans for the following
project.
Descriptio
Address or General�L'ocation: 79 785 ll t
Applicant Contact: _3Z3 3Z3 3 -7 7 0 3 Z O
The Planning Department finds that:
❑ ...these Building Plans do not require Planning Department approval.
...these Building Plans are approved by the Planning Department. li('`��
...these Building Plans require corrections. Please forward a copy of the
attached corrections to the applicant. When the corrections are made
please return them to the Planning Department for review. S'C_ &LJA1e+*o
n
Les Johns n Director -Planning Date
OCT - 7
chy of w Quint"
�� Ia�rim�nt
Din #
&AV
Qty of ' La Quinta
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #'`,
10La
Project Address.VJ
Owner's Name:
V,> -T ^"'V
A. P. Number:
Address: 02,
Legal Description:
Contractor: t
IP—
City, ST, Zip: Or, A)iq 3tkeonl CS
Telephone. M
Address:'�7D �)Pq 4Zr-d roProject
Description: �wl r
City, ST, Zip: Ck OW10
Telephone: 3z
Ivr\ 01\ AA
State Lie. #City
Lie.
Arch., Engr., Designer.
(A
Address:
City, ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
Construction T . ype: Occupancy: C*1
Project type (circle one New Add'n Alter Repair Demo
Sq. Ft.: 8
# Stories: -
# Units:
Telephone # of Contact Person:
matd Vl
EstiI P. nf Prctiecf-
Value e
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec!d
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
(tem
Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit
Truss Coles.
Called Contact Person
Plan Check Balance.
Title 24 Coles.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections
we
Electrical
Subcontactor List
Called Contact Person
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
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date or permit Issue
School Fees
Total Permit Fees
loll
Certificate of Occupancy
INooaoangn ��
OF9�s Building & 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: 79-785 HIGHWAY 111 #101
Use classification: COMM: ( JADABUGS) Building Permit No.: 10-1047
Occupancy Group: M Type of Construction: V-B Land Use Zone: CR
Sprinklers Installed: YES Sprinklers Required: YES Occupant Load: 94
Owner of Building: KOMAR INV
Address: 23 CORPORATE PLZ STE 247
- City, ST, ZIP: NEWPORT BEACH, CA 92660
-�'ZA By: STEVE TRAXEL
Building Official Date: NOVEMBER 4, 2010
POST IN A CONSPICUOUS PLACE