05-5543 (RC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
05-00005543
Property Address:
7-9800=HIGHWAY 1.1.1
APN:
649-020-040- -
Application description:
REMODEL - COMMERCIAL
Property Zoning:
REGIONAL COMMERCIAL
Application valuation:
143640
T4ht 4 4 Q"
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 a rofessionals Code, and my License is in full force and effect.
License Class: B nse No.: 8 0181
I> CLL
D -Ste: T 7 "Contractor:
OWNER -BUILDER DECLARA ION
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, of 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 f
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 contractor(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:
LQPERMIT
Owner:
99C ONLY STORES
C/O JEFF GOLD
4000 E UNION PACIFIC AVE
COMMERCE, CA 90023
Contractor:
JOHNSON - BENEDETTI CO
333 N. PALM CANYON
PALM SPRINGS, CA 92262
(760)677-2053
Lic. No.: 810181
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
BOG
Date: 2/21/06
WORKER'S COMPENSATION DECLARATION\ / '
I hereby affirm under penalty of perjury one of the following declarations: V
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, 1 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 b ome subject to the workers' compensation provisions of Section
,4700 of the Labor Codhalhioripwjtb.cgmply with those 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 authorize representatives
of this coynty lo enter upon the above-mentioned propertyleP inspection purposes.
Signature (Applicant or Agent): i
Application Number . . . . . 05-00005543
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 . . . .
198.94
Plan Check Fee
49.74
Issue Date . . . .
Valuation . . . .
0
Expiration Date
8/20/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
9197.00 .0200
---'-------------------------------------------------------------------------
ELEC GARAGE OR NON-RESIDENTIAL
183.94
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . . . .
42.00
Plan Check Fee
10.50
Issue Date . . . .
Valuation . . . .
0
Expiration Date
8/20/06
Qty - Unit Charge
Per
Extension
BASE FEE
15.00
6.00 4.5000
-'---------------------------------------------------------------------------
EA MECH VENT
INST/ DUCT ALT
2.7.00
Permit
PLUMBING INV FEE
Additional desc .
Permit Fee . . . .
318.00
Plan Check Fee
39.75
Issue Date . . . .
Valuation . . . .
0
Expiration Date
8/20/06
Qty Unit Charge
Per
Extension
BASE FEE
30.00
- 21.00 12.0000
EA.. PLB FIXTURE
252.00
6.00 6.0000
EA PLB WATER
INST/ALT/REP
36.00
----=-----------------------------------------------------------------------
Special Notes and Comments
"Vanilla" shell improvements
in
preparation for future
tenants. Scope
LQPERMff
Application Number . . . . . 05-00005543
----------------------------------------------------------------------------
Special Notes and Comments
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 2145.94
.00 .00' 2145.94
Plan Check Total 615.77
.00 .00 615.77
Other Fee Total 30.16
.00 .00 30.16
Grand Total 2791.87
.00 .00 2791.87
9
LQPERMTT
i