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10-1367 (RC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Applicant: T4ht 4 . 4v Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: 101 KOMAR INV 23 CORPORATE PLZ STE 247 NEWPORT BEACH; CA 92660 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 Business and Professionals Code, and my License is in full force and effect. License C ss: C -B Licens : 910936 ate/ ontractor: 7-7 G /Z -& OWNER -BUILDER DECLARATION I hereby 9f -&der 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._ 1 1, 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, 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 Contractor: DESERT DRYWALL CONSTRUCTI PO BOX 2100 INDIO, CA 92202 (760)391-9700 Lic. No.: 910936 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/19/11 E 3 N (L ilr► 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 worker`s' 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 1958236 _ 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 / 700 of the LaborCSA , I shall forthwit comp ose provisions. DaTe:/ plicant: WARNING: FAIL RE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,0001. 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 city2.4c ounty ordinances and state laws relating to building construction, and hereby authorize representatives ofunty o enter on the above-mentioned pr for inspection p pose DatSignature (Applicant or Agent): Application Number: rl�10-000.01367��= Property Address: 79825 HIGHWAY 111 STE APN: 600-020-034- - Application description: REMODEL - COMMERCIAL Property Zoning: COMMERCIAL PARK Application valuation: 18000 Applicant: T4ht 4 . 4v Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: 101 KOMAR INV 23 CORPORATE PLZ STE 247 NEWPORT BEACH; CA 92660 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 Business and Professionals Code, and my License is in full force and effect. License C ss: C -B Licens : 910936 ate/ ontractor: 7-7 G /Z -& OWNER -BUILDER DECLARATION I hereby 9f -&der 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._ 1 1, 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, 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 Contractor: DESERT DRYWALL CONSTRUCTI PO BOX 2100 INDIO, CA 92202 (760)391-9700 Lic. No.: 910936 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/19/11 E 3 N (L ilr► 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 worker`s' 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 1958236 _ 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 / 700 of the LaborCSA , I shall forthwit comp ose provisions. DaTe:/ plicant: WARNING: FAIL RE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,0001. 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 city2.4c ounty ordinances and state laws relating to building construction, and hereby authorize representatives ofunty o enter on the above-mentioned pr for inspection p pose DatSignature (Applicant or Agent): Application Number . . . 10-00001367 Structure Information Construction Type . . . . . TYPE V, UNPROTECTED Occupancy Type . . . . . BUSINESS <50 Other struct info ., CODE EDITION 2007/08 ENERGY FIRE SPRINKLERS - YES OCCUPANT LOAD 40.00 ----------------------------------------- 1ST FLOOR SQUARE FOOTAGE ----------------------------------- 1843.00 Permit BUILDING PERMIT Additional desc . Permit Fee . . . . 189.00 Plan Check -Fee - 122.85 Issue Date . . Valuation 18000 Expiration Date 7/18/11 Qty Unit Charge Per 'Extension BASE FEE 45.00 16.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 144.00 ---Perm Permit t . . . ELECT.--ADD/ALT/REM Additional desc . . Permit Fee . . . . 41.10 Plan Check Fee 10.28 Issue Date . . . . Valuation . . . . 0 Expiration Date 7/18/11 Qty Unit Charge Per Extension BASE FEE 15.00 20.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 15.00 1.00 3.0000 EA ELEC APPLIANCES 3.00 18.00 .4500 -------------------------- EA ELEC DEVICE/FIXTURE >20 ---------------------------------- 8.10 ---------------- Permit . . . MECHANICAL - Additional desc . Permit Fee . . . . 19.50 Plan Check Fee 4.88 Issue Date . . . . Valuation . . . . 0 Expiration Date 7/18/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 4.5000 ---------------------------------------------------------------------------- EA MECH VENT INST/ DUCT ALT 4.50 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 28.50 Plan Check Fee 7.13 LQPERA11T ' Application Number . . . . . 10-00001367. Permit . . . . PLUMBING Issue Date . . . . Valuation . . . . 0 Expiration Date 7/18/11 ' Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 Special Notes and Comments SUITE 101 - 1843 SF INTERIOR TENANT IMPROVEMENT FOR ACUPUNCTURE OFFICE. "ACQ POINT" OCCUPANCY "B" TYPE V -B CONSTRUCTION. OCCUPANT.LOAD = 40. 20.07 CODES 2008 ENERGY. '=-------------------------------------------_--- ------------------- --------- Other Fees . . . . . . . . . ACCESSIBILITY PLAN REVIEW 12.29 BLDG STDS ADMIN (SB1473) 1.00 ENERGY REVIEW FEE 12.25 Fee summary Charged Paid Credited Due Permit Fee Total 278.10 .00 .00' 278.10* Plan Check Total 145.14 .00 .00 145.14 Other Fee Total 25.54. .00 .00 25.54 Grand Total 448.78 .00 .00 448.78 LQPERMIT Certificate,of Odcupancy Inrntaoan�� . 9w5 OF Building & Safety Department � g Y p 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: 79-825 HIGHWAY 111 STE 101 ` Use classification: OFFICE ("ACQ POINT") Building Permit No.: 10-1367 Occupancy Group: B Type of Construction: V -B Land Use Zone: CR Sprinklers Installed: YES Sprinklers Required: YES Occupant Load: 40 Owner of Building: KOMAR INV Address: 23 CORPORATE PLZ #247 ' City, ST, ZIP: NEWPORT BEACH, CA 92660 —1 By: STEVE TRAXEL Building Official Date: MARCH 2, 2011 POST IN A CONSPICUOUS PLACE