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BCOM2014-104778-495 CALLE TAMPICO D ei VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 Date: 11/8/2016 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: 99) ONLY STORES P O BOX 35547 TULSA, OK 92253 ly BCOM2014-1047 1 0 600010022 AMERICAN TIRE DEPOT, SDP 2 1 -936 BUILDING PFRAIIIT 9 V ,,4 s 0 $274,131.90 cm QF gyp, QUINTA DESIGN AND DVEOMENT DEPARTMENT 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 Professions Code, and my License is in full force and effect. License Class: B. 36 License No.: 930443 —Oates— T .fCaniractar:• 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.). ( ) 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. . B.&P.C. for this reason Date: Owner: Owner: AVA PROPERTY INVESTMENT LLC OUTSIDE CITY LIMITS Contractor: S D DESIGN CONSTRUCTION CORP 1029 MEADOWSIDE STREET WEST COVINA, CA 91792 (626)476-7816 Llc. No.: 930443 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 far workers' comp nsation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. C• I have and will maintain workers' compensation insurance, as required by Section 700 ❑f 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 COMPENSATION INSURANCE FUND Policy Number: 9091827 r" I certify that in the performance of the work for which this permit is issued, I I of employ any person in any manner so as to become subject to the workers' co ensation laws of California, and agree that, if I should become subject to the wo got compensation provisions of Section 3700 of the Labor odeI hall forthwith comply with those provisions- , Date: C Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 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 Building Official 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. CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is correct. I hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all city and county ordinances and state laws elating to building the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby'authorize representatives oft ' ity to ter upo e above -mentioned propp for inspection purposes. Lender's Name: I Date: Ignature (Applicant ent . Lender's Address: J Application Number: BCOM2014-1047 Property Address: 79840 HIGHWAY 111 APN: 600010022 Application Description: AMERICAN TIRE DEPOT, SDP 2013-936 Property Zoning: Application Valuation: $274,131.90 Applicant: 99) ONLY STORES P 0 BOX 35547 TULSA, OK 92253 Date: 11/8/2016 Owner: AVA PROPERTY INVESTMENT LLC OUTSIDE CITY LIMITS Contractor: S D DESIGN CONSTRUCTION CORP 1029 MEADOWSIDE STREET WEST COVINA, CA 91792 (626)476-7816 Llc. No.: 930443 ----------=---------------------------------------------------------------------------------- Detail: 8/11/2016 - PLAN CHECK FEES & EXTENSION PROCESSING FEE PAID. APPLICATION EXTENSION GRANTED TO NOVEMBER 9, 2016 TO PURCHASE PERMIT. FINANCIAL ,1. DESCRIPTION ACCOUNT QTY AMOUNT PLAN CHECK/PERMIT EXTENSION PROCESSING 101-0000-42600 1 $97.17 Total Paid for ADMINISTRATIVE: $97.17 DESCRIPTION ACCOUNT QTY AMOUNT ART IN PUBLIC PLACES - COMMERCIAL 270-0000-43201 0 $1,370.66 Total Paid for ART IN PUBLIC PLACES - AIPP: $1,370.66 DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $11.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $11.00 DESCRIPTION ACCOUNT QTY AMOUNT Credit Card Fee 101-0000-43505 0 $12.21 Total Paid for Credit Card Fee: $12.21 DESCRIPTION ACCOUNT QTY AMOUNT DIF - CIVIC CENTER 252-0000-43200 0 $2,506.56 DESCRIPTION ACCOUNT QTY AMOUNT DIF - FIRE PROTECTION 257-0000-43200 0 $1,155.84 DESCRIPTION ACCOUNT QTY AMOUNT DIF - STREET MAINTENANCE 255-0000-43200 0 $1,559.04 DESCRIPTION ACCOUNT QTY AMOUNT DIF - TRANSPORTATION 250-0000-43200 0 $38,162.88 Total Paid for DIF - GENERAL COMMERCIAL: $43,384.32 DESCRIPTION ACCOUNT QTY AMOUNT TEMP POWER SERVICE 101-0000-42403 0 $24.17 DESCRIPTION ACCOUNT QTY AMOUNT TEMP POWER SERVICE PC 101-0000-42600 0 $16.92 Total Paid for ELECTRICAL: $41.09 DESCRIPTION ACCOUNT QTY AMOUNT NON-RESIDENTIAL, EA ADDITION 2,000SF 101-0000-42403 0 $108.78 DESCRIPTION ACCOUNT QTY AMOUNT NON-RESIDENTIAL, EA ADDITION 2,000SF, PC 101-0000-42600 0 $29.01 DESCRIPTION ACCOUNT QTY AMOUNT NON-RESIDENTIAL, FIRST 2,000SF 101-0000-42403 0 $108.77 DESCRIPTION ACCOUNT QTY AMOUNT NON-RESIDENTIAL, FIRST 2,000SF, PC 101-0000-42600 0 $84.12 Total Paid for ELECTRICAL - NEW CONSTRUCTION: $330.68 DESCRIPTION ACCOUNT QTY AMOUNT CONDENSER/COMPRESSOR 101-0000-42402 0 $36.26 DESCRIPTION ACCOUNT QTY AMOUNT CONDENSER/COMPRESSOR PC 101-0000-42600 0 $24.17 DESCRIPTION ACCOUNT QTY AMOUNT `- EVAPORATIVE COOLER 101-0000-42402 0 $36.27 DESCRIPTION ACCOUNT QTY AMOUNT EVAPORATIVE COOLER PC 101-0000-42600 0 $36.27 DESCRIPTION ACCOUNT QTY AMOUNT FURNACE 101-0000-42402 0 $36.26 DESCRIPTION ACCOUNT QTY AMOUNT FURNACE PC 101-0000-42600 0 $24.17 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN 101-0000-42402 0 $48.36 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN PC 101-0000-42600 0 $19.32 Total Paid for MECHANICAL: $261.08 DESCRIPTION ACCOUNT QTY 1 AMOUNT MULTI -SPECIES COMM/INDUSTRIAL - 2016 UPDATE 101-0000-20310 0 $4,851.39 Total Paid for MULTI -SPECIES COMM/INDUSTRIAL - 2016 UPDATE: $4,851.39 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PERMIT 101-0000-42400 0 $623.57 Total Paid for NEW CONSTRUCTION PERMIT: $623.57 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $128.76 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $1,200.00 Total Paid for NEW CONSTRUCTION PLAN CHECK: $1,328.76 DESCRIPTION ACCOUNT QTY AMOUNT BACKFLOW DEVICE 101-0000-42401 0 $12.09 DESCRIPTION ACCOUNT QTY AMOUNT BACKFLOW DEVICE PC 101-0000-42600 0 $4.83 DESCRIPTION ACCOUNT QTY AMOUNT BUILDING SEWER 101-0000-42401 0 $12.09 DESCRIPTION ACCOUNT QTY AMOUNT BUILDING SEWER PC 101-0000-42600 0 $12.09 DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP 101-0000-42401 0 $48.36 DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP PC 101-0000-42600 0 $48.36 DESCRIPTION ACCOUNT QTY AMOUNT GREASE INTERCEPTOR 101-0000-42401 0 $36.26 DESCRIPTION ACCOUNT QTY AMOUNT GREASE INTERCEPTOR PC 101-0000-42600 0 $12.09 DESCRIPTION ACCOUNT QTY AMOUNT ROOF DRAIN 101-0000-42401 0 $48.36 DESCRIPTION ACCOUNT QTY AMOUNT ROOF DRAIN PC 101-0000-42600 0 $48.26 DESCRIPTION ACCOUNT QTY AMOUNT WATER HEATER/VENT 101-0000-42401 0 $24.18 DESCRIPTION ACCOUNT QTY AMOUNT WATER HEATER/VENT PC 101-0000-42600 0 $14.50 DESCRIPTION ACCOUNT QTY AMOUNT WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.09 DESCRIPTION ACCOUNT QTY AMOUNT WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $12.09 Total Paid for PLUMBING FEES: $345.65 DESCRIPTION ACCOUNT QTY AMOUNT STORAGE RACKS, EA ADDITIONAL 100 LF 101-0000-42404 0 $34.80 DESCRIPTION ACCOUNT QTY AMOUNT STORAGE RACKS, FIRST 100 LF 101-0000-42404 0 $24.66 DESCRIPTION ACCOUNT QTY AMOUNT STORAGE RACKS, FIRST 100 LF PC 101-0000-42600 0 $95.72 Total Paid for STORAGE RACKS: $155.18 DESCRIPTION ACCOUNT QTY AMOUNT SMI - COMMERCIAL 101-0000-20308 0 $76.76 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $76.76 DESCRIPTION ACCOUNT QTY AMOUNT INDUSTRIAL/AUTOMOTIVE REPAIR 224-0000-20320 0 $6,158.41 Total Paid for TUMF - INDUSTRIAL: $6,158.41 DESCRIPTION ACCOUNT QTY AMOUNT TUMF - RETAIL SERVICES 224-0000-20320 0 $4,262.96 Total Paid for TUMF - RETAIL SERVICES: $4,262.96