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BCOM2017-000878-495 CALLE TAMPICO Q�i D VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 760 FAX ( ) 777-7011 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 6/5/2017 Application Number: BCOM2017-0008. Owner: Property.Address: 78046 CALLE BARCELONA OLD TOWN ARTISAN STUDIOIR APN: 770153004 78046 CALLE BARCELONA Application Description: OLD TOWN ARTISAN STUDIO / TI LA QUINTA, CA 92253 Property Zoning:Application Valuation: $200,000:00 LO Applicant: Contractor..RICHARD GRUND DERYK AIREY ZD 77571 BURRUS CTPALM DESERT, CA 92211 (760)497-7654 Llc. No.: 962128 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Cla : B, C29. C53 License No.: 9621 8 Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State Cicense 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: 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 Lender's Address: 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 0 ork for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: MID-CENTURY INSURANCE COMPANY Policy Number: A09476102 _ 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 the Labor Code, I shall forthwith comply ith those provisions. Date: Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVEE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL S 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. 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 city to enter upon the above -m tion d property for inspection purposes. Date: Signature (Applicant or Agent): Date: 6/5/2017 Application Number: BCOM2017-0008,•..,., Owner: Property Address: 78046 CALLE BARCELONA OLD TOWN ARTISAN STUDIO APN: 770153004 78046 CALLE BARCELONA Application Description: OLD TOWN ARTISAN STUDIO / TI LA QUINTA, CA 92253 Property Zoning: Application Valuation: $200,000.00 Applicant: Contractor - RICHARD GRUND DERYK AIREY 77571 BURRUS CT PALM DESERT, CA 92211 (760)497-7654 ----------------------------------------------------=-=-------------------------------------- Llc. No.: 962128 Detail: REMODEL OF EXISTING BUILDING (OLD A-2 RESTAURANT) TO MIXED OCCUPANCY BUILDING CONSISTING OF A-3/B/F-2/R3 - "THE ART PARK" [ART WORKSHOP, POTTERY AREAS,KILND, ART DISPLAY GALLERY AND ARTIST LOFT] 2 -HOUR FIRE WALL SEPARATIONS FOR ALLOWABLE BUILDING AREA & NON - FIRE SPRINKLER PURPOSES. 198 OCCUPANT LOAD. 2016 CODES. FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT ART IN PUBLIC PLACES - COMMERCIAL REMOD 270-0000-43201 0 $S00.00 Total Paid for ART IN PUBLIC PLACES - AIPP: $500.00 DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $8.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $8.00 DESCRIPTION ACCOUNT QTY AMOUNT POWER APPARATUS 101-0000-42403 0' $329.29 DESCRIPTION ACCOUNT QTY AMOUNT POWER APPARATUS PC 101-0000-42600 0 $329.29 Total Paid for ELECTRICAL: $658.58 DESCRIPTION ACCOUNT QTY AMOUNT FIRE COMMERCIAL TI 101-0000-22811 1 $614.00 Total Paid for FIRE COMMERCIAL TI: $614.00 DESCRIPTION ACCOUNT QTY AMOUNT OTHER MECHANICAL EQUIPMENT 101-0000-42402 0 $190.00 DESCRIPTION ACCOUNT QTY AMOUNT OTHER MECHANICAL EQUIPMENT PC 101-0000-42600 0 $190.00 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN 101-0000-42402 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN PC 101-0000-42600 0 $5.07 Total Paid for MECHANICAL: $397.74 DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, EA ADDITIONAL 500 SF 101-0000-42400 0 $228.00 DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, EA ADDITIONAL 500 SF PC 101-0000-42600 0 $182.40 DESCRIPTION - ACCOUNT QTY AMOUNT REMODEL, FIRST 100 SF 101-0000-42400 0 $51.68 DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, FIRST 500 SF PC 101-0000-42600 0 $141.36 Total Paid for REMODEL: $603.44 DESCRIPTION ACCOUNT QTY AMOUNT . TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 TOTALS: