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BCOM2017-005578-495 CALLE TAMPICO 4 a�MUCl/ VOICE (760) 777-7125 DDD FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 1/8/2018 Permit Type/Subtype: BUILDING COMMERCIAL/REMODEL Owner: Application Number: BCOM2017-0055 UGGS7 Property Address: 79305 HIGHWAY 111-STE 5 2205 N POINSETTIA AVE APN: 600340004 MANHATTAN BEACH, CA 92253 Application Description: SHELL IMPROVEMENT - ADD DEMISING WALL TO SEPARATE SPACES Property Zoning: Application Valuation: $6,000.00 Applicant: D L� Contractor: JEFFREY F KELLNER p JEFFREY F KELLNER P O BOX 245 JAN U 8jENTT P O BOX 245 RANCHO MIRAGE, CA 92270 RANCHO MIRAGE, CA 92270 CITY OF LA OMMUNITYDEVELOPPADEPARTMENT (760)774-5333 Llc. No.: 834358 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 License No.: 8,34358 Date: // antra— cto�: 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 f alleged exemption. Any violation of Section 7031.5 by any applicant for a permit 1 subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: L_J 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, 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 . I ) I am exempt under Sec: . B.&P.C. for this reason' Date: Owner: CONSTRUCTION LENDING AGENCY 1 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: 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: _ ��II certify that in the performance of the -work for which this permit is issued, I shaRn;-. e'mploy 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 with those arovisions. Appl�t:�fi 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 Building Official for apermit 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- mentioned property for inspection purposes. A • - Date: 1/8%2018. Application Number: BCOM2017-0055 Owner: PropertyAddress,"'�` :-'==':79305 HIGHWAY 111 STE 5 UGGS7 APN: 600340004 2205 N POINSETTIA AVE Application Description: SHELL IMPROVEMENT - ADD DEMISING WALL TO SEPARATE SPACES MANHATTAN BEACH, CA 92253 Property Zoning: Application Valuation: $6,000.00 Applicant: Contractor: JEFFREY F, KELLNER JEFFREY F KELLN.ER . P 0 BOX 245 P 0 BOX 245 RANCHO MIRAGE, CA 92270 RANCHO MIRAGE, CA 92270 (760)774-5333 Llc. No.: 834358 'Detail: SHELL IMPROVEMENT - CONSTRUCT NON-STRUCTURAL STEIEL STUD DEMISING WALL TO SEPARATE SPACE INTO (2) SUITES + ADD RECEPTACLES AT BOTH SIDES OF NEW WALL. THIS PERMIT IS FOR A SHELL IMPROVEMENT ONLY AND DOES NOT INCLUDE THE OCCUPANCY OF EITHER SUITE. TENANT IMPROVEMENT PERMITS MUST BE OBTAINED PRIOR TO ALTERING OR OCCUPYING THESE SPACES, AND NO BUSINESS LICENSE WILL BE ISSUED AT THIS LOCATION UNTIL THESE ITEMS HAVE BEEN COMPLETED -2016 CALIFORNIA BUILDING CODES. FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 '0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 101-0000-42403 0 $26.01 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 PC 101-0000-42600 0 $26.01 Total Paid for ELECTRICAL: $52.02 DESCRIPTION ACCOUNT QTY AMOUNT PARTITION 101-000042400 0' $78.02 'DESCRIPTION ACCOUNT QTY AMOUNT PARTITION PC 101-0000-42600 0 $143.56 Total Paid for PARTITION: $221.58 DESCRIPTION ACCOUNT QTY AMOUNT PLAN CHECK DEPOSIT - ADDITION/REMODEL 101-0000-42600 1 $125.00_ Total Paid for PLAN CHECK DEPOSIT - ADDITION/REMODEL: $125.00 DESCRIPTION ACCOUNT QTY AMOUNT RECORDS MANAGEMENT FEE - MAJOR 101-0000-42416 0 $20.00 Total Paid for RECORDS MANAGEMENT FEE - MAJOR: $20:00 DESCRIPTION ACCOUNT QTY AMOUNT SMI - COMMERCIAL 101-0000-20308 0 $1.68 .Total Paid for STRONG MOTION INSTRUMENTATION SMI: $1.68 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 n Contractor Name: New SFD Construction: PERMIT# �200 - ~ C'a, w Qiz'al PLAN LOCATION Telephone: _ S33 Patio/Porch SF Project Address: 27 Fire Sprinklers SF Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech APN State Lic: City Bus Lic: Applicant Name:e ;*r 6 Ae / �1 / V Address: �p d City, ST, Zip. m 5QI- Telephone: d -� E-mail: 1 � ( U'� C o Valuation of Project $ v� Contractor Name: New SFD Construction: AddressJ� Conditioned Space SF City, St, 9 2 Garage SF Telephone: _ S33 Patio/Porch SF Email: �,� v� /�� Fire Sprinklers SF State Lic: •'gDT3City Bus Lic: Arch/Eng Name: Construction Type: Occupancy: Address: �_ Grading: City, St,'Zip Telephone:, Bedrooms: Stories: # Units: Email: State Lic: City Bus Lic: Property Owner's Name' 7' ,�r �f�. /` New Commercial / Tenant Improvements: Address: �� /-Sd,2. Total Building SF City, ST, Zip ✓x JdQ( Construction Type: Occupancy: Telephone: Email: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 Job Notes 1) All construction shall comply with the,2016 California Residential, Mechanical, Electrical, Plumbing, Green Building and Energy Codes and the La Quinta Municipal Code. 2) All 'or equal' substitutions must be submitted to, and approved by the Building. Official prior to installation of the item. 3). "Aluminum conductors are permitted only if size 1/0 or larger, and only to feed main or sub -panels. All other current carrying conductors shall be copper." (LQMC §8.03.040) ***PLEASE NOTE: THIS PERMIT IS FOR A SHELL IMPROVEMENT ONLY AND DOES NOT INCLUDE THE OCCUPANCY OF EITHER SUITE. TENANT IMPROVEMENT PERMITS MUST BE OBTAINED PRIOR TO ALTERING OR OCCUPYING THESE SPACES, AND NO BUSINESS LICENSE WILL BE ISSUED AT THIS LOCATION UNTIL THESE ITEMS HAVE BEEN COMPLETED. �j .99 coo . LL. oCL O.zCL$ A 9Qo Um o 11- z uj UJ 391 �LU IMEMA, w ®z LLJ v� O �j .99 coo . LL. oCL O.zCL$ A 9Qo Um o 11-