BCOM2019-0019sery Quiam
78-495 CALLE TAMPICO
VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253
FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 5/28/2019
Permit Type/Subtype:
BUILDING COMMERCIAL/OTHER NON-RESIDENTIAL
Owner:
Application Number:
Property Address:
BCOM2019-0019
78995 HIGHWAY 111 STE 3
WASHINGTON 111, LT S
W
APN:
643020051
30240 RANCHO VIEJO
SAN JUAN CAPISTRAN CA 92675cr) faz
Application Description:
WASHINGTON PARK/ DEMISING WALL
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Property Zoning:
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Application Valuation:
$16,000.00
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Applicant:
Contractor: �
JOSE C. SOTO - PROVIDENCE
GENERAL MAINTENANCE
A 0 TORRES CONSTRUCTION CO U �
46630 WASHINGTON
42-669 LA DANZA CT as
LA QUINTA, CA 92253
INDIO, CA 92203 Z
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(760)834-5870 0
Llc. No.: 550498
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 Class: A B CS License No.: 550498
Date: l Z Contractor: A Zl�r
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.).
() 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 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 N
Lender's Add
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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 thaw k for which this permit is issued.
/i 1 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 COMPENSATION INSURANCE FUND Policy Number: 9a22488
I certify that in the performance of the work for which this permit is issued,
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 with those provisions.
Date Applicant:
WARNING: FAILURE TO SECURE WORKERS'COMOZNSATION COVERAGE IS UNLAWFUL,
ARID 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.
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.
0,t,shv Signature (Applicant or Agent):
Date: 5/28/2019
Application Number:
BCOM2019-0019
Property Address:
78995 HIGHWAY 111 STE 3
APN:
643020051
Application Description:
WASHINGTON PARK/ DEMISING WALL
Property Zoning:
Application Valuation;
$16,000.00
Applicant:
JOSE C. SOTO - PROVIDENCE GENERAL MAINTENANCE
46630 WASHINGTON
LA QUINTA, CA 92253
Owner:
WASHINGTON 111, LTD.
30240 RANCHO VIEJO
SAN JUAN CAPISTRANO, CA 92675
Contractor:
A 0 TORRES CONSTRUCTION CO
42-669 LA DANZA CT
INDIO, CA 92203
(760)834-5870
Llc. No.: 550498
Detail: ONE HOUR RATED DEMISING WALL ONLY. THIS PERMIT DOES NOT INCLUDE OCCUPANCY, SUITE ADDRESSING, REVIEW FOR COMPLIANCE WITH ANY
FUTURE TENANT IMPROVEMENTS, OR ELECTRICAL, MECHANICAL OR PLUMBING INSTALLATIONS. 2016 CALIFORNIA BUILDING CODES
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT
QTY
AMOUNT
101-0000-42600
($1.00)
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $0.00
Total Paid for PARTITION: $107.82
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 $21.00
Total Paid for RECORDS MANAGEMENT FEE - MAJOR: $21.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
101-0000-42600
($4.48)
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - COMMERCIAL
101-0000-20308
0
$4.48
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.00
DESCRIPTION ACCOUNT QTY AMOUNT
TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
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Project Address: V 9 S- CA-1 n , lo. �jx
APN #:
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Applicant Name: ic�2�ce 7p4,n
Address: �.Q ,
City, ST, Zip:
Telephone: �'760 Or S8-5-- -
PLAN LOCATION:
Project Description:
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Email, �1 o5ec eQ��4Pr� , Cdv�Valuation of Project $`/6,.oo®- t--
Contractor Namt 0 FC)TfZ5) �,n5,� SFD Construction:
Address: ,qA6 1 `CA- dan w Conditioned Space SF
City, St, Zip An ( C� 2L Garage SF
Telephone: C "76o ) -�-3 8?3 Patio/Porch SF
Email: Fire Sprinklers SF
State Lik 5 � `� ct�. ity Bus Lic:C)00r'tt--( 5
Property Owner's Name:�� 1ii+� (� New Commercial / Tenant Improvements:
Address: U,, / "ko vk-ez o KJ �a, �e Total Building SF
City, ST, Zip &n A 66 tgffZ41t�, Ca Construction Type: Occupancy:
Telephone: f;I�jc�� 1; qo �($
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
# i Submittal Required I Received
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License