BCOM2019-002078-495 CALLE TAMPICO T� D TVOICE (760) 777-7125
o FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/18/2019
Permit Type/Subtype: BUILDING COMMERCIAL/REMODEL Owner:
Application Number: BCOM2019-0020 WAL MART REAL ESTATE BUSINES
Property Address: 79295 HIGHWAY 111 P 0 BOX 8050
APN: 600340027 BENTONVILLE, AR 92253
Application Description: MCDONALDS / 1,311 SF TENANT IMPROVEMENT
Property Zoning:
Application Valuation: $80,000.00
Applicant: Contractor:
THOMAS TYLER P
C C K BUILDERS INC
625 WEST KATELLA AVENUE #2
LAKEWOOD, CA JUN 18 20�9D ORANGE, CA 92867
CITY OF L AOUINTA (714)538-8200
DESIGN & DEVELOPMENT DEPARTMENT Llc. No.: 855822
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: B License No.: 855822
Date: G' �`r Contractor:
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
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 Add
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 rk for which this permit is issued.
I have and will maimaln 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: INSURANCE COMPANY OF THE WEST Policy Number: WSD5021797
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 a become subject to the workers'
compensation laws of California, and agree at, if should becom jest to the
vrnr'zers' compensation provisions ofSecY n 37.00 f the Labor o I shall forthwith
comply with thoss3-
e provisions.
Date: 0 � `� ` 6t Applicant:
L9U
WARNING: FAILURE TO SECURE WORKE� OMPENSATION 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 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 sta s relating to hulfding
construction, and hereby authorize representatives of thi ity , ter up ove-
mentioned property for inspection purposes. —
/C�
Date: — 0 _ [ Signature (Applicant or Agent).
'Date:--,6/18/2019
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
THOMAS TYLER
LAKEWOOD, CA
:iK6LAAP110112111041,'
79295 HIGHWAY 111
600340027
MCDONALDS / 1,311 SF TENANT IMPROVEMENT
$80,000.00
Owner:
WAL MART REAL ESTATE BUSINES
P 0 BOX 8050
BENTONVILLE, AR 92253
Contractor:
C C K BUILDERS INC
625 WEST KATELLA AVENUE #2
ORANGE, CA 92867
(714)538-8200
Llc. No.: 855822
Detail: MCDONALDS / 1,311SF TENANT IMPROVEMENT/II-A/A-OCC/92-OL/SPRINKLED [MCDONALDS IN WAL-MART] DEMO EXISTING AWNINGS, NEW
PENDANT LIGHTING + MISCELLANEOUS ELECTRICAL FIXTURES/RECEPTACLES AT CUSTOMER SERVICE AREA, REPLACE BULKHEAD SIGNAGE, INSTALL NEW
FLOOR, WALL & COUNTER FINISHES. TUMF ASSESSMENT NOT TRIGGERED DUE TO NO ADDITIONAL TRIP GENERATION. 2016 CALIFORNIA BUILDING
CODES.
1 INFORMATION
FINANCIAL
DESCRIPTION ACCOUNT CITY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $4.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $4.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DEVICES, FIRST 20
101-0000-42403
0
$26.68
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DEVICES, FIRST 20 PC
101-0000-42600
0
$26.68
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DEVICES/FIXTURES, ADDITIONAL
101-0000-42403
0
$2.67
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DEVICES/FIXTURES, ADDITIONAL PC
101-0000-42600
0
$0.67
Total Paid for ELECTRICAL: $56.70
DESCRIPTION
ACCOUNT
CITY
AMOUNT
FIRE COMMERCIALTI PC
101-0000-42420
0
$240.00
Total Paid for FIRE FEES: $240.00
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
CITY
AMOUNT
RECORDS MANAGEMENT FEE - MAJOR 101-0000-42416
0
$21.00
Total Paid for RECORDS MANAGEMENT FEE - MAJOR: $21.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF
101-0000-42400
0
$72.03
DESCRIPTION
ACCOUNT
CITY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$57.63
DESCRIPTION
ACCOUNT
CITY
AMOUNT
REMODEL, FIRST 100 SF
101-0000-42400
0
$54.43
DESCRIPTION
ACCOUNT
CITY
AMOUNT
REMODEL, FIRST 500 SF PC
101-0000-42600
0
$148.89
Total Paid for REMODEL: $332.98
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SMI - COMMERCIAL
101-0000-20308
0
$22.40
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $22.40
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS::• 0:
L
y
tev Qaig r
GEM of h, DESERT -
PERMIT # `J O
PLAN LOCATION:
Project Address: tt
(it
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
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APN #:
Applicant Name:
�S
Address: Z
City, ST, Zip:
Telephone: O _Ve
Email:
44E�mA5
-44��#SeArAA
Valuation of Project $ D u o
Contractor Name:
New SFD Construction:
Address:
Conditioned Space SF
City, St, Zip
Garage SF
Patio/Porch SF
Telephone:
Email:
Fire Sprinklers SF
State Lic: City Bus Lic:
Arch/Eng Name:
Construction Type: Occupancy:
Address: �25
Grading:
City, St, Zip w
ON
Telephone: 331 5
Bedrooms NA.
Stories: `
# Units:
Email: A�Ce to sigWax 0 L JI-Lov. GO/,
[State Lic:d _Z $ 6 5 Z. City Bus Lic:
Property Owner's Name: ML
New Commercial / Tenant Improvements:
Address:
Wtw
Total Building I tZ_C,� SF
City, ST, Zip
C20t d O
Construction Type: Occupancy:
Telephone: o
Email:4,� rb%4
gcp
78495 CALLE TAMP ICO
LA QUINTA, CA 92253
760-777-7000
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