BCOM2019-002278-495 CALLE TAMPICO 4�
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: BUILDING COMMERCIAL/REMODEL
Application Number: BCOM2019-0022
Property Address: 79785 HIGHWAY 111 STE 103
APN: 600440006
Application Description: SPECTRUM/PATH OF TRAVEL UPGRADE AT ACCESSIBLE PARKING
Property Zoning: SPACE
Application Valuation:
$4,800.00
Applicant: D
SIPOVAC CONSTRUCTION INC 72651 THEODORA LANE
PALM DESERT, CA 92260 JUN 1 1 2019
CITY OF UA Q1 ll ffA
DU)IGr'1 & DEVELOPMENT DEP/%RTMENT
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. C33, C53. C-9. C10. C20. C36, C21 License No.: 581636
Date: b Z/ /� 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
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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/11/2019
Owner:
P6K PORTFOLIO KDP
2301 ROSECRANS STE 2110
EL SEGUNDO, CA 92253
Contractor:
SIPOVAC CONSTRUCTION INC
72651 THEODORA LANE
PALM DESERT, CA 92260
(760)567-2347
Llc. No.: 581636
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.
7GI 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: 9087965
1 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 with those provisions.
Date: �/I r �L% Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
❑NE H U N DRED TH 0 USAN D 001-LARS IS100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOW LED GEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the ccnditlons 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 1s 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 ha]d harmless the City of La Quiota, its officers, agents, and
employees for any act or emission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes hull 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 cancelIatlon.
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 ardinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upan the ahove-
mentionad property far inspection purposes.
Date: L-41 / f Signature (Applicant or Agent):
Date: ;,6/11/2019
Application Number: BCOM2019-0022
Property Address: 79785 HIGHWAY 111 STE 103
APN: 600440006
Application Description SPECTRUM/PATH OFTRAVEL UPGRADE ATACCESSIBLE PARKING SPACE
Property Zoning:
Application Valuation: $4,800.00
Applicant:
SIPOVAC CONSTRUCTION INC
72651 THEODORA LANE
PALM DESERT, CA 92260
Owner:
P6K PORTFOLIO KDP
2301 ROSECRANS STE 2110
EL SEGUNDO, CA 92253
Contractor:
SIPOVAC CONSTRUCTION INC
72651 THEODORA LANE
PALM DESERT, CA 92260
(760)567-2347
Llc. No.: 581636
Detail: SPECTRUM / REMOVE CURB AND EXTEND EXISTING ACCESSIBLE PARKING SPACE TO 144 IN. WIDTH + INSTALL SIGNAGE TO CREATE VAN
ACCESSIBLE SPACE AS A PATH OF TRAVEL UPGRADE DUE TO TENANT IMPROVEMENT CONSTRUCTION PER SEPARATE PERMIT (BCOM2018-0047). 2016
CALIFORNIA BUILDING CODES.
FINANCIAL
DESCRIPTION
ACCOUNT CITY
AMOUNT
HOURLY CHARGE - CITY BUILDING STAFF
101-0000-42600 0.5
$80.00
Total Paid for BLDG CITY STAFF - PER HOUR:
$80.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$101.40
Total Paid for PERMIT ISSUANCE:
$101.40
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
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
$5.00
40
�GEM frk,, DF SEK1_ —
PEIuMIT # r_6C o M 20 c 9 — 0 0 2 z
PLAN LOCATION:
Project Address 79-785 Highway 111 Suite 103
La Quinta, CA 92253
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #•
Revise existing van accessible parking stall to new
code standards
Applicant Name: Bob Sipovac
Address:
72-651 Theodora Lane
City, ST, Zip:
Palm Desert, CA 92265
Telephone:
(760) 567-2347
Email:
sob@sipovac.com
Valuation of Project daoo.00
Contractor Name: Bob Sipovac
New SFD Construction:
Address:
72-651 Theodora Lane
Conditioned Space
SF
City, St, Zip
Palm Desert, CA 92265
Garage
SF
Telephone:
(760) 567-2347
Patio/Porch
SF
Email:
Bob@sipovac.com
Fire Sprinklers
SF
State Lie:
581636 City Bus Lie:
Arch/Eng Name:
Wendell Veith
Construction Type: Occupancy:
Address:
80-300 Ullswater Drive
Grading:
City, St, Zip
Indio, CA 92203
Telephone:
(760) 953-4556
Bedrooms:
Stories:
# Units:
Email:
wveith36@yahoo.com
State Lie: C5297
City Bus Lie:
Property Owner's Name: Pacific Coast Commercial
Real Estate
New Commercial / Tenant Improvements:
Address: 41 Corporate Park, Suite 230
Total Building SF
City, ST, Zip Irvine, CA 92606
Construction Type: Occupancy:
Telephone: (949) 870-3466
Email: cbush@pccre.com
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
#
Submittal
Req'd
Req'd
Plan Sets
I
!
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