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11-1035 (RC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 11-00001035 Property Address: 78900 AVENUE 47 STE 100 APN: 643-090-016-286 -24230 - Application description: REMODEL - COMMERCIAL Property Zoning: REGIONAL COMMERCIAL Application valuation: 90000 T4ht 4 4 Q" Applicant: Architect or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Professionals Code, and my License is in full force and effect. License Class: B License No.: 942744 r. ��� Date: �` Contracto/ _ n, /( 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 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.). (_) 1 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 Name: _ Lender's Address: LQPERMIT Owner: DEANZA PLAZA APARTMENTS 11 78900 AVENUE 47 LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/02/11 Contractor: VANDALAY GROUP 79405 HIGHWAY 1 MB 9-498 € LA QUINTA, CA 9 5 € ^° 20 q (619)889-0909 ,k: 0,,p i Lic. No.: 94274 L Ld i 11YOF LA llwr ----------------------------------------------- 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 EXEMPT _ 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 la f-Eai' and agree that, if I should become subject to the workers' com sari Z pro it ection 2 - 3700 of the Labor Code, I shall forthwith comply vyjtia-th se provi Date: L Applicant: f WARNING: AILURE TO ORKERS' COMPENSATION COVERAGECUNLAWFUL, AND SHALL SUBJECT AN EMP 0 CRIMINAL PENALTIES AND CIVIL FINES UP TOkiUNDRED 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 Director of Building and Safety 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 county to enter upon the above -mentioned property for inspection purposes.-� Date: / 7 Signature (Applicant or Agent): Application Number . . . . 11-00001035 ------ Structure Information 1,926SF TI/VB/B-OCC/20-OL/SPRINKLED ----- Other struct info . . . . . CODE EDITION 2010 FIRE SPRINKLERS FULLY MIXED -USE OCCUPANCY B OCCUPANT LOAD 20.00 1ST FLOOR SQUARE FOOTAGE 1926.00 ---------------------------------------------------------------------------- Permit . . . Additional desc . . Permit Fee . . . . Issue Date . . . . Expiration Date . . BUILDING PERMIT 594.50 Plan Check Fee . . 386.43 Valuation . . . . 90000 5/30/12 Qty Unit Charge Per Extension BASE FEE 414.50 40.00 4.5000 THOU BLDG 50,001-100,000 180.00 ---------------------------------------------------------------------------- Permit . . . ELECT - ADD/ALT/REM Additional desc . . Permit Fee . . . . 53.52 Plan Check Fee 13.38 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 5/30/12 Qty Unit Charge Per Extension BASE FEE 15.00 1926.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 38.52 ---------------------------------------------------------------------------- Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 37.00 Plan Check Fee 9.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 5/30/12 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 4.5000 EA MECH VENT INST/ DUCT ALT 9.00 2.00 6.5000 EA MECH VENT FAN 13.00 ---------------------------------------------------------------------------- Permit . . . PLUMBING Additional desc . . Permit Fee . . . . 97.50 Plan Check Fee 24.38 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 5/30/12 LQPERMIT Application Number . . . . . 11-00001035 Permit . . . . . . PLUMBING Qty Unit Charge Per Extension BASE FEE 15.00 12.00 6.0000 EA PLB FIXTURE 72.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 ---------------------------------------------------------------------------- Special Notes and Comments 1,926SF OFFICE TI/VB/B-OCC/20-OL/FULLY SPRINKLED [DOCTOR MOORJANI] THIS PERMIT DOES NOT INCLUDE EXTERIOR SIGNAGE OR ALTERATIONS TO THE SHELL BUILDING. 2010 CALIFORNIA BUILDING CODES. December 1, 2011 8:41:07 AM AORTEGA ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ACCESSIBILITY PLAN REVIEW 38.64 BLDG STDS ADMIN (SB1473) 4.00 ENERGY REVIEW FEE 38.64 Fee summary Charged Paid Credited Due Permit Fee Total 782.52 .00 .00 782.52 Plan Check Total 433.44 .00 .00 433.44 Other Fee Total 81.28 .00 .00 81.28 Grand Total 1297.24 .00 .00 1297.24 � L � 30 �O �. co p *5 >+ N p ca O CL 0. a)U E N cu C t 4!"O O co Q. O co?� .. 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O �� O as�b b Q o-ocn rA CA cn ++ m fl O Q N Z d ��„J Q. fal O O UO ti cC d N U N Vco ,f� O O co cd Q al � La m � � U Z U S W W a z W � � � wN�aF"N o ¢IL U)v Lzo zzw o OQwW Y o O w z O > d = w=ON¢i z w a � U- w a p p ¢ ma O °O W 0 aO U Q CO U)Za zw ¢ow Z J C z IL a:zLL m m U U U 0 w \�o k A»k p u u 2ƒ� f k \ / �ƒ 00 ƒ2 / 2 ® % % k % \ f2 §2 k � C*cd o o o § ©/ 0� (. a ,N •§ § t ƒƒA ƒd CZ �- o » ±±2 a •§ E§ k ° u { /ƒ ƒ ) 00 � \ ��./00 k/ CITY OF LA QUINTA SUB-CONT CTOR LISP' Z,, (.� l A PERMIT NUMBER l!! O OWNER BUILDERSS��J�� AD DREare iZed to work T form shall be posted on the job with the Building Inspection Gard at all times in,a conspicuous place. O ly rsons appearing on this list or their employees on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance rn,. —t—i kainw mint ha rmmnleted by anolicant. "On File" is not an acceptable response, a Ul UU11U."U.. �rasl4 / CIA$effloetion �Q41t� ri"�Cr t0 �erGr�>< �' t44aa WOtW$ Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp. Data (xxixx/xx) License Number (xxxx) Exp. Date (xxlxxlxx) Company Name ClasaiNcation (e.g. A, B. C-8) License Number (xxxxxx) Exp. Date (xx/xx/xx1 ` n l2ri✓ CONCRETE (C 8i FRAMING (C-61 S7RUCT. STEEL (C-51) 3 MASONRY (C-29) i PLUMBING (C-36) . 6 C — 9 !/ "' / ! LATH, PLASTER (C-35) /' 14VAC (C-20) j" t , a3/ s i d0Y>s y>0) ELECTRICAL (C-10) 0 73 q ROOFING (C-39) SHEET METAL (C-43) FLOORING (C-15) GLAZING (C-17) Q G— q/ 4 �j u 3 G l� • Z INSULATION (C-2) SEWAGE. DISP. (C-42) j LO 1 U �°?W / /Da !� PAINTING (C-33) C. 33 JJ e� l0 3 �/ /+� CERAMIC TILE (C-54) CABINETS (C-6) D / 3 FENCING (C-13) LANDSCAPING (C-27) j i POOL (C-53) . �� tea = � d � .0 V C � � j' ►t ro � t'� A d VS It Q W e 0 �t2i5 O ca IV 3 u t 1 $ U a It "n a rw ,. b C 9 n a l to 93 x