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BP 12-0670P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 78900 AVENUE 47- STE 102 643-090-016-286 -24230 REMODEL - COMMERCIAL REGIONAL COMMERCIAL 21000 c&ty/ 4 4 Qum& Architect or Engineer: 100 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: DEANZA PLAZA APARTMENTS 11 78900 AVENUE 47 (" LA QUINTA, CA 92253 t Contractor: VANDALAY GROUP INC, THE 79405 HIGHWAY 111 PMB 9-4 LA QUINTA, CA 92253 (619)889-0909 Lic. No.: 942744 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/24/12 1A, f 1 CITY OF LA QUINTA FINANCE C15PT. ------------------------------------------------------------------------------------------------- L.ICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: B License No.: 942744 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is .-----"""'_--�" issued. ate: Z ntractor. ""—"�' `""�"' _ 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 OWNER -BUILDER DECLARATION insurance carrie-[..an�taolicy number are: 1 hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier E EMPT ._,,: �.."� •�Z�� Policy Number EXEMPT following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to I certify that, in the performATT66 of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forthwith comply with thoseprovisions. 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 ($5001.: e:�?y licant, -� ( ) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and /Jp,'/ the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILU ER TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). (_ 1 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 Name: `� Lender's Address: V5 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. 'Dofate: % Z Si p6ture (Applicant or Agent-- _ _ ..- •--� LQPERMIT Application Number . . . . . 12-00000670 Structure Information 4,460SF OFFICE TI/VB/B-OCC/47-OL/SPINK Other struct info . . . . . CODE EDITION 2010 FIRE SPRINKLERS FULLY MIXED -USE OCCUPANCY B OCCUPANT LOAD 47.00 ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 4460.00 Permit . . . ELECT - ADD/ALT/REM Additional desc . . Permit Fee . . . . 30.00 Plan Check Fee 7.50 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 1/20/13 Qty Unit Charge Per Extension BASE FEE 15.00 20.00 .7500 ---------------------------------------------------------------------------- PER ELEC DEVICE/FIXTURE 1ST 20 15.00 Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 216.00 Plan Check Fee 140.40 Issue Date . . . . Valuation . . . . 21000 Expiration Date . . 1/20/13 Qty Unit Charge Per Extension BASE FEE 45.00 19.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 171.00 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 24.00 Plan Check Fee 6.00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 1/20/13 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 4.5000 ---------------------------------------------------------------------------- EA MECH VENT INST/ DUCT ALT 9.00 Permit . . . PLUMBING Additional desc . . Permit Fee . . . . 55.50 Issue Date . . . . Expiration Date . . 1/20/13 Qty Unit Charge Per Plan Check Fee . . 13.88 Valuation . . . . 0 Extension LQPERMIT Application Number . . . . . 12-00000670 Permit . . . . . . PLUMBING Qty Unit Charge Per Extension BASE FEE 15.00 5.00 6.0000 EA PLB FIXTURE 30.00 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 4,460SF PROFESSIONAL OFFICE REMODEL AT EXISTING TI/B-OCC/47-OL/SPRINKLED [LIVE WELL CLINIC] THIS PERMIT DOES NOT INCLUDE ALTERATIONS TO LOAD BEARING OR LATERAL RESISTING CONSTRUCTION. 2010 CALIFORNIA BUILDING CODES. July 10, 2012 2:00:22 PM AORTEGA ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ACCESSIBILITY PLAN REVIEW 14.04 BLDG STDS ADMIN (SB1473) 1.00 ENERGY REVIEW FEE 14.04 Fee summary Charged Paid Credited Due Permit Fee Total 325.50 .00 .00 325.50 Plan Check Total 167.78 .00 .00 167.78 Other Fee Total 29.08 .00 .00 29.08 Grand Total 522.36 .00 .00 522.36 LQPERMIT z 0 U w O x IL w U- p z =a m �U) zw 0� 0 LL (O 0Z U2 0 a N m Q .0 U `o uS d ` m LL 2 3oC) 0) co sCU i O '- rn na) _o N I-- a O cd o z Cd to �x rA a> _ O cd d '0 3 d o -o a, a° o ed U 0�3yon >° �CA nY En b �"° .fly '�° o ' o o rz H U p ` a`"i sU. anti od Q o. y °p Q 15 c ° .o Q to"� U O v�i p, °O 0o cC we °a �°°' U a�i kCc "ow �iO3 on �?fl_�'a,4° N U O¢ 3 C d 0 N.-- a Ar OO om� "OZ +4 i by o .fl a) a o CIS O> iti O a> ul Cd = Q 4, w Lo .. 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