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10-0168 (RC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T-iht 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 10-00000168 Property Address: 79295 HIGHWAY 111 APN: 600-340-027- - - Application description: REMODEL - COMMERCIAL Property Zoning: REGIONAL COMMERCIAL Application valuation: 1084019 Applicant: Architect or Engineer: C�v 4111�_ VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/21/10 Owner: LMART REAL ESTATE BUS. TRUST 02 S.W. EIGHTH STREET JUL 23 20 ENTONVILLE, AR 72712 e LICENSED CONTRACTOR'S DECLARATION 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 CI ss: B-ALicense No.: 667051 Date: nvactor: _111t[Jnn grem zU aT, 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).: (_ 1 1, 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. , BAP.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 Contractor: `""_ HBI CONSTRUCTION, INC. 4921 BIRCH STREET, SUITE ##1 NEWPORT BEACH, CA 92660 (949)851-2211 Lic. No.: 667051 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 STATE FUND Policy Number 719000087 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 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. e"aeZ GA055-1-cant: H6/ C-ol37 o-%oN WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 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 infor tion is correct. I agree to comply with all city and county ordinances and state laws relating to building constructs n, and hereby authorize representatives offtth/is,Coun�ty to for upon t ove-mentioned pro erty for inspectioi purposes. at nature (Applicant or Agent): 0.0 Application Number . . . . . 10-00000168 ------ Structure Information EXIST. 221694 SF STORE ----- Construction Type . . . . . TYPE V, UNPROTECTED Occupancy Type . . . . . MERCANTILE Other struct info . . . . . CODE EDITION 2007/08 ENERGY FIRE SPRINKLERS YES MIXED-USE OCCUPANCY M/S3/A2 OCCUPANT LOAD 6171.00 1ST FLOOR SQUARE FOOTAGE 221694.00 ---------------------------------------------------------------------------- 2ND FLOOR SQUARE FOOTAGE .00 Permit . . . BUILDING PERMIT Additional desc REMODEL OF EXIST STORE Permit Fee . . . . 3709.50 Plan Check Fee 2411.18 Issue Date . . . . Valuation . . . . 1084019 Expiration Date . . 1/17/11 Qty Unit Charge Per Extension - BASE FEE 3539.50 85.00 2.0000 ---------------------------------------------------------------------------- THOU BLDG 1,000,001 - UP 170.00 Permit . . . ELECT - ADD/ALT/REM Additional desc . . Permit Fee . . . . 259.62 Plan Check Fee 64.91 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/17/11 Qty Unit Charge Per Extension BASE FEE 15.00 146.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 2.92 20.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 15.00 4.00 11.0000 EA ELEC MISC 44.00 406.00 .4500 ---------------------------------------------------------------------------- EA ELEC DEVICE/FIXTURE >20 182.70 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 137.00 Plan Check Fee 34.25 Issue Date . . . Valuation . . . . 0 Expiration Date . . 1/17/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 12.00 6.5000 EA MECH VENT FAN 78.00 LQPFRMIT Application Number Permit . . . . . . . . 10-00000168 1010140 Qty Unit Charge Per Extension 4.00 6.5000 EA MECH OTHER MECH EQUIPMENT ---------------------------------------------------------------------------- 26.00 Permit . . . PLUMBING Additional desc . . Permit Fee . . . . 273.00 Plan Check Fee 68.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 1/17/11 Qty Unit Charge Per Extension _ BASE FEE 15.00 39.00 6.0000 EA PLB FIXTURE 234.00 2.00 7.5000 EA PLB WATER HEATER/VENT 15.00 3.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS ---------------------------------------------------------------------------- 9.00 Special Notes and Comments REMODEL TO WALMART SUPERCENTER. 221,694 SF EXISTING. 128 SF ADDED OUTDOOR STORAGE. M/S-2/A-2 OCCUPANCY.TYPE V -B CONSTRUCTION.**2007 CODES / 2008 ENERGY CODE. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ACCESSIBILITY PLAN REVIEW 241.12 ART IN PUBLIC PLACES -COM 5400.10 BLDG STDS ADMIN (SB1473) 41.00 ENERGY REVIEW FEE 241.12 STRONG MOTION (SMI) - COM 227.64 Fee summary Charged Paid Credited ----------------- Due ---------------------------------------- Permit Fee Total 4379.12 .00 .00 4379.12 Plan Check Total 2578.59 .00 .00 2578.59 Other Fee Total 6150.98 .00 .00 6150.98 Grand Total 13108.69 .00 .00 13108.69 LQPERMIT