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0401-305 (RC)LICENSED CONTRACTOR DECLARATION F,l 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 # Lic. Class Exp. Date r• �4Date7 17 Signature of Contractor' - OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 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 & Professionals Code). ( ) I, .as owner of the property, am exclusively contracting with licensed contractors to construct the -project (Sec. 7044, Business & Professionals Code). () I am exempt under Section B&P.C. for this reason Date R Signature of Owner' 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'& policy no. are: Carrier CNs4. C.A.SUMMY px', Policy No. .1.47665 114 . (This. section need not be completed if the permit valuation is for $100.00 or less). () 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 Secsst °on 3700 of the Labor Code, I shall forthwith comply with those provisions. -'bate: Applicant"-•-_ .. Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $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. IMPORTANT Application -is hereby made to the Director of Building and,Safety for a permit subject to`:the� conditions and restrictions set forth on his 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 applicaton agrees to, & shall; indemnify & hold harmless the City of La Quinta, its,officers, agents and employees. 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 Lhave read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the.,above- property for inspection purposes. Signature (Owner/Agent) � , /�'�� � "' Date i ' ,1 BUILDING PERMIT... PERMIT 7f DATE "' VALUATION LOT TRACT-, JOB SITE ADDRESS 73.-`•lVe 5'ff , APN OWNER CONTRACTOR / DESIGNER / ENGINEER 2205 Ti FO�'.iS TRAAVK 5 G%60 Et.©E3ERT ibis`! 11EWS PAR-10MAY T c; l MANFIATIT J.ii BEACH CA 90266 VI :DORADO IMLS CA 95762 .(91 5 j541-'3900 CE110 6949 USE OF PERMIT COMMERCIAL M11.0.DM f;"011timv,=AL imm4f?, (tforto't'owN viRe.. M fi) 455 sQrr, -w- occuPl�t1 Y,'' I'C-V' t P;11 KLF.i�, OCCUPANT %.27.1�D 14, 2941 0 0 ' TA-TATiOi Lg' ES:r,` "sT'EM COSH' OF COINS'E�'�tG` PIAN C'MECK F.EE CGHSTRUCTION FEE ... 10 � -00"1 18-0 00 S'PR4MMOTION YE9 CaIAM 10-0-000.241-000 p Q FEB 12 2004 CITY OF LA QUINTA FINANCE DEPT. - :-iiaB-'ZOTAL CC1A1'9MUC'1IO9 AND l;?LAN CR C1: �Y��•.91 34a PES -PAW E'F.3�S O,Da RECEIPT DATE j� �/ BYf DATE FI ALE INSPEC ; 0 INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap 4 F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS BLOCKWALL APP OV LS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring p Law Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) x x Bm # City of La Quinta Building S Safety Division P.O. Box 1504, 78-495 Calle Tampico Permit # La Quinta, CA 92253 - (760) 777-7012 t{o� .3oS Building Permit Application and Tracking Sheet Project Address: — Zlj 11,-/ o%%mer's Name: 0 �R mit A. P. Number: Address: Legal Description: Contractor: �/ �� (70)V -$7A?</ G'►d -4 City. ST. Zip: FTelephone: Address: ZZ �- 2� �t Project Description: (,v& A72& Oi �7J D�cJ city, ST, zip: Tw/ '/'Y'o6 p*7 /V ._o .S . �T S�G�O o oe- 7-lt-t_ Telephone: 330- State Lic. # : -710 '7 % City Lic. #: AY V9, C, cog— &/C-Cflec eR-t... Arch., Engr., Designer: /" e ti IV12 YK�I L 8E/Si P ovp- ,B wwltin PirtT Address: Od L4/ * FZat)f ILL On/ ldOs rn%ArL C Gt�t-f City, ST, Zip: C.O,v CAfO E-0-2—Tb 3 -"OR .5ez j*J t,'r-1L -dc#C& jo Telephone:�Z► Z� ��� a? - `` % b Construction Type: Occupancy: State Lic. #: Project type (circle one New Add'n Alter Repair Demo Name of Contact Person: ZdbEi2� 42�E, "T q. Ft.: �j PstimatcdValucofPro,.iect:g..�ZO-110;/- # Stories: (# Units: # Ul Telephone # of Contact Person: 77/ Y—47—Z.cp �Zg APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal //��p U-1 Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted ! Item Amount Structural C21c5. Reviewed, ready for corrections Y2,71Plan Check Deposit Truss Calcs. Called Contact PersonI 2 • �Z Plan Check Balance !J_`� Energy Cafes. Plans picked up A00 Construction • S/ . 00 Flood plain plan Plans resubmitted Mechanical Grading plan2" Review, ready for corrections/issue l � Electrical Subcontaetor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''' Review, readv for correctio s<ssue Developer Impact Fee Planning Approval Called Conta �� D A.I.P.P. Pub. Wks. Appr a of permit issue School Fees / ,QIBXT LTi 1i i .ifs b7�itf� Total Permi Fees i3 9/ �Ccll.,a„,�t S�rl1� nK ' J PP/L C� �K I o SSu P�J� 71 �M4L C of 0AA-0 t� �K Certificate of Occupancy Tw f 4 xP agwo Building & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this . structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 79-295 Highway 111 Use classification: Commercial "Hometown Threads TI" Building Permit No.: 0401-305 Occupancy Group: M Type of Construction: VN Sprinkled Land Use Zone: CR Owner of Building: Walmart Real Estate Trust Address: 2001 SE 10th Street ld Ale - Building Official City, ST, ZIP: Bentonville, AK 72716 By: Daniel P. Crawford Jr. Date: 2/26/04 POST IN A CONSPICUOUS PLACE N oPflc� ?CAAI Se7` A REINSPECTION FEE OF $30 Hometown Threads 1MILL BE CHARGED IF THE APPROVED PLANS AND 10B CARD ARE NOT ON 79-295 Hwy 111 #803 THE SITE FOR A SCHEDULED _ La Q I n a. 92253 NO ExCEPz,oNs ��Witi the Wa Supercenter at the same address. Plan Legend Pg 5 -Site Reference Pg 6 -Template of store layout Pg 7 -Key to store layout ' r;,g,18 - 1 c truction drawing 11-�Di lay blue prints I .� plan,get was`p�r e t ity of La Quinta by Robe Tornetta. (?fy)14?- 4t- AtL oe. e5"L- 5u5�1VfWJS Mubr 86SjaA41TWV 10 AoVD APoA&W BK rrhV' BumOiAdj &Ar1e4A1_, P V struction shall comply to the 2001 California building, b' , mech electrical, ang engrgy codes and a l UK �Ls NOT- 1A(C,6v0§_ 4NA1 AUrMj__ k-rva&1X ; NML_ - rfAE-i7& pAA ua W*er-Vav f'lNQti �►u0i� ��w'2up)�i !NS!lIE�LT1un1 CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION I DATE /j 2016r_ BYE_ CITY OF LA QUINTA APPROVED FOR CONSTRUCTIOI BY __Ro-eGl2_-r-T-37_mGnA (71(�)267-7,207 CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE BY 504 TEMPLATE (1) CHECK BLUEPRUM FOR ACTUAL SIZE t 46 '/2" W 72" W x 22" D 72" W x 22" D B 30" .. 24 32" D Refer to display Refer to display Refer to d" print CN -M5 print CN -0215 i isplay' print CN 0214 14 /2" FT. CABINETS (2 QTY) Clothing C 36" MA HINE BASE Existing Stock t6°' 3'4- Door '4"Door Refer to sit a Room 72" w x 22" D 'Refer to display reference pAt print CN -MG 15' a GLASS CASE No door or hardware ' D 9'6" i 7' 2" 6'4" I l 46%2"W 40 32"D Refer to displaji 5 V, print CN -0214 MACHINE BASE 49 2" Refer to display • pri , CN -0218 F %W'Wv�)A"lr 7 „ " 18" K fer displa Refer too di play x22 D X afar t disula in 17 Ont CN -0216 22" print 0297 5'4" p 342" DESIGN GLASS CASE FILLER P.O.S. —r— H E A APPAREL W (24' 3I0") 7 G (31',) �I CIrt out of wall drawing on Solid Picket Fench Gate 10" mos KICK ROM with smooth bottom, K�sr $x-[�77cf To k— Luavu- to" (4G,- R'm ee c��s lot��2oo� CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION KEY TO STORE LAYOUT DATE BY t A. 24'%" FROM BACKSIDE OF GATE HOUSING TO FRONT OF NEW WALL BEFORE SLATWALL GETS. INSTALLED. B. 30" FROM BACKROOM SIDE WALL TO EDGE OF DOOR HOUSING. C. 36" WIDE DOOR OPENING (NO DOOR OR HARDWARE TO BE INSTALLED)(NO METAL FRAME WILL BE NEEDED, EDGE OF FRAME WELL ONLY BE FINISHED). 6" OF WALL SPACE TO COUNTERS. D. APPROXIMATELY 9'6" FROM EDGE OF DOOR OPENING (NO DOOR OR HARDWARE TO BE INSTALLED)TC OTHER SIDE WALL IN BACKROOM. E. 5'6" REMAINING FEET FROM EDGE OF P.O.S. STATION TO FRONT OF STORE. F. 4 FENCE POSTS INSTALLED ON TOP OF CARPET G. 31' LENGTH OF STORE FROM FRONT EDGE TO BACK WALL. H. 18'6" FROM END-TO-END OF CENTER COUNTERS. C -71q) 1 A' TYPICAL SALES WALL PARTITION Ceilin g 5/8 °0 Gyp. Bid Secured to ceiling with angle On Both Sides brackets along a track every 24" MT 4718 N 9 f Studs at 16" OC c rn L--= 0 m z z � 0 D m -n. C.C) 0. n G)o zgo cf)CnD �> Existing concrete Secured to floor with powdered slab Milli 11/2" fasteners along a track every 1601 Machhe Cuter an OF Ej??. I ME 07 CK -0914 1056 mmw *w dO to 3 1/4 FM 11110 J If 1-1 219 (l 1 '14,77 - 2,8a -7 ?oarow tm% XZ 3,10-3 kn4x. 3m: is tA'm J --,:: &.1. t-'.- i THE DISPLAY + EXHIMT SOLMM DRAGIC SCU NTS 4715 MaflfffidW, TX 7520 FN " M -M FAX (" 73-6731 45 - 15A F L 1-1 219 (l 1 '14,77 - 2,8a -7 ?oarow tm% XZ 3,10-3 kn4x. 3m: is tA'm J --,:: &.1. t-'.- i THE DISPLAY + EXHIMT SOLMM DRAGIC SCU NTS 4715 MaflfffidW, TX 7520 FN " M -M FAX (" 73-6731 I . . I a � 2 {1j22 �2 (07/11/02) Storage (2) ee•a. .�A�:i.c9: +•�5��..� •st +mtomf.:T:t�• :-u::. ?ai inmr:: mei* e9+ al hxr+md dreset dq% b 19 (07/13/02) � � ���_: •"s. -nom -i =0 E.Q.P.Ism 47 (9 D2 I Em- Imsmognm THE DISPLAY + EXHIBIT SOME x m®t weil 10 IM6*4 QRM $ • HE 4715 W1IB1 AILLAS, 47 732$4 FR( t _ PH It 239-0061 fAl (972) Tffi-W# i IAN F==1 101 r i� In � I! id la I I0il o j II1�M I 0111 l B I I I{I ql I III �I ®_—_�--- i r -.—n 0 I 9� 36 � �4 -I------23A -21--' 4i2�- oB � _Cat��rn ?tµ� 269'LBo- 171 _ ` CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE __ BY jS�Qtt1 E LV{Aftei CN' V 1�6 d , 1 (1) laa;Q drmu *6 b 19 (07 j13j02) Q o Hill if �_=J hill II Y#�s ID1 rt �s:b 7H 0%+7t r?t ..aye eP THE DISPLAY + - EXH8T SOME MS MdM VALLA TI 75244 pH 074 BMW FM 1974 725-011 ERP. '� 07/09/02 "'� ` "� Ai�1G $QBE ITS 1) AIDE{ ) - ire 4 DO — Sia a t' 1919 I IdlO MW �__� 0181 I 11 li hill I I low II 11 hill I i 1011 I 1010 o Hill if �_=J hill II 72----- —1 • 4 C7(4� 167-.80-7 I-----22 --I ` CITY OF LA QUINTA TUILDING & SAFETY DEPT. 20 J4APPROVED FOR CONSTRUCTION _ L i DATE BY • It R - w 1. ......... _ - CITY OF LA QUANTA BUILDING & SAFE i Y DEPT. c APPROVE® _ FOR CONSTRUCTION ` it d.,�e�► k:. ATE BY 1T Q a - �g�T Z'oe�uel-t7a C�(�� 2(07-x$07 A fMv Coster - 1056 0 ap. 0710/V 4* 19 F-- 22 . sa-1 c f ;v: !bio n (EDO >4 THE DISPLAY + EXHIBIT SOURCE SCALE: ro 4715 AM DALUS U 75244 PH (" 2391-M FAX (9m 73-01 CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE BY4 I M�