04-3623 (RC)3
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BUILDING &. SAFETY DEPARTMENT
P.O. BOX 1504 (760) 777-7012
78-.495 CALLE'TAMPICO FAX (760) 777-7011
LA .Q.UINTA, CAiIFORN.IA 92253 INSPECTION REQUESTS (760)777-7153
BUILDING PERMIT
Application Number 04-00003623 Date 4/21/04
Property Address . . . . . 79295 HIGHWAY 111
APN: 649-030-999-1 -30420 -
Application description . . . REMODEL - COMMERCIAL
Property Zoning . . . . . . REGIONAL COMMERCIAL
Application valuation . . . . 5000
Owner
STAMKO DEV CO
C/O PROVIDENT FINANCIAL MGMT
10345 W OLYMPIC BLVD 2 FL
LOS ANGELES CA 90064
Contractor
COLORADO STRUCTURES, INC.
5060 ROBERT J MTHWS PRKWY #110
EL DORADO HILLS CA 95762
(716) 941-7900
WCC: HRH OF COLORADO
WC:. 109835252 11/01/04
CSLB: 710391 07/31/04
CCC: B
-------------------------- Structure Information -------------------------
Construction Type . . . . . TYPE V - NON RATED
Occupancy Type . . . . . MERCANTILE
Other struct info . ... . . CODE EDITION
FIRE SPRINKLERS YES
---------------------------------=------------------------------------------
Permit . . . . . . .BUILDING PERMIT
Additional desc
Permit Fee 72.00 Plan Check Fee. 46..80
Issue Date . . . . . Valuation --., �� hy� 5000
Qty Unit Charge Per '; --'hEXtension
BASE FEE e j , ;'-' 2 � � ,� 45.00
3.00 9.0000 THOU BLDG 2,001-25,000 M 27.00
---------
Permit . . . . . . MECHANICAL
Additional desc . .
Permit Fee . . . . 28.00 Plan Check Fee 7.00
Issue Date . . . . Valuation . . 0
Qty Unit Charge Per Extension.
BASE FEE 15.00
1.00 6.5000 EA MECH_VENT FAN 6.50
1.00 6.5000 EA MECH EXHAUST HOOD 6.50
----------------------------------------------------------------------------
Permit . . . . . . ELECT - ADD/ALT/REM
P.O. Brix 1504 a
VOICE (760) 777-7012
78-495 CALLE TAMPICo FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
. Appl•Ication Number: (9 el Z Date: � - Z 2 - OX
Applicant: G�dIL Architect or Engineer.
Appl'icant's Marling Address: Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affarh under penalty of pexjury that I am'- 'under Provisions of Chaplet 0 nctiq vAh Session 7000) of Division 3 of the Business and Professionals
Code. and my Llcense�in kA force and effect
License pass License No. 7 1 3 9 j
Da*_42L o CarMrawor
OWNER -BUILDER DECLARATION
1 hereby affirm tinder penalty of perjury treat I am exempt tom the Contractors' Stale License Law for the klow kV mason (Sec- 703.1.6. Busiass and Professions Code: My
tdty or county rint fepirec a perils locasbuck ahem. hnp w, e. demolish, or repair ami WucuM prior loos issuance, also requires the applicant for the pemtit i o Ne a signed
t#aia,. that he or she Is licensed Pursuant 10 the provisions of the ConlraeWe State license Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he «she Is exempt 11m.661. and the basis for to alleged exemption. Any violation of Section 7031.5 by any applicant for a Permit subjects
the applicantloa civi penalty of not more than live hundred dollars ($5W0 y
U 1. as owner, of the property. or my enplayees with wages ens their 9010 oompensaiph,.wiM do the worts, wW the structure is not Intended or oRered for sale (Sec 7044.
Business and Professions Code: The contractors! State License Law does not appy to an owner of property who in" or improves thereon, and who does the work
twrtseff or herself ar through his or her own employees. Provided ghat the inprovemenls aro not Intended or ottered for salt it. however. the buid9q or improvement is
sold within one year o(conhpletion, the owner-04ilder will have the burden of proving that he or she did not build or irpnove for the purpose of sale.
U Lacs owner of the property. am exdusively eonbactk with: ense0 contractors to construct the Project (Sec. 7044. Business and Professions Code: The Contractors'
State License Law does not appy to an owner of property who builds or improves l eie and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec . BA P.C. for this reason
Date ` Owner
WORKERS• COMPENSATION DECLARATION
I hereby affirm under penalty of perjury ore of the following declarations:
—I have and wit maintain a certificate of consent to seN4nsure for workers' compensation, as provided for by Section 3700 of the Labor Code. forte pedomwwe
of the work for which this pet.. Is issued.
I have and will maintain workers• compensation isurence. as required by Section 3700 of to Labor Code. for the performance of rid work for which this permit is
Carries iim peed�My wafters' compensation Insurance carrier and policy nunnbet are:
POW Number �,� 51 3 S-2 S Z
_ I =* riot, In the performance of to wok for which this pem* is Issued. I shall not Wm Fn_ any person In any manner 90 its to become subject to to workers'
compensation laws of Caifomia. and agree that, If 1 should became akied fo to workers' compensation provisions of section 3700 of the Labor Code. I shat
kWflwft.c1x ply w tti those provisions.
WARNING: FAILURE TO SECURE WOWCERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES MID
CML FINES UP TO ONE HUNDRED T HOUSAM DOLLARS ($100.000). IN AMMON TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE. MEREST. AND ATTORNEY'S FEES. .
CONSTRUCTION
1 hereby affirm under Penalty o Perjury that two is a construction lending he pe perfaft AGENCY
lenp agency for the mance of the wok for which this pemtit is issued (Sec. 3097. Civ. C.).
/ Lenders Name
Lenders Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Butkfing and Safety for a pemtit subject to the eortlitions 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 wock is perfumed under or pursuant to. any permit
Issued as a result of this application, the owner. and the applicant, each agrees to. and chap, defend. indemnify and hold harmless the City of La Gulnta, is
officers. agents and employees for any act or orttission related to the wok being perkxmed under or following issuance of this Permit.
.2. Any permit issued as a Mutt of this application becomes null and void It work Is not commenced within 160 d4Ys from date of Issuance of such Penn' or
cessation of wock for 160 days will subject permit to cancellation.
I certify that I have read this application and state That the above Iniformation is correct 1 spree to comply with as city and county ord nancds and state laws relating to building
constvcft . and hereby authorize representatives of this County to enter upon the above-mentioned property for Inspection purposes.
Date 2 z �7 Signature (Applicant or Agent):
Page
2
Application Number . . . . 04-00003623
Date
4/21/04
Additional desc
Permit Fee . . . . 18.00
Plan Check Fee
4.88
Issue Date . . . .
Valuation . . . .
0
Qty Unit Charge Per
Extension
BASE FEE
15.00
4.00 .7500 PER ELEC DEVICE/FIXTURE
1ST 20
3.00
Special Notes and Comments
SERVICE DELI REMODEL - ADD ROTISSERIE
UNIT AND TYPE I EXHAUST HOOD, WALMART
CCD #16.
Other Fees . . . . . . . . . STRONG
MOTION (SMI) - COM
1.05
Fee summary Charged Paid
Credited
Due
Permit Fee Total 118.00
.00 .00
118.00
Plan Check Total 58.68
.00 .00
58.68
Other Fee Total 1.05
.00 .00
1.05
Grand Total 177.73
.00 .00
177.73
RIVERSIDE COUNTY FIRE DEPARTMENT
In cooperation with the
California Department of Forestry and Fire Protection
82-675 Highway 111, 2nd FI., Indio, CA 92201 • (760) 863-8886 • Fax (760) 863-7072
March 19, 2004
Tom Tisdale Perkowitz + Ruth Architects
r Fire Chief '
111 W. Ocean Blvd.; 21"t Floor '
Proudly serving the Long Beach, CA 90802
unincorporated
areas of Riverside Re: Hood & Duct Mechanical Plan Review ,
County and the LAQ-04-TI-040 / Super WalMart Deli
Cities of.
Fire Department personnel have reviewed and approved the plans submitted for the above referenced
Banning project. Please be advised the following conditions apply as apart of the conditions for the issuance of
a building permit.
Beaumont
Calimesa 1) Install a Hood/Duct automatic fire extinguishing system. System plans must be submitted, along
1C, $ I with a plan check/inspection fee, to the Fire Department for review.
Canyon Lake
e. 2) Plans must be reviewed and approved by the City of La Quinta Building Dept. prior to installing
Coachella equipment.
Desert Hot Springs Applicantllnstaller shall be responsible to contact the Fire Department to schedule inspections.
Requests for inspections are to be made at least 24 hours in advance and may be arranged by calling
Indian Wells (760) 863-8886.
Indio All questions regarding the meaning of these conditions should be referred to the Fire Department
r Lake Elsinore, Planning & Engineering staff at (760) 863-8886.
La Quinta
�• Sincerely,
Moreno Valley
d• FRANK KAWASAKI
Palm Desert Chief Fire Department Planner
Perris
eti
Rancho Mirage
By !�
San Jacinto Walter Brandes
Temecula Fire Safety Specialist
- .
Cc: CRY of La Quinta — Building. Dept
Board of Supervisors ,
Bob Buster,
District 1
John Tavaglione,
District 2 ,^
Jim Venable,
District 3
ti
Roy Wilson, -
District 4
r 022 Dada, oamdwRaEcrsv4&auo-o4Tn )MXa).du
Marion Ashley
District 5
EMERGENCY SERVICES DIVISION • PLANNING SECTION • INDIO OFFICE
82-675 Highway 111, 2^d FI., Indio, CA 92201 • (760) 863-8886 • Fax (760) 863-7072