The URL can be used to link to this page

10-0465 (SOTB)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000465' Property Address: 79295 HIGHWAY 111 APN: 600-340-027- - Application description: STRUCTURES OTHER THAN Property Zoning: REGIONAL COMMERCIAL Application valuation: 275000 Applicant: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT BUILDINGS Architect or Engineer: T ss psv f c"i- A 4AA1 . �'Gi83gq VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: WALMART REAL ESTATE BUS. TRUST PO BOX 8050 BENTONVILLE, AR 72712 Contractor: HBI CONSTRUCTION, INC. 4921 BIRCH STREET, SUITE !F NEWPORT BEACH, CA 92660 (949)851-2211 tic. No.: 667051 Date: 9/13/10 Q OCT 2 0 2010 CITY OF LA QWNTA ------------------------------------------------------------------------------------------------- LICENS CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am li ensed 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 Pr essionals 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-A License No.: 667051 for by Section 3700 of the Labor Code, for the .performance of the work for which this permit is /a/��/ // Dat (( � /Contractor: 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 OWNER-BUIL ER DECLARATION insurance carrier and policy nu bar are: , 1 hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND olicy'Number 719000087 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of a 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 be me 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 bject 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 de, I shall fort with comply with those provisions. 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.: Date: 10IZ. 1 114pplicant: (_) 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 WARNING: FAILURE TO SECURE WORKERS' C NSA 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 1$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 _ 1 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. 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: LQPE14-s1IT _ 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 ull and void if work is not commenced within 180 days from date of issuance of such permit, or essation of work for 180 days will subject permit to. cancellation. certify that 1 have read this application and state that the above inform tion is correct. I agree to comply with all city and county ordinances and state laws relating to building constructio , and hereby authorize representatives county to enter upon the above -mentioned y for inspection urposes. Date;�Ol��/Signature (Applicant or Agent): 'tl Application Number . . . . . 10-00000465 Permit BUILDING PERMIT Additional.desc RACKING & SHELVING Permit Fee 1252.00 Plan Check Fee 813.80 Issue Date . . . . Valuation 275000 Expiration Date-. 3/12/11 Qty Unit Charge 'Per Extension BASE FEE 639.50 175.00 3.5000 THOU BLDG 100,001-500,000 612.50 ---------------------------------------------------------------------------- Special Notes and Comments RACKING & SHELVING IN GENERAL MERCHANDISE AREA FOR"WALMART RETAIL STORE PER ENGINEERED DRAWINGS. 2007 CBC. ---------------------------------------------------------------------------- Other Fees . . . ... . . ACCESSIBILITY PLAN REVIEW 81.38 ART IN PUBLIC PLACES-COM 1355.00 BLDG STDS ADMIN (SB1473) 11.00 STRONG MOTION (SMI) - COM 57.75 Fee.summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 1252.00 .00 .00 1252.00 Plan Check Total 813.80 .00 .00 813.80 Other Fee Total 1505.13 .00 .00 1505.13 Grand Total 3570.93 .00 .00 3570.93 0 LQPE%NfIT C City of La Quinta Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: 79295 Us Hwy 111 Owner's Name: Wa1mart R.E. Business Trust A. P. Number: 6 0 0- 3 4 0- 0 2 7 Address: 7 0 2 S: W. Eighth Street Legal Description: City, ST,Zip:Bentonville, AR 72716 Contractor • To Be Determined Telephone: 479-204-0220 <~r=<:.>•»«::>>::[><_r':< Address: TBD Project Description: Ra c k i ng plan submittal. City, ST, Zip: TBD Telephone: TBD L::<:'.3::2:rit.vr::ii: •i: j:(iiii'l.� :'?} ::5:':: "V'nJ -...<.:�».�<�:::::�r:>>::<:>.ii:><.;:r:•<::�i:>:.. State Lic. # : TBD City Lic. #.: TBD Arch., Engr., Designer: Jame s A. Ha i l ey Address:6700 Antioch Plaza, Ste. 300 City, ST,Zip:Merriam, KS 66204 Telephone: 913 - 2 6 2- 9 0 9 5 Construction TYPe • VN Occu an cY: S3, M , A3 State Lic.#: C-30870" ' ' :=�::'`::;»;�-�. Project type (circle one): New Addn Alter Repair Demo Name of Contact Person: Che 1 sea Covington Maass Sq. Ft.:50 000 1 #Stories: 1 #Units: Telephone # of Contact Person: 415 - 7 8 2 - 4101 Estimated Value of Project: $ 2 7 5 , 0 0 0 . 0 0 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACING PERMIT FEES Plan Sets Plan Check submi �� Item Amount Structural Calcs. Reviewed, ready K c07ectiony Plan Check Deposit Truss Calcs. Called Contact Pe n 7 Plan Check Balance. Title 24 Caics. Plans picked up Construction Flood plain plan Plans resubmitted_ Mechanical Grading plan 2°d Review, ready for Corr ectio i ue Z Electrical Subcontactor List Called Contact Person Gt' I i> a� Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 7rd Review, ready for corrections/issueDeveloper Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees 3570•`�3 Total Permit Fees IQ5- RfZ:- bkk - -ie �� --P 3,