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14-0272 (RC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Td4t 4 4 0" Application Number: 14-00000272 Property Address: 79795 HIGHWAY 111 APN: 600-020-033- - - Application description: REMODEL - COMMERCIAL Property Zoning: COMMERCIAL PARK Application valuation: 50000 A Appj' and Architect or Engineer: 01 �-- X)AL BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: COSTCO WHOLESALE CORP 999 LAKE DRIVE ISSAQUAH, WA 98027 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/17/14 II APR. 2011, {� L.} CITY OF LA QUANTA -- - - - - - - - - - ----------------------------------- _----------------- ----- - - - - -j _ --_..--- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perju 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 Busin 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 Li, 66177 for by Sec7pe.on', he Labor Code, for the performance of the work for which this permit is ` is sued. f7aie: contractor: _ I have and III miker8' compensation insurance, as required by Section 3700 of the Labor _ �� a -5 Code, f hece of the work for which this permit is issued. My workers' compensation "YOWN ILDER DECLARATION insurance icy number are: 1 hereby affir under penalty of perjury that I am a pt m the Contractor's State License Law for the Carrier EVEREST INSPolicy Number 760006791 following reason (Sec. 7031.5, Business and Pr ns C e; Any city or county that requires a permit to construct, alter, improve, demolish, or repair any stru 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 �) 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 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. , 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: Contractor: HARVEY INC 8973 COMPLEX DRV, SAN DIEGO, CA 92 (858)769-4000 1 Lic. No.: 8661771 I cartity that, in the ormancs of the work for which this permit is issued, I shall not employ any person in any mertner as to become subject to the workers' compensation laws of California, and agree that, if I shouk ma subject to the workers' compensation provisions of Section 371 of the Labor Code, Is I forthwith comply with ovisions. 4 Date: Applicant: WARNING: VIE TO SECURE WORKERS' COMPENSAT COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND IVI PINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF OMA SATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND TTO EY'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 appl�ca tc, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, ents and emplc es for any act or omission related to the work being performed under or foiiowi issuance of this permit. 2. Any permit issued as a result is application becomes null and void if work is not commenced within 180 days from date of )ss 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 t hove information is correct. I agree to comply with all city and county ordinances and state laws relating to buildin nsiruction. and hereby authorize representatives of this. my to anF{{er upon the abrne-mentioned property for i ection purposes. ,Dare: { 151gnature (Applicant or Agerrri:'- V LQPERMIT Application Number . . . . . 14-00000272 Permit . . . . . . ELECTRICAL 2013 Additional desc . . Permit Fee . . . . 71.49 Plan Check Fee .00 Issue Date . . . . Valuation 0 Expiration Date . . 10/14/14 Qty Unit Charge Per Extension 3.00 23.8300 EA ELEC APPLIANCES, NON-RES 71.49 Permit _ . . . _ . MECHANICAL 2013 Additional desc . . Permit Fee . . _ _ 23.84 Plan Check Fee .00 Issue Date . . . Valuation 0 Expiration Date . . 10/14/14 Qty Unit Charge Per Extension 1.00 11.9200 EA MECH APPL REP/ALT 11.92 1.00 ----------------------------------------------------------------------------- 11.9200 EA MECH EXHAUST HOOD 11.92 Permit _ . . PLUMBING 2013 Additional desc . . Permit Fee . . . . 35.76 Plan Check Fee .00 Issue Date Valuation . . . . 0 Expiration Date _ 10/14/14 Qty Unit Charge Per Extension 3.00 ---------------------------------------------------------------------------- 11.9200 LS PLEG GAS SYS, 1-4 OUTLETS 35.76 Permit . . . REMODEL 2013 Additional desc . . Permit Fee . . _ . 70.07 Plan Check Fee _ .00 Issue Date . . . . Valuation 0 Expiration Date . . 10/14/14 Qty Unit Charge Per Extension 1.00 48.6200 LS MISC REMODEL, 1ST 100 SF 48.62 1.00 21.4500 EA MISC REMODEL, ADDL 500 SF 21.45 ---------------------------------------------------------------------------- Special Notes and Comments REMOVE AND REPLACE PIZZA OVEN AND HOOD March 28, 2014 12:45:53 PM JJOHNSON. ----------------------------------------------------------------------------- Other Fees . _ _ PLAN CHECK, ELECTRICAL 71.49 PLAN CHECK, REMODEL 150.15 LQPERMIT Application Number . . . . . 14-00000272 Other Fees PLAN CHECK, MECHANICAL 9.54 PLAN CHECK, PLUMBING 23.83 STRONG MOTION (SMI) - COM 10.50 Fee summary Charged Paid Credited Due Permit Fee Total 201.16 .00 .00 201.16 Plan Check Total .00 .00 .00 .00 Other Fee Total 265.51 .00 .00 265.51 Grand Total 466.67 .00 .00 466.67 LQPERMIT f Bin # City of La Quinta -Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # n Project Address: _% 9•�5 t-i�(,1 r 1 1 (� Owner's Name: A. P. Number: `� Ql!—✓�tr�4 �.e -S 3 Address: 99CI �� \�2�✓ts City, ST, Zip: UJA c) cg06 Legal Description: i�` I-1'j6& Contractor: tOQec one: Address: Project Description tZZA. 14COD — City, ST, Zip: cp A d 1 a-3 5t' vl LE , Telephone: C9!�_ /'Ocx: ) z> ?'> 2r"s.':':>«>#: `s::s: z::<;:< s :. >.:::<r,.:;., s State Lic. # : F3GX0 I City Lie. #: Arch., Engr., Designer: t( j _\IA'J'\JY Address: t I [C) j City., ST, Zip: 13e LE t, cigto4- Telephone: �� LI-�3 anGb i$F:•: ""'' ' «:<.<::::•>•;•. •> •:.:«:•>.:: Construction Type: Occupancy: YP P Y State Lic. #: Project type (circle one): New Add, n Alter Repair Demo Name of Contact Person: G�-L I Mc,4A5 Sq. Ft.: # Stories: # Units: Telephone #,of Contact Person: (a� 400e!> Estimated Value of Project: 517, 000. C'0 APPLICANT: DO NOT WRITE BELOW THIS LINE "Y Submittal Req'd' Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount 2 Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person Plan Check Balance. Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan god Review, ready for correction issue 3 Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN IiOUSE.- 'rd Review, ready for corrections/issue stq Developer Impact Fee Planning Approval Called Contact Person ' A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees 3& 12�i9D Tb Sts 0 �- RIVERSIDE COUNTY COMM UNITY'HEAL'TH'AGENCY; DEPARTMENT OF ENVIRONMENTAL HEALTH" FOOD ESTABLISHMENT PLAN APPROVAL NOTICE SR# 30660 Date 4-17-14 Project Name Costco Wholesale Corp #628 Address 79795 Highway l 11, La Quinta CA Plans Submitted by - Kate Hanson Phone. 858-769-4000 Owner Costco #638 Phone None listed . t. The plans are now approved subject to the conditions listed below and the attached compliance sheet. This is for a remodel for replacing existing pizza equipment with a new type 2 hood and three deck door pizza oven only. ' 1. Finishes will be evaluated onsite. r CONSTRUCTION INSPECTIONS: Contact the Plan Checker for a Preliminary Inspection when construction is approximately 80% complete, with plumbing, rough ventilation, and rough equipment installed. Request for inspection should be made at least five (5) working days in advance. r A FINAL INSPECTION MUST be made upon completion of ALL work including finished details. APPROVAL to operate shall not be granted, or remodeled areas approved to operate, until the facility has passed the FINAL INSPECTION, and "APPLICATION TO OPERATE" has been completed and PERMIT FEES have been paid. Request for inspection sh Id --'be made at least five (5) working days in advance. ; PLANS CHECKED BY Tracey Ford, EHS Phone - (760) 863-8287 I acknowledge the corrections noted herein and indicated on the plans and agree to inco orate them during construction: a j,Signature Date •tom, �c Company Name - DEH-SAN-178 (Rev 2/06) > Corona Hemet Indio Murrieta Palm Springs Riverside - 2275 S. Main St 800 S. Sanderson 47-950 Arabia St 38740 Sky Canyon 554 S. Paseo Dorotea 4065 County. Suite 204 (951) 766-2824 "A" Dr " 'r (760) 320-1048 Cir (951) 273-9140 Fax (951) 766- (760) 863-8287 (951) 461-0284 Fax (760) 320-1470 (951) 358-5172 Fax (951) 520-8319 7874 Fax (760) 863- Fax (951) 461-0245 Fax (951) 358-.' 8303 5017 Department Web Site — www.riveoeh.org r r