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12-0183 (RC) 1 I IIIIIII IIID III VIII III 13 IE1T4hf4 P.O. BOX 11504 -- - -- VOICE(760) 777-7012 78-495 CALLE TAMPICO FAX(760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING&SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 3/26/12 Application Nurnber:-- _12-00000183 Owner: Property Address: 78900 AVENUE 47 STE 100 DEANZA PLAZA APARTMENTS 11 APN`. 643-090-016-286 -24230 78900 AVENUE 47 Application description: REMODEL - COMMERCIAL LA QUINTA; CA 92253 Property Zoning: REGIONAL COMMERCIAL Application valuation: 8000 D 4 Contractor: n Applicant: Architect or Engineer: VANDALAY GROUP IN r, HE 1 79405 HIGHWAY 111 P B 9144 n LA QUINTA, CA 92,253 c7 (619)889-0909 Lic. No. : 942744- -- - -- -- ---- --- -- --- - -- - - ----- -- - -- ---- -- --- ------ - ----------- --- - -- - - --- --- - - - ----- - -- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury 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 Business 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 Lic nse Class: B License No.: 942744 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Date: Z L tractor• _�� _ 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-BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier EXEMPT Policy Number EXEMPT 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 the 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 become 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 subject 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 Code,I shall forthwith 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($500).: te: 2 11- AiVeam: (_1 1,as owner of the property,or my employees with wages as their sole compensation,will do the work, and 1, structure is not intended or offered for sale(Sec.7044,Business and Professions Code: The WARNING: FAIL RE TO SECURE WORKERS'COMPENSATION CO AGE IS UNLAWFUL,-AND 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($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.). APPLICANT ACKNOWLEDGEMENT (_1 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044,Business and Professions Code: The Contractors'State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon,and who contracts for the projects with a contractor(s)licensed 1. Each person upon whose behalf this application is made,each person at whose request and for pursuant to the Contractors'State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_1 I am exempt under Sec. ,B.&P.C.for this reason 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. Date: Owner: 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 CONSTRUCTION LENDING AGENCY permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all work for which this permit is issued(Sec.3097,Civ.C.). city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. Lender's Name: f 1_11 ate: Signaa(Applicant or Agent): Lender's Address: LQPERMIT Application Number . . 12-00000183 ------ Structure Information BATHROOM ADDITION ----- Other struct info CODE EDITION 2010 FIRE SPRINKLERS FULLY MIXED-USE OCCUPANCY B -----------------=---------------------------------------------------------- Permit . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 16.40 Plan Check Fee 4.10 Issue Date . . . . Valuation 0 Expiration Date 9/22/12 Qty Unit Charge Per Extension BASE FEE 15.00 70.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 1.40 ----------------------------------------------------------=----------------- Permit . . . BUILDING PERMIT Additional desc . Permit Fee 99.00 Plan Check Fee 64.35 Issue Date . . . Valuation . . . . 8000 Expiration Date 9/22/12 Qty Unit Charge Per Extension BASE FEE 45.00 6.00 9.0000 THOU BLDG. 2,001-25,000 54.00 ---------------------------------------------------------------------------- Permit . . . MECHANICAL Additional desc . Permit Fee 26.00 Plan Check Fee 6.50 Issue Date . . . Valuation 0 Expiration Date 9/22/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 4.5000 EA MECH VENT INST/ DUCT ALT 4.50 1.00 6.5000 EA MECH VENT FAN 6.50 ------------------ - ------------------------------------------------------------ Permit . . . PLUMBING Additional desc . Permit Fee . . . . 27.00 Plan Check Fee 6.75 Issue .Date . . . . Valuation . . . . 0 Expiration Date 9/22/12 Qty Unit Charge Per Extension LQPERMIT Application Number. 12-00000183 . Permit . . PLUMBING Qty Unit Charge Per Extension BASE FEE 15.00 2.00 6.0000 EA PLB FIXTURE 12.00 -----------------------------------_----------------------------------------- Special Notes and Comments 70SF OFFICE TI = CONVERT EXISTING OFFICE SPACE INTO STORAGE CLOSET AND ACCESSIBLE BATHROOM. THIS PERMIT DOES NOT. INCLUDE ADDITIONAL CONDITIONED SPACE. 2010 CALIFORNIA BUILDING CODES. March 19, 2012 2:22:40 PM AORTEGA ---------------------------------------------------------------------------- Other Fees .. . . . . . . . . ACCESSIBILITY PLAN REVIEW 6.44 BLDG,STDS ADMIN (SB1473) 1.00 ENERGY REVIEW FEE 6.44 Fee summary Charged Paid Credited Due Permit Fee Total 168.40 . .00 .00 168.40 Plan Check Total 81.70 .00 .00 81.70 Other Fee Total 13.88 .00 .00 13.88 Grand Total 263.98 00 .00 .263.98 LQPERMIT _ • RtDE COUNW inn r IN COOPERATION WITH THE CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION g John R. Hawkins - Fire Chief ' 210 West-San Jacinto Avenue— Perris, CA 92570 (951)940-6900 —www.rvcfire.org PROUDLY SERVING THE UNINCORPORATED AREAS March 26, 2012 OF RIVERSIDE COUNTY AND THE CRIES OF: BANNING RE: TENANT IMPROVEMENT PLAN,CHECK-Non Structural RE-DESIGN LAQ-I2-TI-025 Dr.Moorjani Offie ADA Toilet 78-900 Ave 47#100 La Quinta,CA BEAUMONT CALIMESA CANYON LAKE You have been issued a release for a tenant improvement on an existing building. THIS IS NOT COACHELLA AN OCCUPANCY PERMIT. DESERT HOT SPRINGS It is prohibited to use/process or store any materials in this occupancy that would classify it as an EASTVALE "H" occupancy per Sec. 307 of the 2010 CBC. INDIAN WELLS INDIO THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO INSPECTION: JURUPA VALLEY LAKE ELSINORE All breakers must be labeled and a clearance of 36 inches must be maintained around the panel at all times. LA QUINTA MENIFEE A durable sign stating"This door to remain unlocked during business hours" shall be placed on or adjacent to the front exit door. The sign shall be in letters not less than one inch high on a MORENO VALLEY contrasting background. PALM DESERT PERRIS As may be necessary to maintain proper fire sprinkler protection due to constructions changes, fire sprinkler system plans for the tenant improvement area may be required to be submitted to RANCHO MIRAGE the Fire Department for review. RUBIDOUX CSD SAN JACINTO Applicant/installer shall be responsible to contact the Fire Department to schedule inspections. A re-inspection fee will be required if more than one(1) inspection is necessary. Requests for TEMECULA inspections are to be made at least 72 hours in advance and may be arranged by calling(760) WILDOMAR 863-8886. All questions regarding the meaning of these conditions should be referred to the Fire Department Planning&Engineering Staff at(760) 863-8886. BOARD OF SUPERVISORS: BOB BUSTER cerely, DISTRICT 1 JOHN TAVAGLIONE DISTRICT 2 By: JEFF STONE Jaso Stubble DISTRICT 3 Fire Safety Specialist JOHN BENOIT DISTRICT 4 MARION ASHLEY DISTRICT 5 .,... ,. Bin otv La QuintA 6 . BWkffng*Sbfe0,.DW6n Perini&: P.O.Box:t504,:78-495.Calle Tampico'. :' . Ca.Quinta,CA 92253-(760) 777-7012 Willing Pennit Application and Tracking Sheet Project Address: O Owner's Name:. A.P.Number. Address: . n� Legal Description: City,ST,Zip: Contractor. Telephone: Address: Project Description: City,ST,Zip: Telephone: State Lie.#: City Lie,#: Arch,Bag., er 6116e Address: a City,STS Zip: DrNe v4 Telephone: p'�1$'�� t ConstructlonType: . Ooahpaacy: State Lia#: Project type(circle one): New Add'n Alter Repair Demo Name of Conzacx Person: ` Sq.Ft.: T#Stories: #Units: Telephone#of Contact Person: �(p C� �Fj Estimated Value of Project APPLICANT:DO NOT WRITE BELOW THIS.LINE # Submittal Req'd Recd TRACMG PERMIT FEES Plan Sets Plan Check subtaltttd Amount Structural CaIes. Reviewed,ready for correcdons Plan Check Deposit. . 'less CaIcs• Called Contact Person Plan Check Balance Title 24 Calci. Plans picked up Construction Flood plain plan Plans resubmitted.' . Mechanical Grading plan 211 Review,ready for correctionstissue Eleedital Subcoataetor List Called Contact Person Plumbing Grant Deed Plans picked up I S.M.I. 19.0.A.Approval Plans resubmitted I Grading IN NOUS&- Review;relay for correctionsilzue Developer Impact Fee Planning Approval. Called Contact Person �• A.I.P.P. Pub.Wks.Appr Date of permit issue School Fen Total Permit Fees ,q 42c ���� � /! 7j? `CITY OF LA QUINTA SUB=CONTRACTOR :LIST T ' JOB ADDRESS�� 9Oa.A� 7 rI�1CLL k'T •PERMIT NUMBER OWNER BUILDER 16ya:C .. ..' This form shall be posted on .the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees ar a ithori ed to work . on this job, any changes to this list must be approved by the Building Division prior to commencement df work. Failure to comply will result in a stoppage of work and/or the voidarice . of building permit. For each-applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. trade / Cln's.sification Coctroctor State Cormactor•.s.License Wortc'ers Compensation I00urani;e ness License city•RtiS1 . .. Company Name Classification License Number Exp. Date Carrier Name Policy Number Exp. Date. License Number. Exp. Date (e.g. A, B, C-8) (xxxxxx) (xx/xx/xx) (e.g. State Fund, CalComp) (Format Varies) (xxlxx/xxl (xxxx) lxx/xx/xx1 7/c. `/ 1 31`/ L..D a. .-Ol/111-3 , ---- ? 3- .2 CONCRETE (0-8) 19L L 'FIR IC-5) 9S1 °BTRUCT. STEEL (C>51) MASONRY (6-29) PLUMBING (C-36) �O 3> l _ LATH, PLASTER (C-35) -9) pRYWALL (C � G��G� � ��� �/3/ �� V� �9'Y.�3 7l HV .. AC (C-20).' : ELECTRICAL (C-1'0:) - —�/ .20 ?.2l C34ex�AD X 38 31 ROOFING (C=39) . c :.SHE.F.T METAL'(C-43) ,/ FL.O.ORING (C-15) �j D C f7`t'C /S ['p 3(a 7` /p S g/3/�/2 Gv/!CS• �7 .ASB GLAZING (C-17) INSULATION(C-2) SEWAGE DISK. (C-42) PAINTING (0-33) , . P C -33 9 3l3/l/a 174.�os 3bK -20049 A 161131, CERAMIC TILT.(C-54). CABINETS 4C-6) FENCING (C-7:31 n LANDSCAPING ('C=27) POOL (C-531