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0401-298 (RC)78015 Main St Ste 100 0401-298 LICENSE D CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and C14 W Professionals Code, and my License is in full force and effect. O =) C) License # Lic. Class Exp. Date CY In W 771 i$:3 B 12,t30/2.( ., .o Z r-- fDate Signature of Contractor- CoOr J U C) OWNER -BUILDER DECLARATION W W r- I hereby affirm under penalty of perjury that I am exempt from the Contractor's ~ Cl to License Law for the following reason: Z_ ( ) 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). C0 () I am exempt under Section , B&P.C. for this reason ul C\1 Date Signature of Owner ON CA Q WORKER'S COMPENSATION DECLARATION p Cc I hereby affirm under penalty of perjury one of the following declarations: `r H p () 1 have and will maintain a certificate of consent to self -insure for workers' X w = compensation, as provided for by Section 3700 of the Labor Code, for the O Q performance of the work for which this permit is issued. Go Q U ( ) I have and will maintain workers' compensation insurance, as required by O Q Section 3700 of the Labor Code, for the performance of the work for which this d 0)H permit is issued. My workers' compensation insurance carrier & policy no. are: It Z Carrier STATEC, F 111 I1 + Policy No. 1,iATi15 ^3 oo 0 r- C) J (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 3 subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: f Applicant - : l t H r• — • 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 hi application. 1. Each person upon whose behalf this application is made & each person tD whose request and for whose benefit work is performed under or pursuant o any permit issued as a result of this applicaton agrees to, & shall, indemn f, & hold harmless the City of La Quinta, its officers, agents and employe s✓ 2. Any permit issued as a result of this application becomes null and voi if work is not commenced within 180 days from date of issuance of s ch permit, or cessation of work for 180 days will subject permit to cancellat I certify that I have 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 fthe above-mentioned property for inspection purposes. Signature (Owner/Agent) I 0 r /)• . Date ''- •u/, I r y , + BUILDING PERMIT PERMIT# £G1 -mac DATE VALUATION LOT TRACT JOB SITE ADDRESS ^jitiCliv Il:fYalla.1.(l i APN w OWNER CONTRACTOR / DESIGNER / ENGINEER OLD P,,YV41" LA QTJR4Tii LT.G MARVIN HOVIES 7F-080 C.Ai,L ,=ADO 9TE201 78.080 OAi.Ue,HST -100 TE 201 L7s t UNTA. CA 92253 I;P,. Quaq:irk CA 92253 (766)771-2567 01314 5407 USE OF PERMIT COMM:-MCCIAT I rr fiC31 i»J COlJIMERCIA.i. R MODSL (STUIrr PIZZA) 4,0.73 SQFT, ': fPIEV14 SPRIT MLELG 'A.a OCCUPANCY, OCCUPANT LOAD 261 (11YNWi/TC,00R .ElKiN0)11`ftiTF..` TIaAT1,0N FRE IMPDSZLI RX1, WORK PZRP`OR.MUJD',WTi40EUT ''.e4.1.t1.f TIC ?i 3 Q2,fl Lam' EYJVAATKD COST OF CONSTRUCTION 2.00 33A2.00 1'K1dL+11*F li'ET, SUMMARY PlAli C'HECK rSF 101.000.439-318 S.210,28 CONSTRUCTION FEE 101-000.418-000 $323.1" N1 ECHAIN I CA LbEE 101.000.4:11-,00 J S45,S0 F..LECTRIC,NI, PY9 101-000•1420-000 $34.96 P1+i3 ABD46) FEE 101.000.419.000 V93.25 3T]1ON ?'MMT! N PKE - COA.E1i 100-000-241-000 aNf LST i 0ATJ ON FER 101-000-423.000 ' a p„1 TOTAf C:E".ItTSfECfJO"1:TON .ANj-) PLAt3 CIMi'X $1,391..80 »... UI S,S PRL LPAM:F.M. 'I+S It0.U4 Ci y ®, - FINANCE RECEIPT DATE BY DATE FINALED INSPECTOR 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 0.K to Wrap _ Framing tet/ F.A.U. 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 BLOCKWALL APPROVALS POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final I I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines — - Q 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 Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: John R. Hawkins Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of- Banning £ Banning 4. Beaumont 40 Calimesa Canyon Lake Coachella Desert Hot Springs 4. Indian Wells Indio Lake Elsinore .P. - La Quinta 4. Moreno Valley Palm Desert Perris Rancho Mirage 4. Rubidoux CSD San Jacinto Temecula Board of Supervisors Bob Buster, District I John Tavaglione, District 2 Jeff Stone, District 3 Roy Wilson, District 4 Marion Ashley, District 5 yRIVERSIDE COUNTY FIRE DEPARTMENT In cooperation with the California Department of Forestry and Fire Protection 77-933 Las Montanas Rd STE 201 • Palm Desert, CA 92211 • (760) 863-8886 • Fax (760) 863-7072 December 14, 2009 RE: TENANT IMPROVEMENT PLAN CHECK LAQ-09-TI-043 Stuft Pizza Addition 78-015 Main Street # 103 La Quinta, CA You have been issued a release for a tenant improvement on an existing building. THIS IS NOT AN OCCUPANCY PERMIT. It is prohibited to use/processor store any materials in this occupancy that would classify it as an "H" occupancy per Sec. 307 of the 20007 UBC. THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO INSPECTION: Install door hardware and exit signs as per Chapter 10 of the 2007 UBC. A minimum 2A1 OBC Fire Extinguisher, (State Fire Marshal Approved) must be mounted in a visible location within 75' walking distance from any point in your building or suite. Fire extinguishers can be installed by a licensed extinguisher company with a State Fire Marshal service tag attached to the extinguisher, or purchased from a retail store with a sales receipt attached. A licensed fire'extinguisher company must service extinguisher yearly. All breakers must be labeled and a clearance of 36 inches must be maintained around the panel at all times. 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 contrasting background. Provide key(s) to the tenant space for inclusion in the main building Knox Box. Key(s) shall have durable and legible tags affixed for identification of the correlating tenant space. Key(s) shall be provided at time of final inspection. An approved audible interior notification alarm device shall be provided in approved locations. A C-1 O licensed contractor must submit plans, designed in accordance with NFPA 72, 2002 Edition, to the Fire Department for review and approval prior to installation. 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 the Fire Department for review, along with a plan/inspection fee. The. sprinkler system will have to be modified and designed in accordance with NFPA 13, 2002 Edition. A licensed C-16 contractor shall do all sprinkler work and certification. The approved plans, with Fire Department Job card must be at the job site for all inspections. Approved suite address shall be placed in such a position to be plainly visible and legible from the street. Said numbers shall contrast with their background. 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 inspections are to be made at least 72 hours in advance and may be arranged by calling (760) 863-8886. All questions regarding the meaning of these conditions should be referred to the Fire Department Planning & Engineering Staff at (760) 863-8886. incerely, By: . Jaso Stubble Fire Safety Specialist Fill indicates area under existing roof trellis to be enclosed. El I I I I I III ............ I ............. I ........ ...................................... ... ... ......... ......... ........ ............ ......................................... Pot with Bouganvillea espalliered on wall Poche indicates new walls SITE/FLOOR PLAN ADDENDUM A 3/3/04 1/4" = V-0" 111111 john stanford architect In73-350 el pasec, suite 207 palm desert, ca. tel. (760) 776-8478 fax (760) 776-8477 Area in question Existing facade r - — — — — — — — --- I I I ": DO 00 00 ❑❑ ED] ED] 'DD 0 00 00 D Do L---- J In fill existing arch with exterior plaster finshed to match existing 6070 solid panel doors New light fixt. to match existing Bottom of fixture to be a minimum of 80" above fin. grade SOUTH ELEVATION ADDENDUM A john stanford architect 73-350 el paseo suite 207 palm desert, ca. tel. (760) 776-8478 fax (760) 776-8477 3/3/04 1/8" = 1'-0" 2 sa- —Q Temporaryo Certificate of ° Occupancy U LNXMORATM G OF Taw 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: 78-015 SUITE 100 Use classification: COMM Building Permit No.: 0401-298 Occupancy Group: A3 Type of Construction: VN -SPRINKLED Land Use Zone: VC Owner of Building: OLD TOWN LA QUINT LLC Address: 78-080 CALLE ESTADO SUITE 201 City, ST, ZIP: LA QUINTA CA 92260 By: KIRK KIRKLAND Date: 10-29-2004/EXPIRES 11-29-2004 Building Offi al POST IN A CONSPICUOUS PLACE