The URL can be used to link to this page

0109-212 (CSCS)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I_am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date 445832, Ada L40 C-8 '01c9ab: c Date Af Signature of Contractor ,� • •�"y OWNER -BUILDER DECLARATION I hereby affirm- under penalty of perjury that I am exempt from the: Contractor's License Law for the following reason: ( ) 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). () I am exempt under Section B&P.C. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm .under penalty of perjury one of the following declarations: ( ) I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by rection 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier & policy no. are:. Carrier 'k l3'? VUND Policy No. _V61003$66 (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 subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro0isions.. ter' Date: !� ,f'�` " Applicant ,=/`" •'' �• ,..e- Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection,purposes. Signature (Owner/Agent) °` r"� f'•+' Dater, � =7 BUILDING PERMIT PERMITN 1 ORf-d DATE J VALUATION LOT TRACT. J / 1-7/2 29736-7 JOB SITE 1y,r ADDRESS r "v�P�b.�ZV'J 1.• APN !'.,ya°'�.'E'ti��:! OWNER CONTRACTOR / DESIGNER / EN (NEER j 0.1;t'9.0ME RMINa •i'17 aha TY 1 RD.iriUALDEPW 3525 HY14 )`7'D 63'�J : \ 1320 114 3- IMPSON :"ti 0.,rC L: .'Mk ij iMIA. CA 92626 A,].�IAHZM : Co. 9,29�a f (1m)533 -133a C)"Aldr' 6618 USE OF PERMIT 40.JW4-tt+dt' , C:3R,M,fy K/716 ;rl t;':Ar CE, STNNOW - OOMMERC'11AL MYR.C:A1V' ILE `4 3�334b5.i�} �iJl5�.�5�' l"OV.�;>,,i�01��'f'IC.i �3�.1��.iYC� til".o�'f�f�� t=`��fC�i?�' �;;•3 • �. wev SlYt'a13x$.tt V/L PO1.0 TYPA1 kC3 SF EAXA iGACARPOLT .;,590.08 Sir A/C -• COM M1 IRMA,% :t03&00 5P CONTRACT AMOUNT 3!;1,14 140 f -S Es smMarm COST air COIF "`)`§s.4 CTI(YO ME 01.00.41S-00%1 $113:16,00 PL/413°f f>kUXV 4-� � 1.01-0010-439-3 d 8 s 1, rn. 13 1.01-0010-439-318 FEE 1 IEPOS13' 101 G000 -439m318 -$1,500,00 EUt TIUC AL FEE Cal . { O -4?;? -000 S.M.02 Pl.f f'1k�.B.twa k 101-000-419-000 $964< � kl3WO MOTION .�`l±. - UCJ4M 100-000-241-000 ORA-INNO FEB 54 00,MLOf'>•.,R IMPACT T fVX S10,00 ,54 ,RT Sid T UIVIAC P•s ACYS - C OM3 270--000-445-000 $1.,490.31 °Et $15,,276.86 Rt7cF �� (`PRE 1X00' RE AN 1 i 1001 NOW CffV0 1AknQ 114 RECEIPT DATE BY� DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs O 2 Underground Ducts Forms & Footings G- Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap. F.A.U. Framing Compressor Insulation , O 2 Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wail Insulation Condensate Lines Party Wall Firewall Exterior Lath Xmv 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 Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines 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 ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fbdures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) - G COMMENTS: co/U. Virg S -.e— CAG— +Ow� ✓.�-.��w� ;,,,�IIC�w c�ul.�.�5 ,2.�-/ c�2 LGccif�c,.vL Tj! /✓Uo t L/—Gl-u2 !�� LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date 445832 AB D40 C-8 09/30/2( Date Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 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 ow&r of the property, am exclusively contracting 'with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code): () I am exempt under Section B&P.C. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ( ) I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is 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 insurance carrier & policy no. are: Carrier STATE FUND Policy No. ' 046-008566 (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 subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant 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, domages.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 his 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 applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 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 permit to cancellation. 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 the above-mentioned property for inspection purposes. Signature (Owner/Agent) Date BUILDING PERMIT PERMIT" ;�`,� ,-Y DATE VALUATION LOT 0109-212 TRACT 5298,062.00 29736-7 JOB SITE ADDRESS 78-34 HWY 111 APN 604-05O-035 OWNER CONTRACTOR / DESIGNER / EN (NEER TOSCO 1AAR1C=G COMPANY R D BUILDERS 3525 HYLAND AVE 1320 3 SEAPSON CIRCLE COSTAMESA CA 92626 ANAHEIM CA 92806 (714)533-1331 CBL4 6678 USE OF PERMIT COhDAE RCIAL CIRCLE K/76 SERVICE STATION - COMMERCIAL MERCANTILE (M 3936SF) W1512SF COVERED PATIO AND FUELING STATION CANOPY (S-3 5590SF SPRINKLED) PORCH/PATIO 512.00 SF GARAGE/CARPORT 5,590.00 SF A/C -- COMMERCIAL 3,936.00 SF CONTRACT AMOUNT 151,142.40 LS ESTIMATED COST OF CONSTRUCTION 298,062.00 PERAM FEE 9UhEW"Y CONSTRUCTION FEE 101-000-418-000 41,336.00 PLAN CHECK FEE 101-000-439-318 $1,179.15 FEE DEPOSIT 101-000-439-318 -$1,500.00 MECHANICAL FEE 101-000-421-000 $110.50 ELECTRICAL FEE 101-000-420-000 $273.02 PLUMBING FEE 101-000-419-000 $164.75 STRONG MOTION FEE - COMM 100-000-241-000 $62.59 ORADIN4 FEE 101-000-423-000 $20.00 DEVELOPER IMPACT FEE $10,640.54 ART IN PUBLIC PLACES - COMP 270-000-445-000 $1,490.31 SUB -TOTAL CONSTRUCTION AND PLAN C9HECK $15,276.86 LESS PRE -PAID FEES -$1,500.00 TOTAL PERAM FEES DUE NOW $13,776.86 RECEIPT DATE BY DATE FINALED INSPECTOR Jan -25-02 O4:4OP P. 02 T v « z Memorandum To: Greg Roberts From: Dawd Peyton Date: 01125/2002 Subject: TOSco, l a QuInla As requested we have reviewed digital photos of the subject Job site with regard to the market building faan&dons. it is our opinion that the vents; pipes, Band uitss, eta. p ,� the perimeter footing are normal for this type of structure. By way of this memo we are approving the insta 60n as it exists. Plewc contact nae if you require arty further information. NO.Sm t , CT �F 0AL�� I IJ I A. A, 7 A A 7 . n 7. 110 A City of La Quinta Developers Project Approval Form Prior to the issuance of Building Permits for the project listed below, the following Departmental ` clearances must be obtained. Please return thisform to the Building and Safety Department only 'after approval. Contact applicant for resolution of conditions preventing or delaying approval. Project: Circle K - Service Station/Store 78-364 Highway 111 Applicant Contact: Mark Kennedy (714) 769-2000 ii Application / Circulation Date: (2nd Revision) 1/04/03 Date Community,Development Department 4I Christine Iorio, Planning Manager Date Public Works Department Steve Speer, Senior Engineer D to .I h Tit�t 4 .4� Qui4v MEMORANDUM To: Greg Butler, Building & Safety Manager From: Christine di lorio, Planning Manager To CDD: /z Due date: Status: 3'—JC HE C K Building Plans Approval (this is NOT an approval to issue a Building Permit) The Community Development Department has reviewed the Building Plans for the following project: Description: C/ 2c- L4 S,^, T7 -o A//Sion.E Address or general location: APN and/or legal description: 79--39Y H,,,y /ll The Community Development Department finds that. - ... hat: ... these Building Plans do not require Community Development Department approval. ❑ ... these Building Plans are approved by the Community Development Department. ❑ ...these Building Plans require corrections. Please forward a copy of the attached corrections to the applicant. When the corrections are made please return them to the Community Development Department for review. Christine di lorio, Planning Manager Date r z T -4b- , t 4 Xfv Qumt MEMORANDUM TO: GREG BUTLER, BUILDING AND SAFETY DEPARTMENT FROM: FRED BAKER, PRINCIPAL PLANNER VIA: ..JERRY HERMAN, COMMUNITY DEVELOPMENT DIRECTOR SUBJECT: CONSTRUCTION DRAWINGS FOR CIRCLE K AND UNION 76 (SDP 2000-685) s DATE: NOVEMBER 20, 2001 The Community Development Department has reviewed the above noted project and r finds it not acceptable as submitted. The following items are to be corrected prior to Community Development Department approval: 1) the pre -finish orange sheet metal gutter for the canopy needs to painted to match the building i.e. not orange, and 2) the Virginia ledge stone veneer is not allowed per the Point Happy Specific Plan 2000-043. Should you have any questions, please contact me at extension #7065. A:\Bld Saf Plan Chk memo.wpd l 4 MEMORANDUM C OF I79 TO: Greg Butler, Building & Safety Manager. FROM: Raoul Martinez, Assistant Engineer II DATE: April 15, 2002 SUBJECT: Parcel Map 29736, Parcel 7, Toscoe - Circle K The Engineering Department agrees with issuing a Permanent Certificate of Occupancy, as all punch list items have been addressed and/or completed. The developer of the subject project has substantially completed the onsite improvements. If you have any questions please call me at x7047. RM:rm TAMDEMSTAMMartineiVnemo 02\Building & Safety\02415b.wpd NOTE: With proper validation ; this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) I For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS Subdivision Improvement Permit — Class I I I DATE: 1.2/17/2001 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION —CIRCLE K AT POTNT HAPPY PM 2o736 PAurFT j (Street address oe Description of Location) j PURPOSE OF CONSTRUCTION PRECISE GRADING AND PAVING Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 12/17/2001 SEE ATTACHEDISPECIAL CONDITIONS APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ 186,986.00 (Including removal of all obstruction, materials, and debris, backfilling, com- paction and placing permanent resurfacing and/or replacing improvements) Inconsideration of the granting of this permit, the applicant hereby agrees to: Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started. Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of La Quinta and to pay for any additional replacement necessary as the result of this work. Sig ature of Applicant or A TOSCO MARKETING COMPNAY Name of Applicant (please print) Business Address Telephone No. RD BUILDERS 1320 SOUTH SIMPSON CIRCLE ANAHEIM CA 92806 714 333 1331 Name of Contractor and Job Foreman Business Address Telephone No. 445832 Contractor's License No. City Business License No. STATE FUND 0 6010008566 Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class I I I f Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs Minor. Improvement Permit — Class IV: See attached schedule Inspection Fee Permit Fee - Penalty Cash Deposit -Surety Bond if required TOTAL: —1500.00, credit $ 4209.58 Receipt No. Received by Date Recorded by 3594 PERMIT VALIDATION PERMIT NO. 3594 a. 1 DATE APPROVED 12/17/2001 I . EXPIRATION DATE 12/17/2002 I DATE UED4 2-0 D By, d inistrative Authority Telephone: (760) 777-7075 Tbe' following General and Special Provisions are attached to and made a part of Permit No. -� J/ qt GENERAL PROVISIONS The following shall always apply: ENROACH ENT ON PRIVATE PROPERTY: This permit authorises work to be accomplished within City of La Quints right of way ONLY. Whenever construction extends within private property, it is the responsibility of the permittee for his contractors to secure permission from abutting property owners. Such authorization must be secured by the permittee prior to starting work. TRACKLAMG CONSTRUCTION EQU)IPMEM Cleated tracklaying construction equipment shall not be permitted to operate on any paved surface unless fitted with smooth -faced street pada. All mechanical outriggers shall be fitted with rubber street shoes to protect the paving during excavations. Rubber red equipment only shall be used in backfill operations in paved areas. If the existing pavement is scarred, spalled, or broken during the term of this contract, or if the pavement is marred, City of La Quints shall request that these portions of road be resurfaced over thew entire width. Resurfacing shall consist of out coat of two inches (2) of A.C. surfacing plus appropriate seal coat as specified above. PR07EC ON OF TRAFFIC: Ail excavations and work areas shall be properly lighted and barricaded as deemed necessary by the City Engineer or La Quints City Public Works inspectors. Suitable detours and detour signs sball be placed and maintained for the duration of the project. The City shall be notified.24 hours in advance of any traffic detours or delineations. CARE OF DRAINAGE STRUCTURES: Any drainage structure including corrugated metal pipe, concrete pipe, steel culvert and concrete structures encountered during excavation which necessitate removal shall be replaced in kind. In the event it becomes necessary to remove or cut existing drainage structures, City of La Quints shell be notified prior to commencement of this work. Drainage structures and open drains shall be kept free of debris at all times for proper drainage. RIGHT OF WAY CLEANUP. Any surplus materiel resulting from excavation and backfill operations shall be removed from the Tight of way. All paved surfaces shall be broomed clean of earth and other objectionable materials immediately after backfill and compaction. Existing gutter line and drainage ditches sbail be roplaced to their original standard or better. AU excess material shall be removed prior to paving. Water (eater #ball be used, as required, to sprinkle the job site to keep down dust conditions and shall be used immediately after backfill. DE -WATER OPERATIONS: If de -watering operations are required and pumps are forcing water on City of La Quints roads, it shall be the responsibility of the permittee (contractor) to control this water and to provide off-street barricades when necessary. CLOSING S77EM: No street shall be closed. A minimum of one lane of traffic aball be maintained at all times to provide limited access for the adjoining property owners and emergency vehicles. In the event it is felt by the permittee that be 'must close a street for any length of time, permittee sball contact this office to obtain the necessary permission. SPECIAL PROVISIONS The following shall apply when indicated: NOTIFICATION: Permittee shall notify the City at (619)777-7075 at least 48 hours in advance of starting construction. 2 UTIUX]ry CLEARANCE: (Substructures) Prior'to making any excavation within the City of La Quints right of way authorised by permit, the permittee shall contact all concerned utility companies relative to the location of existing substructures. Damage to existing substructures resulting from operations conducted under this permit &hall be the sole reapon#ibitity of the permittee. R3 U JI I7Y CLEARANCE- (Surface Structures) No work shall be done under this permit until all utilities are clear of the proposed work site. The permittee shall notify all concerned utility companies of the proposed work. R4 PAVEAGM WIDENING: Area between the proposed concrete gutter tine and the existing toad pavement @ball be surfaced with inches of A.C. paving placed on inches of class aggregate subbase course having an 'R' value of not less than and in conformance with City of La Quinta Road Improvement Standards and Specifications, Ordinance 0461. / PARKWAY GRADING: Area between the property line and top of the proposed concrete curb shall U graded to a slope of 1/4 inch to one foot (11. R6 GRADE CHECKING: City of La Quinta sball check grades upon receipt of plan and profile and/or grades as established by a licensed engineer. R7 CURB REMOVAL. FOR DRIVEWAYS: A portion of the existing concrete curb and/or curb and gutter (_feet) shall be removed. Curb and/or curb and gutter shall be saw cut prior to removal. Depressed curb, matching concrete gutter and concrete driveway approach shall be constructed in conformance with City of Le Quinta Standard #207. Its DRIVEWAYS: A.C. driveways @bell be constructed as not to alter existing drainage pattern. Surfacing between the property line and the existing road paving shall be 2 112 inches of A.C. paving placed on L_) of clava aggregate base. Driveway construction shall conform to attached drawing. R9 SIGHT CLEARANCE: Sight clearance of 600 feet in all directions shall be assured and maintained at all times. RIO SOIL SIERIIIZER: The area to be surfaced shall be treated with soil steriliser. Rate of application shall commply with. the manufacturer's specifications. •EL61 Almost palep '9a,o;!la0 jo a1n1S'9.(o mgl'H JO ao!s!A!Q'suoneoy!mdS PJBPaeiS aqi J0 10'E 9 act oaS gium Lldmoo paps s1ra3 aonoudmo0 •poglam plag ,o loedme ag1 Lq pan!m,alap se aonoedmoa ,algal ag1 9! JaAaga!tlmm'pana8 8atpano„n9 sip oi.iaa(sA!nba so 1nao,ad 06 aagl sal lou of paloBdmoo Pm pallyllaeq aq IIsg9 peoma, am moa; 8913lnni 93loq alml amp (p To m qnd Ra!lanan aql loalwd 03 pap!Ao,d aq 11sg9 9apeau,eq Cry m pan mazleg 'ea8ts asenbapV •amp ano Lae ze 1aa; OOS Jo mntu!xam s ¢3 paiouwa, aq pegs 1(3oAm aql 'agJen iO!ilsa of LJessama eamoaaq m asaq& •gdaamd 8almogo; atp m.pagtoads se paloadmoa Llglno,ogi pas paUUXmq aq II8g9 aloq dorms sg,L •,C—qg!q asp Jo —!A m m!ema sugap on leV m jo pasods!p pas pawoma aq gegr dmms aan.ag3 Jo q%pi m anua eq j *Vjm C—g2lq ci p—q m aouaaj,aia! Ingo- ,Cpjvs palpmq aq uao go!gAm 9aogoa9 at aq flays panoma aq of sm, L monsool mau ell is noq!p000 8mmo,8 sno,o8lA e m aa1 ag1 UMu!em M m!m,ad agi jo LUl!gl9aod9a, aql aq IlBg9 1( •ot(gnd f[2 BmlaAai alp 03 p,azeq so aoaa,a;jaiat 1nog1!Am Lla;ss palp0wq pas laatA,as *an pa,nsa! pus popuoq'pa9uao!l a dq pags!Idmoaae aq gegs .(— JO iq8!+ PBOJ aia!nDWI JO. LuO atg a!gl!Am aonwoop, m,t : WA0PM V0 NOLLV3013H 333iL KK w!edai ivaasm,ad jo aogaldmoa coda paaelda aq pegs gut d. gano 'pameoxl aq ol slmns no algm9 % qn9 rt 8atdu19 laa,W aaglYl :Sba mr tC m LMIMIS £ Z -r�aa!8a3 Li!O aql dq pau!—tap we seas timed Us ,aAo pagdda aq Irygr ao!9lnats an legdse Jo aonea!ldde us jo 8ans!saoa laoa leas 801 Y :'LV3S 90.1 Z'Z •J!eda, paw L,s,odmal jo uogaldmoa,aye step • aegl sale( on paowld aq Begs asap —13 qau! e no paoeld 8aimpris •0•y sagaa! jo gored ivaaem,ad y •Llmgpomme paoeld aq gsgs 009-:)S 10 (.Z) sagom oeu ;0 90gnsao3 paled L,e,odmal e''palaldmoa aaaq aeeq aonaedmoa pas IM=q ,sVV :1QVdCIli IlIQi1QAYd' IACiIt[VNIll3d f? •itmq Lep (S) aAg w paaoxa mamaAed Lmodusm atp jo luamaasid am [lags am on at inq 'pataldmoa 9aou"o,11y11oeq pas paleAsaxa uoaq seq gouan JO mi ,eautl000E;o mmmrcaia e,aye paoeld aq 1pgs 8a!Awd L,a,odmn 008-,S aqy •ape,8gns paeda,d a no paoeld aq llsgs 00S -JS Jo sagom Z jo 8un9!9¢03 gored L,s,odmal a •sao!ie,ado aogoedmoa pas Ily>tosq jo aonaldmoa iayY :SM&M .I1m3i aAYd jLvVl[OdNCLL U61 LJanumf P419P'a.—OVIV3 ;o Diels `sLeat[8g[ Jo aowu!Q '_q_V!_dS p,e"S aqi Jo jo•E•9 aonaaS m past se apem aq pegs Iwai aomadmo0 'UMW iaaawm,ad 8mllem ca mud palg pan psAo,dde,oj uam8u3 Lu,'agi o3 ppm easq; aq peps lar goes jo Ldoo (l) aa0 -am( m!A,as m to— goes mJ apam aq Reqs swat aonaadmoo •,oaaadmi aQ1 Lq•pa!nba o9J[ :SLS3L NOL(JVdN100 6'T2 VAT L,etmel pa1eP'Itta,oR93 JO ata3S'rLentg 0 Jo uO!" Q •saoneay!aadS p,epumS oq1 Jo [p E g no!1mS m paanno m spent aq 11sq9 swat ¢onaedmoQ s,!eda laaaem,ad 8unpm o1 ,oud paly pas pewdde mJ,asa!8a3 Li!Q aq1 01 pap—ol aq Usg9 (sal qmm jo Ldoa (1) aa0 'Pem gala no tsar (1) aao jo mnm!a!m a paw 13s; 0001 ttegl wom ion jo rpA,alm ie apem aq gag9 nm aonasdmoa',oliadsa! aqt Lq pa,!nba, mjl :SLS3L NOL[JVd ()3 sill tnonagaoa aq gags Llddns ,4sm agl pae,aCel qmm In mouoq atp gasa, o3 gl8aal 1aa!oyjns jo oq INgs slat aqi 'pagn s! 8a!usf wagM -ms& aqi moria, of palannsaoa aq tpA% saitp aienbaps 'laamaluas mnm!xam a ,oj pasn 9! 8a!pooU ,o 8a!pood a,agM •aogasdmoo ,a1ea,8 sqi s! ,aeago!" Ipuno,8 8a!panomns aq1 03 30apA!nba ,o lam»d 06 ttagl seal to aq (legs aonaedmoa 8agltlsa, sip iegl as paaeld aq (lsga p !ja om ggtlosB •sao!19,3do 8a!pooq Lq IlaAms amanxa m palaafgns loo st pualsm gylloeq oq1 P1g1 panaaxa aq as n a,ej •sgidap *tg9mxa jo an »gmaa aagm sy!l Ls) looj-any jo mnm!xam a ,o 8a!pooy a,ojaq ti -aa atp jo gldap pnoi sip jo inawad 05 asgl =am lou jo s,aLel at'psgddo aq !lags 11yxosS :.Il43pMVjd •Y1ZD[0VH Lim •Lenmpew sq1 jo aogoas lwn3oftm sip g1!Am paatsu4 aq (lags iva„ad 56 Jo aonaedmoa aAnap, e 'alwa Lae at inq'paim!19gn9 aq Lem gmgiam a18a,a1ry •ioamdtnba tualwAtnba,o,adamolgtA 8at9n pal9,q!A Pae LC)laaj m,to an ,a1wa8 loo Jo s8!I a! paaald.aq Reqs Pae 1021wA!nba m pass xpu-3!9am Panwdds aq (fags (IyKawa :aNVS TEM:)YIi 91E •pAstS so pees paeo,dde aw Lq peanda m palaama[ddas aq getp inq'1[ ppaq,oq para aq lou paps aoneAeaxa 8aunp pasmunoaaa 9! ga!gb (pualem pme,mas m LBuods) olgwutuan smsep eimo0 Ir[ jo Lim aq1 ga!gm lsualem Any •gy>)asq palep!l—oa Llaienbape as 80unpwd jo sarodlnd mJ -a si! as (el¢amulap aoaemgns ome8m saw so spas 'gnuq jo aaj aq lleg9.11g:losg :'LirduYN1 TUDDvIl Cry a9n ;roM aq1 no Lgetam It Isis aogatuls¢oa aql 9alan apem aq pegs aogeAeoxa ON •sLep (S) aAg 8a!paaoxa pouad it m; gado aroma, Ipgs aoneAaaxa oN. •eeso gots m 8mpeou,eq aoQUAinxa jo L1![!ge1!ne aqi aa!m,alaP Ifags loiaadsn[ s:uoM ot(gnd aqy ro!(gnd 8a110nen og1 Jo aogoaiwd agl ,Ol sLep!loq patr spaa>(aanA ao ygBwaAo 9ig8!1 Ri!^m papea!„aq Ll,ado,d aq llwy9 suouaeeoxa l[V a!8aq imm eaogtuado ((g:(oaq —;aq goaaa gado ;o laaJ ,snug 000[ of pm!mg aq 11egs 9¢opeAeox3 :SNOCLYAYJX3 30 L1I�'I f[2 -pmassoo aq gttgr alpa 3g8!B,w laamaAed of a8emep Lae 'saopmado BmAsd (etly of ,oud '*UFA Aw8 la,aa28 agi aleul!oa; ieaq of n act uod a 4ana m paagd aq pegs leualem aogensax3 (7aamawed;o 8¢glno m mud aleneaxa a0 pa9n aq 3¢amd!ttba 8mieweoxa MW aaamm— ca toptlN •-au!8ag L3rJ agl JO -Wo ag1 g8no,g3 paAo,dde aq I" 8ag11r3 lnamawed jo poglapi -oogurtxa ai mud a8po ig8!Blw • 01 lg8!e,p • as lna Aces Lgtnmegaam aq qw laamawBd :9NLLJllT7. I1 AYd •mas,ea(o iaafwd,adwd mJ smamnaom LaA,m qe jo iaamaoslda, m aogaldmoo aodn poygo¢ aq Reqs aay;o ee9L •slaamnaom [ae;o lenoma ag103 mud,aaa!8a3 Ll!, sipa1 pags!a+!N aq peps 9laamnuom asap( al saq atp 8auaogs raloa jo in maldmoa y 'aapim,ad ag1;o uaodxa aqi le mLaA,m m ,aam8aa ltA!o Pasaaog 9.(q paoalda aq ((loa„oo Pae L(!pa, Lem Lag1 m fro pap Lplaldmoo aq [legs pa -1 -at mgAm sa q Lyado,d m IiaaJ11 jig jo aa!l,alaao ev no lama ga!gnm 9inamnaom LaA,tn qs 'ao!latuwaoa Jo 8ama!8aq m aogmeoxa of xm,d :&L%j3jH11NON[ A3AWIS f? goafwd s1a!tto w, JO Ag .3 Jo ;nnS gum aoaa,aj,ala! ,o Lepp apnload of sao,oj e1a!nQ wl jo L1!3 ,o ala1S aqi tp!- psm!piooa aq gegs >(ioM •11m,ad 9lg1 jo pouad 3g1 8aunp ea,a 9!tp a! lanpaoo Lem elmno e•[ ;o A!Q so e!woj.M jo vmS aqi ga!gm aopmado Las of paiealp,ogns aq ((eqs ;,onm pasodo,d aq.L :}1�i0M 3ZVNIQ1i000 SPECIAL CONDITIONS --PERMIT NO. 3594 --- TOSCOE MARKETING COMPANY/R-D. BUILDERS --- In addition to the standard permit conditions, the following shall apply: 1. Pursuant to Section 14.16.320 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), all work shall be performed in accordance with the latest edition of the Standard Specifications For Public Works Construction (SSPWC) and as directed by and to the satisfaction of the City Engineer. 2. TOSCOE MARKETING COMPANY/R.D. BUILDERS, hereinafter referred to as "Permittee", shall be responsible for providing continuous dust and erosion control. 3. Streets shall be kept clean. They shall be completely cleaned at the end of each working day and more frequently if required. 4. Pursuant to Section 6.08.050 of the La Quinta Municipal Code (Ordinance 18 § 1, 1982), throughout the work site, the Permittee shall comply with City regulated work hours. Operation and maintenance of equipment within one-half mile of human occupancy shall be performed only during the following time periods: October 1st to April 30: Monday -Friday 7.00 a.m. to 5.30 p.m. Saturday 8:00 a. m. to 5.00 p.m. May 1st to September 30: Monday -Friday 6.00 am to 7:00 p.m Saturday 8:00 am. to 5:00p.m. Work shall be prohibited on legal holidays and Sunday& 5. Work performed within 500 feet of a signalized intersection is restricted between the hours of 9 a.m. - 3 p.m. Traffic control shall beset up after 9 a.m. and removed before 3 p.m. The Permittee shall contact the Riverside Country Traffic Signal Maintenance Department at (909) 275-6894 if signal operation at the intersection is to be altered in any way. 6. ° Pursuant to Section 14.16.110 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), Permittee shall assume responsibility for repair of any pavement damage to any public or private street and for any damage to other City. streets or facilities as a result of work performed under this permit. 7. Pursuant to Section 14.16.250 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), advance warning signs and traffic control shall be installed and maintained in accordance with Cal Trans Standards or the Work Area Traffic Control Handbook (WATCH Manual). A traffic control plan, if required, shall be prepared in accordance with the WATCH Manual and submitted to the City for review and approval one (1) week prior to starting any construction. It shall be the Permittee's responsibility to appropriately detour and barricade all construction sites. 8. Pursuant to Section 14.16.290 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), street closures shall not be permitted. A minimum of one travel lane of paved surface shall be maintained with flagmen at all times. Special Conditions - Permit No.3594 Page I of 4 SPECIAL CONDITIONS --PERMIT NO. 3594 --- TOSCOE MARKETING COMPANY/R.D. BUILDERS --- 9. Prior to excavating, if required, the Permittee shall contact Underground Service Alert at 1-800-422- 4133. It shall be the Permittee's responsibility to notify the Public Works Department of anticipated excavation which impact City facilities, including but not limited to traffic signal conduits and loops, irrigation lines, electrical conduits, and storm drain facilities. 10. Should additional work, materials, or modifications of the work be required in order to meet City standards, safety requirements, signage requirements, or to fit actual field conditions, the work shall be performed by the Permittee as directed by and to the satisfaction of the City Engineer at no cost to the City of La Quinta. 11. Pursuant to Section 14.16.370 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), backfill compaction within street rights-of-way shall conform with Section 306-1.3 of the latest edition of the Standard Specifications for Public Works Construction (SSPWC), except as otherwise specified. Native material may be used as backfill material provided that minimum.compaction, achieved in the manner prescnbed herein, .is achieved. Backfill shall be performed by mechanical means; no water densified compaction via jetting or flooding or other means shall be allowed. It shall be the Permittee's responsibility to provide appropriate geotechnical supervision, testing, and inspection, onsite, at all times during backfill operations. Backfill compaction shall be achieved by the following conditions: A. When a firm foundation is not encountered due to soft, spongy or other unsuitable material, such material shall be removed to the limits directed by the Geotechnical Inspector and/or the City Inspector and the resulting excavation backfilled with pipe bedding material. B. Backfill materials shall be brought to or maintained at an appropriate moisture content for compaction. The appropriate moisture content range shall be established at the onset of the project and ensured prior to use of the materials through progress testing on the stockpiles. C. The first length of trench backfilled shall be backfilled in the presence of the City Inspector. Compaction shall be tested at random depths at approximate three-foot vertical intervals as backfill is placed to ensure the effectiveness of the compaction methods and to establish the depth of lift that can be compacted. D. If lifts greater than one foot are attempted in this trial length of trench, compaction tests shall be taken within the lifts to ensure that the full depth of the lift is compacted. Upon satisfactory completion of this portion of trench, the City Inspector shall establish the maximum lift thickness to be compacted for the remainder of the project. E. In subsequent lengths of trench, the frequency of compaction tests shall equal one per each lift of backfill, per 300 linear feet of open trench, at randomly selected locations within the open length of trench. Special Conditions - Permit No.3594 Page 2 of 4 SPECIAL CONDITIONS --PERMIT NO. 3594 --- TOSCOE MARKETING COMPANY/R.D. BUILDERS --- F. The depth of the randomly selected compaction tests shall also be randomly selected except that where multiple tests are required in a given length of trench, the tests shall be no closer than three feet (vertically) from each other. G. If any compaction test fails, previously placed backfill (in the same length of open trench or previous lengths of trench) which is represented by the failing test (as determined by the City Inspector), shall be tested for compliance with compaction requirements. H. All costs incurred due to the conditions above shall be borne by the Permittee. Copies of all test results shall be furnished to the City Inspector. 12. All excavations within City of La Quinta right-of-way shall be backfilled, and temporarily paved if within the existing travel way, at the end of every workday as directed by and to the satisfaction of the City Engineer for the protection of the public. Lengths of open trench shall not- greatly exceed that which can not be backfilled in the same day. Excavated trenches shall not be allowed open overnight, however, Permittee may leave a length of excavated trench, not to exceed twenty (20) feet in length, open overnight at a point where construction will begin the next day, provided that this length of trench is completely covered by steel plating. 13.. All landscaping, irrigation, decorative rock, decorative concrete, lighting, etc., shall be replaced to its original condition. 14. Access and egress to all local properties shall be maintained at all times. 15. Pursuant to Section 14.16.375 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), permanent pavement replacement shall be completed no later than seven (7) days after the completion of the work. Permanent pavement replacement shall conform to the following conditions: A. Existing asphalt concrete pavement shall be sawcut one (1) foot beyond trench edges. Edges shall be straight and clean. B. Permanent pavement replacement structural section, within all trenches, shall be 1" thicker than existing of asphalt concrete over the same existing thickness of crushed aggregate base or crushed miscellaneous base, meeting the requirements of Sections 200-2.2 and 200-2.4 of the Standard Specifications for Public Works Construction. The replaced pavement and base material shall be compacted to 95% relative compaction and respectively tested, for each 300 linear feet of trench. Verify exact structural replacement section thicknesses with the City prior to installation. C. Permanent pavement replacement shall be installed using a City approved'/4" max medium asphalt concrete as the base course lift and a City approved t/2" max medium finish course lift for capping. Asphalt concrete mix design shall be approved by the City prior to its placement. D. Cold -Mill and Overlay - The existing pavement which was properly protected in place during the trenching operation located adjacent to the trench saw cut shall be cold -milled to a depth of 0.10 Special Conditions - Permit No.3594 Page 3 of 4 SPECIAL CONDITIONS --PERMIT NO. 3594 --- TOSCOE MARKETING COMPANY/R.D. BUILDERS --- feet with butt joint created next to the existing unmilled pavement surface. The cold -milled area and base asphalt concrete in the trench area shall be overlaid with a City approved C2 -AR -4000 asphalt concrete mix. The width of the cold milling area shall be as follows: For longitudinal trenches located in a parking lane: two (2) feet outside the sawcut removal lines. For longitudinal trenches located in a traffic lane: two (2) feet outside the sawcut removal lines, or to the lane line striping, whichever is greater. For transverse trenches across existing street: two (2) feet outside the sawcut removal lines. E.• If grinding and capping operations are not performed in the same day as base paving operations, the base course lift of 3/4" max medium asphalt concrete shall be installed from saw -cut .edge to saw -cut edge flush with the existing street surface. The base course lift of paving shall not be left 0.10' low in anticipation of grinding and capping. F. Any existing lane striping affected by this resurfacing shall be replaced in kind by the Permittee, as directed by and to the satisfaction of the City Engineer. Affected traffic signal loops shall be removed and replaced in kind. The finished pavement surface shall be smooth, consistent, and shall conform to the surrounding grades. 16. Permittee shall permanently stabilize any and all soil that was disturbed as a result of work performed under this permit with an approved dust control treatment. Soil stabilization shall be done immediately after completing the operation. 17. Pursuant to Chapter 12.56 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982) the City has designated certain city streets as Truck Routes. The weight limit for restricted streets (i.e., streets not part of the Truck Route network) is three (3) tons; trucks exceeding the weight limit may use a restricted street if making a delivery or pickup on the subject street, or if this permit specifically grants permission to use the street to deliver street construction materials and/or equipment. 18. Stock pile shallnot exceed 3' in total height from the existing surrounding area. 19. This permit allows for the Precise Grading and Paving of Parcel 7 of Parcel Map 29736, per the approved plans dated December 17, 2001. This work is located on Highway 111 west of Washington Street. Ingress and egress from the construction site will not be allowed from the signalized intersection of Plaza La Quinta Drive and Highway 111. 20. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time. Special Conditions - Permit No.3594 Page 4 of 4 Ii.�l`....ty..�+r�r 'w�'S`l�.�i.�- 'fi-id'.y. ..�. r.eH,.k"',.;k•✓:•jRi•{. '>S:fYiI�7yC`i+, �: x1�'"%j'.��. .:ti-itti�.a�, �.S?.. •,i•�'1M"�. L��.�� 1 ASSESSOR'S PARCEL NUMBER COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY HEALTH DEPARTMENT OF ENVIRONMENTAL — — APPLICATION FOR WASTE WATER DISPOSAL APPROVAL APPLICANT: Submit this form with four copies of a SCALED plot plan (1"=20' to 1"=40' SCALE) drawn to County specifications as indicated on the attached check list. A non-refundable filing fee is required when the application is submitted. Check must be made payable to the County of Riverside. Approval of this application shall remain valid for a period not to exceed one year from date of payment. LMS # Agent, Contractor, Contact Person Address State Zip Telep/hone_Kfxtf�G \`r �,vi+ � ('� \ � � City jj ,I _`; IV !��I Vit. �11Z_ ``.� �f �`� -n � . � 1 n ` f ire + Own e„gr„//^ Address City State Zip Telephone" Q { /� + V )f l ) OJob Prrjoperty Address 1 City Zip t FJ r^ w 0 Lot Size Water AgencyANell Use of Permit, P/P,, SUP, PUP ,etc. Legal Description ' DBA (wbrT�. Dwelling, MH Site Prep. etc. Signature of Ap1icarlt Date . y # r FOR OFFICE USE ONLY CHECK BOX IF REQUIRED If any box is checked, this application shall be considered rejected until the ❑ Detailed Contour Plot Plans Required (1 to 5 foot interval) information is provided and the fee paid. Resubmittals later than 90 days after date noted below may require. repayment of fees. ❑ Other ❑ Staff Specialist Lot Inspection Required Z❑ Holding Tank Agreements Completed O ❑ Certification of Existing S.D. System Required Thomas Bros. Page Grid WEIWQCB Clearance Required ❑ Date Lot Inspection Completed: Initials U) (Attach for DOH -SAN -007, Santa Ana Region Only) Remarks: ❑ Soils Percolation Report Required ❑ Maintenance Booklet Provided ❑ Special Feasibility Boring Report Required ❑ Final Inspection by Department of Environmental Health is required. ❑ Rereview Required Initials Date Please call 24 hours PRIOR to inspection. C/42 / Soils Percolation Boring Report By Lic/Project # Date Soils Map Page Soil Type Approved By Date No. of Systems Type of System(s). No. Dwelling Units (1) Septic Tank Soil Rate Gr.easekSamd ❑ Holding Tank ❑ Replacement Bedrooms, Fixture Units Grease Intcp/Lint Trap ❑ New ❑ Addition ❑ Existing ❑ Connect to Sewer Gal. i Gal. Sq. Ft. Total Linear Sidewall Allowance Leach Bed sq. ft. Bottom Area Ft. ft. rock/ sq. ft. running ft. Install Line(s) ft. long ft. wide of Bottom Area Inlet Tested Depth ❑ N/A with min. inches rock below d_rainlines L) Proposed Bottom Tested Depth or Z Leach lines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Inlet (131) Seepage Pit Maximum Other: 0 Applicable Total Depth Allowable W N/A Overburden Factor ❑ 5' ❑ 6' TD Depth CO Well Review Approved: Date: Well Drilling Permit# SIGNATURE Grading Plan Approved: Date: SIGNATURE Plan Check Only Approved: Date: { REMARKS: 6, C 0 f 0�S.3Q f e p -r R r -,s n (A t,ie- 3 � i t t This application Vs A�APPRQYED/DENIED for the category checked in SECTION B above, regarding the design of a disposal system as indicated on the accompanied plot plan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the above- 9Z.## Revenue Code �.. Fee $ f i designed system. No construction is Permitted in the required reserved %)Cn''j, '11 rl et r� ! 100% expansion area. ) Check # (1) Septic Tank must be 100' minimum from any wells. Z (2) Leach lines must be 100' minimum from any wells, including expansion Date r �c.' %� ? Initial �I 0 area. (� (3) Sewer lines must be 50' minimum from any wells.;` LU Cn (4) Seepage pits must be 150' minimum from any wells, including expansion RIVERSIDE: 909-955-8980 area. (` INDIO: 760-863-7000 .Psi A o SOUTHWEST- 909-600-6180 gignature NJ Date 4 pen-aNry-icz (nev oiui) Ulstnbution: WHITE—Office File; YELLOW—Applicant; PINK—Bldg. Dept; GOLDENROD—Plans/Records DIST. # - r COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH PLAN CORRECTION Plan Check # i r �� Date j , r-. , DBA 7 (1 c t Address r) `,/ Plans Submitted by `� �� Phone Owner r.0 Address ' �� - ^ `r f " "Phone The plans are now approved subject to the conditions listed below and the attached compliance sheet. % r � 1� r f r { { 1 (: /I ! / � I l CONSTRUCTION INSPECTIONS: Contact the Plan Checker for a Preliminary Inspection when construction is approx- imately 80% complete, with plumbing, rough ventilation, and rough equipment installed. Request for inspection should be made at least five (5) working days in advance. 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 should be /made at least five (5) working days in advance. PLANS CHECKED BY { Phone I acknowledge the corrections noted herein and as iinndica�ted on the platens and agree to incorporate them during construction: Signature Company /. ✓ �- .� r Date DOH -SAN -178 (Rev 1/92) w -OFFICE — Y -APPLICANT — P -BLDG. DEPT. RIVERSIDE COUNTY FIRE DEPARTMENT In cooperation with the California Department of Forestry and Fire Protection 210 West San Jacinto Avenue • Perris, California 92570 • (909) 94G-6900 Fax 909 940-6910 nEW September27, 2001CEE Tom Tisdale Fire Chief� —Western States 733 Main Street Proudly serving the Orange, CA 92868 unincorporated areas of Riverside Re: Non -Structural Building Plan Review County and the SDP 2000-688 / Circle K Cities of: Fire Department personnel have completed a review of the plans you submitted for the above Banning referenced project. Please be advised the following conditions apply as a part of the conditions'for the issuance of a building permit. Beaumont 1) The Fire Department is required to set a minimum fire flow for the remodel or construction of all Calimesa 4.commercial buildings using the procedure established in the 1998 CFC. A fire flow of 1,750 gpm for Canyon Lake a 2 -hour duration at 20 psi residual operating pressure must be available before any combustible .;+ material is placed on the job site. Coachella 2) The required fire flow shall be available from a (Standard/Super) hydrant(s) (6" x 4" x 21/2" x 21/ " ❖ located not less than 25' or more than 165' from any portion of the building (s) as mea red along Desert Hot Springs approved vehicular travel ways. 40 3) Install. portable fire extinguishers with a minimum 2A1 OBC rating. One 2A1 OBC shall be provided for Indian Wells every 3,000 square feet and/or 75 feet of travel distance. Contact certified extinguisher company for 4. India proper placement of equipment. 4) Approved building address shall be placed in such a position as to be plainly visible and legible from Lake Elsinore the street and rear access if applicable. Building address numbers shall be a minimum of 12" for building(s) up to 25' in height, and 24" in height for building(s) exceeding 25' in height. All La Quinta addressing must be legible and of a contrasting color with the background. ❖ 5) Electrical room door shall be posted "ELECTRICAL ROOM" on the outside of door. Moreno Valley 6) All egress doors shall comply with UBC, Sec. 1003.3.1.8 for proper door hardware. Palm Desert Please contact the Fire Department Planning & Engineering staff for final inspection prior to occupancy. Penis Requests for inspections are to be made at least 24 hours in advance and may be arranged by calling Rancho Mirage (760) 863-8886. San Jacinto All questions regarding the meaning of these conditions should be referred to the Fire Department t ❖ Planning & Engineering staff at (760) 863-8886. Temecula Sincerely, Board of Supervisors Bob Busted, FRANK KAWASAKI District 1 Chief Fire Department Planner John Tavaglione, Distrix 2 Jim Venable, By � District 3 Walter Brandes Roy Wilson, - Fire Safety Specialist District 4 H:kPE2IWPDATAUAOUIHTAWROJEC MBLDG_PC%SDP2000.888-Chile ILdm Tom Mullen, 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 ' De I �L Cityo La.Qui to Developers Project Approval Form Prior to the issuance of Building Permits for the project listed below, the following Departmental clearances must be obtained. Please return this form to the Building and Safety Department only v. after approval. Contact. ,applicant for resolution of conditions preventing or delaying approval. Project: Circle K - Service Station/Store 78-364 Highway 111 Applicant Contact: Mark Kennedy (714) 769-2000 Application / Circulation Date (REVISED PLANS) II/Y/O( Date Community Development Department Christine di Iorio, Planning Manager Public Works Department Steve Speer, Senior Engineer Building and Safety Department Greg Butler, Building & .Safety Manager PLEASE RETURN BY 11/16/01 Date Date Date = M E T R O S C A N PROPERTY PROFILE= Riverside (CA) **************************************************************************************** * <<< OWNERSHIP INFORMATION >>> * Parcel Number. :604 050 019 S: T: R: Q: * Ref Parcel # :000 000 000 Pos Interest: * Owner Name :La Quinta Real Estate Ptn * CoOwner * Site Address :78250 U's Highway 111 La Quinta 92253 * Mail Address :2526 S Highway 101 Cardiff By The Sea Ca 92007 * Telephone :Owner: Tenant: * <<< SALES AND LOAN INFORMATION >>> * * * Transferred :01/28/1991 Loan Amount * Document # :29962 Lender * Sale Price Loan Type * Deed Type :Trust Transfer Interest Rate * % Owned :100 Vesting Type * * * * * <<< ASSESSMENT AND TAX INFORMATION >>> * * * Land :$957,622 Exempt Type, * Structure :$1,842,378 Exempt Amount .. * r Other Tax Rate Area :20-065 * Total :$21800,000 Taxes :$26,892.40 * % Improved :66 * <<< PROPERTY DESCRIPTION >>> * * * Map Grid :849 G2 * ••Census :Tract:451.04 Block:3 * Land Use :Cll Com,Restaurants And Bars * Legal :2.00 ACRES IN PAR 3 PM 160/087 PM * :22596 * Sub/Plat :Pm 22596 * Book Page: * <<< PROPERTY CHARACTERISTICS >>> * * * Bedrooms Stories YearBuilt: AgPreserve * BathFull Units :1 MiscImprv:No * Bath3Qtr Bldg SgFt: Street ADDITIONAL * BathHalf Gar SgFt Waterfrnt: * Fireplce :No Gar Type Elect Svc: RmAddtns :No * Cntrl Ht :No Lot Acres:2.00 Gas Svc RmAddSF * CntrlA/C :No Lot SgFt :87,120 WaterSrce: AddGarType * Pool :No Roof Type: SewerType: OthrPkng **************************************************************************************** Information compiled from various sources. Real Estate Solutions makes no representations '� or warranties as to the accuracy or completeness of information contained in this report. Notice: Document Cannot Be Duplicated Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 760-771-8515 CERTIFICATE OF COMPLIANCE Date 1/10/02 No. 22818 Owner NameTosco Marketing Co. APN# 604-050-035 Jurisdiction La nuinta Permit # No. 78-364 Street Hwy. 111 Log # city La Quinta Zip 92253 Study Area Tract # 29736-7 Lot # Square Footage 3936 Type of Development Commercial No. of Units 1 Comments Bldg. is gas station/convenience store. f At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: Commercial Building EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of .33 X 3,936 or $ 1,298.88 the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now 'be issued" Fees Paid By CC / Union Bank of California - Mark Kennedy Telephone Name on the check •e By Dr. Doris Wilson Superintendent Fee collec4/expted by Annette Barlow Signatur Payment Received Check No $1,298.88 7404993 OTICE: Pursuant to Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified bove will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to ollect them on the DistrictCs)(s') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting Project: LA nJi'4c4 Peyton-Tomita & A s s o c i a t e s Client: Structural Engineers Job No. si I 1 Date: ► Eng: 4 S, �' �SS�S �Q:= r-) AX i rn U 1,1 Assur�k. 4" � N�LC 0( = s11`1/cf� ►.9.4-, = D.3'39f3 W N F --2L. Q= L- .-1-7S t r o: n S :5�% + Adz = 2'19 - 2-19 -►� -).g9 - '13 = 2 14 ..,° G, = (a .3'� S r 0 3 5 z '7• I.1 - S, ..., = 3,Z> A = ) 4 •lo -) . S1"� ) 3 n� 1 I U It ? Ara 0 1-a DLfi�' < 1,0 1�1X'i• Sq T.) Rc> t- PL'ptD gY ARC -A. S"-- S p -T 'S DF CA LI- . s�� SSS. s�S ►'a2 A�-rA�'--.5. d 954 Town & Country Road Orange, CA 92868 Tel: (714) 245-4930 Fax: (714) 245-4933 4 1. 2. 4. 5. 6. 7. 8. 9. 10. 4 Business License No. \, 'BUSINESS LICENSE APPLICATION FORM APPROVED g� DATE *��**�•*ate*�***�+***��*� ** �** PROOF OF WORKER'S COMPENSATION INSURANCE IS REQUIRE PRIOR TO ISSUANCE Business Name: `' a++1.1uur5,, Inc. Business Address: 1320 S. Simpson Circle, Anaheim, CA 92806 Mailing Address: Same as above Business Phone: (7� _ 533-13 31 Owned By: XCORPORATION PARTNERSHIP INDIVIDUAL If Corporation or Partnership, Tax I.D. #: 33-0009614 If Individual Owner, Social Security #:----- -------- Name of Owner or Officers and Title: Gary L. Redfern President SBE Resale Number: --------------- Number of Decals Needed: 3 Vehicle License Number Permit Number (Finance Dept. Only) 4S58349 5A-7585 _. N/A 11, CONTRACTORS, ONLY: Copy of State Contractors License Pocket Card Is Required.* A. Type of Contractor: Construction B. Classification: 3162A C. State License Number: 445832 or B License Classificatio $100.00 Per Year or Semi -Annual C License Classification $ 50.00 Per Year or $25.00 Semi -Annual I HEREBY CERTIFY that all the information supplied by me is correct and any licenses required by the Cou to or Fe Govern been iss� to me and are in full force and effect. Signa e Title Date Send Completed Form To: CITY OF LA QUINTA BUSINESS LICENSE DIVISION P.O. BOX 1504 La Quinta, CA 92253 Butler-��CircleK %76-78-364 :.::::. ... ..................................................:............................................................. :...........g.. .......................-Highway..111 Fire Sprinklers..................... Page...:: From: Greg Butler To: groberts@wsecinc.com Subject: Circle K / 76 - 78-364 Highway 111 - Fire Sprinklers December 13, 2001 Re: Fueling Canopy Sprinkler Requirements Given the following facts: - The area covered by the Fueling Canopy is classified as a Group S, Division 3 occupancy; - The Fueling Canopy exceeds 5,000 square feet in area; - The La Quinta Municipal Code (secs. 8.02.060 & 8.08.090) requires installation of an approved automatic fire sprinkling system in newly constructed buildings of this occupancy and size. Findings: After conferring with Walter Brandes, Fire Safety Specialist with the Riverside County Fire Department, it is determined that the application of water to a fuel fire would increase the possibility that such a fire would spread to areas where containment would be greatly hindered (e.g. public and private streets, and ' storm drains). Conclusions: The requirement for the installation of automatic -fire sprinklers that would spray below the Fueling E Canopy is not applicable in this particular situation. This decision shall not be construed as Departmental, Policy. Future applicability of thi requirement shall be determined on an individual basis. Signed, Greg Butler Building & Safety Manager City of La Quinta, CA CC: Danny Crawford City of La Quinta Developers Project Approval Form Prior to the issuance of Building Permits for the project listed below, the following Departmental clearances must be obtained. Please return this form to the Building and Safety Department only after approval. Contact applicant for resolution of conditions preventing or delaying approval. Project: Circle K - Service Station/Store ti 78-364 Highway 111 Applicant Contact: Mark Kennedy (714) 769-2000 u Application / Circulation Date: (2nd Revision) 1/04/0 Date Community Development Department , Christine di Iorio, Planning Manager Date Public Works Department Steve Speer, Senior Engineer Date r • p • IM r/o� Ci of La Quinta Developers Project Approval Form Prior to the issuance of Building Permits for the project listed below, the following Departmental clearances must be obtained. Please return this form to the Building and Safety Department only after approval. Contact applicant for resolution of conditions preventing or delayin,; approval. Project: Circle K - Service Station/Store 78-364 Highway 111 Applicant Contact: Mark Kennedy (714) 769-2000 Application / Circulation Date (REVISED PLANS) Date Community Development Department Christine di Iorio, Planning Manager Date Public Works Department Steve Speer, Senior Engineer Building and Safety Department Greg Butler, Building & Safety Manager PLEASE RETURN BY 11/16/01 Date Date EO xTIN.%, O —777 N O q N V 0 m� b N w 9 O POOONONr.�ry�,np^ OOOOMO00�o00 �S, mac., ogg d o0 0h0000 ►� a aQee 00000 �ISY C�yj Q� EO xTIN.%, O A N N q N V 0 m� b N w �O 0 • ee� ti lt, O a aQee � C�yj Q� • � � N �b„ N � � ry N A A A O: Q: C)i O La O a ` V 0 m� �O • ee� ti lt, O a aQee � C�yj Q� Bin # ,.City of La Quinta Building a 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:78 - 3 (c q Owner's Name: A. P. Number: Address: y % 5- 6 'API V Gtn Legal Description: City, ST, Zip: Cpxo94 CA ?0&7 7 Contractor: S 1 p4e�A Ievw Address: 1`0 SVL Qcx Telephone: Y451' 270 —451 73 r Project Description: /A✓ N'67W 05AL � City, ST, Zip: UiG�Y�/i �I.2 ��i• z3g2 GL��l/� {� �� .(,L Telephone: 109- 23 _ c1343 x City Lic. #: Es? L sE State Lic. #: Arch., Engr., Designer: Address:- 20 7 z4l1?11 In C.Q. ! A4/E- City, ST, Zip:,5MgI5-9 k (174 71So Z Telephone: Q �,/ Sr� 8 �� ' 3 y / , Construction Type: Occupancy: , State Lic. Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: OQA,�N I%L Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: 81 Estimated Value of Project: p 0 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING f PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections` Z Plan Check Deposit Truss Calcs. Called Contact Person .Z Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted I Mechanical Grading plan 2"" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 7nd Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Z 6123 AJ6 Pf:r.-- VAPOR RECOVERY CERTIFICATION C&MMM ft aovm ilohed Fi M"1,= PSpe 1 of 1 ' CLW M sEPAi AYM SYM "CoMpL4M LiM — H@*brt0? Montodtire Orin,1 bil ss. Ner lata 0=1 DOW —7e fi" 91111110 MOM t2 Ct'+AirSlperab 1p* b deNow d formft Raw ter.itb orad 1naa�utdbn ttrll� 1w ptodnd etri� f�nityanl 4m tdMi ooi t Up b eppe vil odlom(53� afatooeet paeolMmMpora, �p�MnptJwfiniwN bfiatllnoo�w, �a�etw„tehen fie :rn b tmdera nepM�r Prwt+iecond, twsbnd Mpors e� w4nned bite pnodutdtttata�, the sl�em mnmlrw nonttwlrg ak�t p�rb end 4 b111%d h day MiroodRltlytiD Iw prodgcteior�e bnict+wti h aaoadenoer#t1�PAa01� CiNpwrl0. APM=7W—Wft dM nd bwAwAb e,I;**ftftl, MLnk VW =W"rlftn WMh 1wtd air wktr�ts r+sbrttwit�e OFtVR ��Oed tr! Mlodei9�Zanrro�lc Mtt �twport�eryt>�e� Onl ffwh p pffib* epLedp d a:twpow. iKBTAU.ATM—lfta bdk In d it dea lodotw in am0ordetroerd 1 #18 ffdrdhdMSQAMucim 17te tmb are "ended 10 ba insbladvft cAbrr" 8411 % hlsld cw" and C�tt�IbleYbporReooMoyB P 9tndt ^ howt. Y R t+�un aaroerandhaastt1, Tfta i dit b +�onttlble iroorenarlp oattpt�ilgRd� and onrt�al�te iAnMnl ArllbMton. eAotdanoe "W model , and tLMftttt d Wwon a Md sfendb %ftjf&k%*jt Uwsntdlons, :.liEOH—Tha Hatt' MOdd9ids CieeRAtBttpralorb ptiNied iortiw atttbiand oonertettdel �totorA�M dbpetreirtg, ItM anQseliaetri�e Thr+ewporaoowryieda�darrequi�adbyil�l►. T� mon b irwde puarantb tr ►fid b tie CeMfomia 941e AraYeretwr a oor�ohed iaSidta>s 41956 418601rWww.*g nbt�tUM"k*OWL Tbsoaralml-lebeeed�an�teet;a ft k� wb�rlttid aPP CSMiblfha-ll blredIr1dtr4MftSroftalwdftbttdesnol fthm(s) 9tt�t argrdt , 7ftwoAeallortbnoton"n nerantatt5=01 wnMloAlb ftaw / KtyariwOslaliortartrla ba,sMtlARtr it 2006 auittotlad et': ,hakes c ot'M Prrn 000aaktalor Califomia State Fire Marshal CODE INTERPRETATION Date Issued 9/01/2005 7 Interpretation # 05-019 Topic Healy Phase II enhanced vapor recovery system Code Section(s) 2001 CFC Section 223 Requested by Tom Waller Fire Marshal Oxnard Fire Dept. 251 South C St. Oxnard CA 93030 I am requesting an Interpretation of the California Fire Code with respect to the Healy Phase Il Enhanced Vapor Recovery System. The Healy Phase If EVR includes a vapor processor, also known as a Clean Air Separator (CAS). The CAS Is 400 -gallon capacity vessel that will contain gasoline and gasoline vapors during operation. The CAS has come Into question as to whether It will be regulated as an above ground storage tank (AS7). My request for c/arification4ntmpretation Includes the following: 1. Is the Clean Air Separator an aboveground storage tank in accordance with the California Fire Code? No. 2. • If the Clean Air Separator Is not an aboveground storage tank, what /s it? There is no clear definition in the CFC however, U.L. has certified the unit as a 'Vapor Processing System.' 3. If you call the CAS a vapor processor, or a processing vessel, what Is the CFC definition of a vapor processor? Processing vessel? CFC Article 2, .Section 223 best defines these as a 'vapor processing unit: "" r R lk 05-019 Waller Page Two 4. What are the installation requirements for secondary containment, vehicle crash protection and labeling? There are no requirements for secondary containment. However, protection against physical damage shall be provided in accordance with Article 52, California Fire Code, Section 5202.13.3.12. 5. Does draining of the bladder and/or tank (CAS) (see Healy . Operating Instructions) amount to dispensing as defined In the CFC? 0 , No. Footnote: The Intent of this footnote Is for reference only and to provide clarification. It Is not the intent of the State Fire Marshal to endorse any one specific product, device or methodology. Description of Operation of the Healy Clean Air Separator": The Healy Systems, Inc., Model 9981 Healy Clean Air Separator'' Is a stand-alone, completely mechanical device Mat assists in c gntrolAng the gasoline vapor emissions from a gasoline dispensing facility. It consists of a 400-galion storage vessel with integral gladder and associated valving. It Is connected to the ullege apace of the GDF storage tanks via the venting system of the under ground storage tanks. During normal operation of the GDF, with today's concentration of 'RVR vehicles approximating 200A, the storage tank ullage space will usually operate In the V to negative (up to r WC PN cracking pressure) pressure range. During' closed' perkxds of the GDF, the utiage pressure will usually begin to increase due to vapor growth Inherent in the process of Introducing air Into the USTs. if the pressure goes slightly above atmospheric the vapor from the UST's will flow Into the Internal bladder. Conversely, when'RVR refueling begins and the UST pressure falls below atmospheric, the vapor Internal to the bladder will be drawn back into the UST until the bladder is fully collapsed waiting for the next cycle. The Clean Air Separator" In over two and one half years (installed late September of 2002) of being M operation at our C.A.R.B. Last site In Sacramento has been evaluated repeatedly to see If there is any liquid conderisation in either the bladder or the space between the inner wall of the vessel and outer wall of the bladder. To data there has been no liquid found In either area. S' 10/•19/2007 10:'52 5624384036 ABT SERVICES PAGE 01/03 File MH15389 Project 04MKO4880 July 20, 2004 REPORT on VAPOR RECOVERY SYSTEM ACCESSORIES, FLAMMABLE LIQUID Healy Systeris, Inc. Hudson, NH Copyright ® 2004 Underwriters;Laboratories Inc. Widerwriters Laboratories Inc. authorizes the above named Company to reproduce this Report provided it is reproduced in its entirety. 10719/2007 10:52 5624384036 Pile MR15389 Vol. 2 A. DESCRIPTION ABT SERVICES Sec. 12 Page 1 and Report PRODUCT COVERED: USL - Mcda18 9961 and 9961H Clean Air Separators. PAGE 02/03 Issued: 2004-07-20 Revised: 2007-06-30 GENERAL: *Phis device is for use with flammable liquid storage tanks and is intended to be connected in parallel with the existing pressure vacuum vent connected to the tank. The bladder within the Model 9961 and 9961H is intended to expand and contract with the changingpressure within the storage tank to prevent the pressure vacuum vent from opening and releasing gasoline vapors. The bladder within the tank has not been evaluated by Underwriters Laboratories for material compatibility requirements. The area around the Air Breather Assembly, Healy Part No. 9948 should be considered to have the.same hazardous locations as that of tank vent. The performance characteristics of this device with regard to its intended function have not been evaluated by Underwriters Laboratories. USL indicates evaluation: to the Standard for Electrical Apparatus for Explosive.Gas Atmospheres - Part 1: Flameproof Enclosures "d", first edition; and the standard for'Steel Aboveground Tanks for Flammable and Combustible Liquids, UL 142, eighth edition. SIZE AND INSTALLATION: All field connections are made through 1 inch NPT pipe fittings. The devices are intended for installation and use in accordance with NEPA 30, Flammable and Combustible Liquids Code and NFPA No. 30A, Code for Motor Fuel Dispensing Facilities and Repair Garages. MARKING: Listee's name, model designation and the statement, "Only for use as specified in the installation instructions." Marking material is R/C Marking and Labeling System (PGDU2) that is suitable to the material to which it is affixed and exposure to high humidity, outdoors use, occasional splashing of gasoline, -40C and +100C. Healy Label a" ASM data plate(s) may be alternatively placed on the tank shell. INSTALLATION INSTRUCTIONS: ILL. A{Each device is provided with the installation instructions shown in Model 9961 is Anstalled an Jadioatad in Fig. 1 and XLW. 6 through 8. Dbdal 9961st is installed as ' ndi ceted in Fig. 2 and ILLS. 9 through 12. it 1eF/19/2007 10:52 5624384036 G ABT SERVICES PAGE 03/03 File MH15389 Vol. 2 Sec. 12 Page 2 Issued: 200407-20 and Report Revised: 2007-06-30 MODEL 9961 and, 99619 - FIG. 1 & x General - Only those components specified below are provided. The models 9961 and 99619 use Adentical oomponents. The Model 9961 is installed Vertically and the Model 99618 is installed horizontally. 1. -Tank - ASME Certified with a working pressure of 137 psi. Overall shape and dimensions are as shown in ILL. 1 for Mode. 9967. and =. 1A for Model 99619. Provided with upper assembly as shown in ILL 2 and 2A r®epect3velp.. 2. PV•Vent Valve - OL Listed, with pressure and vacuum ratings of +3" WC/ - 8" WC. 3. Ball Valves.- UL.Listed, locking type, suitable for gasoline service. 4. Pad Locks - Four keyed alike, must fit item 3, -ball valves. 5. Breather Assembly - see ILL. 3 for assembly.. 6. Vapor Inlet Assembly - See ILL. 4 For assembly. 7. Float Check Valve --Sealy Systems Model 9644G, see ILL. 5 for details. 8. Gasket --All gaskets are UL Listed and suitable for use with gasoline. 9. Pipe Joint Compounds - All pipe joint compounds are UL Classified and suitable for use with gasoline. VAPOR RECOVERY CERTIFICATION f.em �aMrad WMI'm Pipe i of 1 CLEAN nit solwm S'YS m mm COmpLAm LXM — He* Sft= km 17 JlanpeAire W#C I Wd m Ww tah�dC(w 0 1 ma —Them"formea.looft6pool raft. it is treed lnaoc*atcOon>dh dteptt�dctd elor tiniteent*W awls oorrldn w b apprordnul�dpp Asfbn, efarocest Oa��, �p�►esi�q�tahae bsitrasbrtoopttare, Jda,lttier�rtter the W* wildn Is under a nspatba pra�acrreaondiort, Otesiorad tors era w4trrted bOte pttodudetorepr:s�, ilte sIem aonbtNu nonrorltg or ttbdci pft sm ll * No h doN pfood yio prodgdstorrrge talc vett system to soaondnr�oer�lrlifPA'01� gtsp1ar10. Wt.oCA7i0M7MY16daied b+lcwnh 4.tt�el�#q.1n�a�ist+�AaY wMh 1d air W*M rehmwfe fuepnp CRVR p�i4Pedvd hel. Mudd 99dZt�ttrrorlc rrAh t !►4 n Otd flay h re peclodie oh A M tt of c=u ffw& . " M–rw tank iroldto6on t, done h soot 1 1.0 fmnwviaaml gim� yam, me cads era bttended 10 be inalaNduft C&Wrrh go Rye MardttiCartOied and Cbrnpalbleltiporlieoorr9 fiol ern �rtporterliPael� 9tt�h ae rrooNa, haa. y,,lmm „sin u rm xmlmadaplo Ty luau b c'ssponv�le iioransurinS concpai grd p" and oetsntCft t ftb Are l�lera1-d Cerff=&r. "M�1,wdtLMA*lWWw4nstam!Oftledflbft�bff@W*jt tlL� tnt+adlorts, - ITM –The Hatt' Mode 9U CIMAir ftwabrta Grob brtm ataWWA oonrrtwdet mowtd nd and setiaerviCs „d,er„ vaparraoowgrle d�irad arregtttraQbyho. Thk oa uc e5m it fiede pususntb Ota atditocttypr� b lite CaAlorNe Own firm as oorthitedh Sadlor6 dh � wft dW Udteei� gyp tf aerOt snd Sf�t code. Ths ! I NaQon is beeed qm kw ww" %* ar aubmltled �ftappt CSFMs4dCttee j m imred Ore loat.t+sNtihDtdtOrdWdlbbc#ehee not ffaimanMdadWVOWtlIMofaaddo&lbbmOAMbnotn�d�nw. geoiai RXMYeo1 • Wbeadbvrmfwwt .1.11 Qnorlr Wumt Fmt v 1, 2006 aroadMr. :D iMpapa, p000drt W f STATE=AL California State Fire Marshal CODE INTERPRETATION Date Issued , 4 05-019 STATE=AL California State Fire Marshal CODE INTERPRETATION Date Issued 9/01/2005 interpretation # 05-019 Topic Healy Phase II enhanced vapor recovery system Code Section(s) 2001 CFC Section 223 Requested by Tom Waller Fire Marshal Oxnard Fire Dept. 251 South C St. Oxnard CA 93030 I am requesting an Interpretation of the California Fire Code with respect to the Healy Phase 11 Enhanced Vapor Recovery System. The Healy Phase It EVR includes a vapor processor, also known as a Clean Air Separator (CAS). The CAS is 400 -gallon capacity vessel that will contain gasoline and gasoline vapors during operation. The CAS has come into question as to whether it will be regulated as an above ground storage tank (AS7). My request for clarrfication/intmpretation includes the following: I. Is the Clean Air Separator an aboveground storage tank /n accordance with the California Fire Code? No. 2. If the Clean Air Separator is not an aboveground storage tank, what Is It? There is no clear definition in the CFC however, U.L. has certified the unit as a 'Vapor Processing System.' 3. If you call the 'CAS a vapor processor, or a processing vessel, what is the CFC definition of a vapor processor? Processing vessel? . • CFC Article 2, Section 223 best defines these as a `vapor processing unit. I, 05-019 Waller Page Two 4. What arse, the installation requirements for secondary containmen4 vehicle crash protection and labeling? There are no requirements for secondary containment. However, protection against physical damage shall be provided in accordance with Article 52, California Fire Code, Section 5202.13.3.12. 5. Does draining of the bladder and/or tank (CAS) (see Healy Operating Instructions) amount to dispensing as defined in the CFC? No. Foot nota: The intent of this footnote Is for -reference only and to provide clarification. It Is not the Intent of the State Fire Marshal to endorea any one specific product, device or methodology. Description of Operation of the Healy Clean Alr separator•: The Healy Systems, Inc., Model 9981 Healy Clean Air Separator'■ is a stand-alone, completely mechanical device that assists in controlling the gasoline vapor emissions from a gasoline dispensing facility. It consists of a 400 -gallon storage vessel with integral bladder and associated valving. It Is connected to the ullage space of the GDF storage tanks via the venting system of the under ground storage tanks. During normal operation of the GDF, with today's concentration of ORVR vehicles approximating 20°/6, the storage tank ullage space will usually operate In the *T to negative (up to 8' WC PN cracking pressure) pressure range. During' closed' periods of the GDF, the ullage pressure will usually begin to Increase due to vapor growth Inherent in the process of inUoducing air into the UST's. ff the pressure goes slightly above atmospheric the vapor from the USTs will flow into the Internal bladder. Conversely, when ORVR refueling begins and the UST pressure falls below atmospheric, the vapor internal to the bladder will be drawn back into the UST until the bladder is fully collapsed waiting for the next cycle. The Clean Air Separator" in over two and one half years (installed late September of 2002) of being In operation at our C.A.R.B. fast site in Sacramento has been evaluated repeatedly to see If there Is any liquid condensation in either the bladder or the space between the Inner wall of the vessel and outer wall of the bladder. To date there has been no liquid found in either area. r 10/19/2007 10:52 5624384036 ABT SERVICES File MH15389 Project 04NK04880 July 20, 2004 PAGE 01/03 REPORT on VAPOR RECOVERY SYSTEM ACCESSORIES, FLAMMABLE LIQUID Healy Systems, Inc. Hudson, NH. Copyright ® 2004 Underwriters -Laboratories Inc. Underwriters Laboratories Inc. authorizes the above named company to reproduce this Report provided it is reproduced in its entirety: 10%19/2007 10:52. 5624384036 File MR15389 Vol. 2 DESCRIPTION Sec. 17_ and Report ABT SERVICES PAGE 02/03 L1 Page 1 PRODUCT COVERED: USL - Hodals 9961 and 9961H Clean Air Separatora, Issued: 2004-07-20 Revised: 2007-06-30 GENERAL: *This device is for use with flammable liquid storage tanks and is intended to be connected in parallel with the existing pressure vacuum vent connected to the tank. The bladder within the Model 9961 and 9961H is intended to expand and contract with the changingpressure within the storage tank to prevent the pressure vacuum vent from opening and releasing gasoline vapors. The bladder within the tank has not been evaluated by Underwriters Laboratories for material compatibility'requirements. The area around the Air Breather Assembly,.Healy Part No. 9948 should be considered to have the same hazardous locations as that of tank vent. The performance characteristics of this device with regard to its intended function have not been evaluated by Underwriters Laboratories. USL indicates evaluation to the Standard for Electrical Apparatus for Explosive Gas Atmospheres - Part 1: Flameproof Enclosuresd', first edition; and the Standard for Steel Aboveground Tanks for Flammable and Combustible Liquids, UL 142, eighth edition. SIZE AND INSTALLATION: All field connections are made through 1 inch NPT pipe fittings. The devices are intended for installation and use in accordance with NFPA 30, Flammable and Combustible Liquids Code and NFPA No. 30A, Code for Motor Fuel Dispensing Facilities and Repair Garages. MARKING: Listee's name, model designation and the statement, "Only for use as Specified in the installation instructions." Marking material is R/C Marking and Labeling, System (PGI)U2) that is suitable to the material to which it is affixed and exposure to high humidity, outdoors use, occasional splashing of gasoline, -40C and +100C. Healy Label amd ASW data plate(s) may be alternativ4ay placed on the taalr eholl. INSTALLATION INSTRUCTIONS: *Each device is provided with the installation instructions shown in ILL. A. Model 9961 ie imetalled as LAftcated in Fig, 1 and II.I.S. 6 tbraugh B. Dbdsi 9961H is installed as indicated in Fig. 2 and ILLS. 9 through 12. 0 10%19/2007 10:52 5624384036 ABT SERVICES PAGE 03/03 File MH15389 Vol. 2 Sec. 12 Page 2 Issued: 2004-07-20 and Report Revised: 2007-06-30 MODEL 9961 and 9961H - FIG. 1 & 2 General - Only.those components specified below are provided. The mcdel8 9961 and 9963JI use idantioal 000spcnents . The Model 9961 is installed VQrtf.vally axed the nodal 9961H is iastallod horizontally. 1. Tank -. ASME Certified with a working pressure of 137 psi. Overall shape and -dimensions are as shown in ILL. 1 for Madel 9961 and ILL. lA for Model 9961H. Provided•with upper assembly as shown in ILL 2 and 2A • re+speCtivp].y.. 2. PV Vent Valve - UL Listed,°with pressure and vacuum ratings of +3" WC/ - 8" WC. 3. Hall Valves - UL Listed, locking type, suitable for gasoline service.. 4. Pad Locks - Four keyed alike, must fit item 3, ball valves. 5. Breather Assembly - See .ILL. 3 for assembly. 6. Vapor Inlet Assembly - See ILL. 4 For assembly. 7. Float Check Valve -Healy Systems Model 9644G, see ILL. 5 for details. 8. Gasket - All gaskets are UL Listed and suitable for use with gasoline. 9. Pipe Joint Compounds - All pipe joint compounds are UL Classified and suitable for use with gasoline. J4 p C�- LA QUINTA F Zi i —off BUIL ,NG ; FETY DEPARTMENT , N �_ "J 77-7o1z I 5,P€CTIOIN REQUEST LINE �a 777-7153 nor CO MARKETING COMPANY Contractor R D BUILDERS Permit Number 0109-212 POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 78-364 HWY 111 'CIRCLE K/76 SERVICE STATION - COMMERCIAL MERCANTILE (M 3936SF) W/512SF COVERED PATIO Si FUELING STATION CANOPY (S-3 5590SF SPRINKLED). TYPE OF INSPECTION DATE INSP. FOUNDATION & SETBACK FOOTING STEEL MAIN GROUND SYSTEM GROUND PLUMBING .G2_ PRE-GUNITE DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED CONCRETE SLAB IT JOISTS &GIRDERS ELECTRICAL GROUND WORK DO OT P UR CONCRETE UNTIL ALL ABOVE HAS BEEN SIG ED ROUGH ELECTRIC ROUGH PLUMBING ROUGH GAS & GAS TEST HEATING & VENT- A/C FIREPLACE ROOF BOND BEAM O.K. TO WRAP GROUT ❑ 4' ❑ 8' FRAMINGlit- 7- v INSULATION _I I t:5�A COVER NO WORK UNTIL ABOVE HAS BEEN NED DRYWALL INTERIOR _ EXTERIOR LATH POOL PRE PLASTER POOL FENCE & GATE SEWER NK FINALS ELECTRICAL PLUMBING I FINAL GAS TEST HEATING - A/C HOUSE NUMBERS JOB COMPLETED TEMP POWER ' a,,.a y5%� .� ABOVE APPROVALS DO NOT INL IGHT TO TURN ON UTILITIES OR OCr:1IPY RI III niNr- P' ° �� t � { it � drr 4 ,i -•�-�" � -'�I tiJ"�tly4�-A - Yh�-��ttRr lyy -S, v MIP Shy �g yy�`��g__SC�;fy"�S'iAr,,Hu'f','ti''�5.�'�25.. Ga�i�y�C{ici1�1<��a� �� Ova �� •%R ll +�. •Vi OM E l4. M ON et �� i � �� 4, '��,�"t ��.• � tea. � � l5 �- �, u1 •. lh �' 1. K. p fi �' � f � t '- ivO C ' i,, �y ✓rM _ ,�� v.Y`gF",,��Vt � { F +.h " 1.�1f � /7,�i e�� % '�.�� S 44ti d �� +�1 ✓a r ��r k t t a ��.,t. �'y-may _ .. ' 9 r * aii� gin L ,�I 12 SPP�� f t ! w t Certificate of Occupancy City of La Quintal Building and Safety Department This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code, certifying that, at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: BUILDING ADDRESS: 78-364 HWY 111 Use Classification: COMMERCIAL MERCANTILE/FUEL STATION Bldg. Permit No.: 0109-212 Occupancy Group: M/S-3 Type of Construction: VN Land Use Zone: COMMUNITY COMMERCIAL Owner of Building: TOSCO MARKETING COMPANY Building Official Address: 3525 HYLAND AVE'. City: COSTA MESA CA 92626 By: KIRK KIRKLAND Date: APRIL 15, 2002