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11-0863 (RC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Applicant: c&`!t 4 4a Q" Architect or Engineer: a� fX BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am li ensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and rof sionals Code, and my License is in full force and effect. License f,lass: B -C10 / License No.: 934412 ate: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). - ( ) 1 am exempt under Sec. , B.&P.C. for this reason ®AMc Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: ' LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: Owner: SCI PLAZA AT POINT HAPPY FUND PO BOX 543185 DALLAS, TX 75354 Contractor: D Q M & M TOTAL SERVICE 74260 VELARDO DRIVE PALM DESERT, CA 92260 ��17 �± 2U�1 (760)779-0736 1 Lic. No.: 934412 CITY OF !.A QUINTA 8/29/11 WORKER'S COMPENSATION DECLARATION 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 and policy number are: Carrier EXEMPT Policy Number EXEMPT I c=at, 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 becori"r ubject to the workers' compensation provisions of Section 0 of the labor Code, I`shall Yort with comply a provisions. Da et : LZEYKppficant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes 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 an unty ordinances ands to laws relating to building constructs nd hereby authorize representatives oft county to enter upon above-mentioned property for ins c ' p oses. Date: nature (Applicant or Agent): Application Number: 11-00000863 Property Address: 78370 HIGHWAY 111 STE 160 APN: 604-050-048- - - Application description: REMODEL - COMMERCIAL Property Zoning: COMMUNITY COMMERCIAL Application valuation: 5000 Applicant: c&`!t 4 4a Q" Architect or Engineer: a� fX BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am li ensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and rof sionals Code, and my License is in full force and effect. License f,lass: B -C10 / License No.: 934412 ate: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). - ( ) 1 am exempt under Sec. , B.&P.C. for this reason ®AMc Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: ' LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: Owner: SCI PLAZA AT POINT HAPPY FUND PO BOX 543185 DALLAS, TX 75354 Contractor: D Q M & M TOTAL SERVICE 74260 VELARDO DRIVE PALM DESERT, CA 92260 ��17 �± 2U�1 (760)779-0736 1 Lic. No.: 934412 CITY OF !.A QUINTA 8/29/11 WORKER'S COMPENSATION DECLARATION 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 and policy number are: Carrier EXEMPT Policy Number EXEMPT I c=at, 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 becori"r ubject to the workers' compensation provisions of Section 0 of the labor Code, I`shall Yort with comply a provisions. Da et : LZEYKppficant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes 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 an unty ordinances ands to laws relating to building constructs nd hereby authorize representatives oft county to enter upon above-mentioned property for ins c ' p oses. Date: nature (Applicant or Agent): Application Number . . . 11-00000863 ------ Structure Information 900SF OFFICE TI/VB/B-OCC/9-OL/SPRINKLED ----- Other struct info . . . . . CODE EDITION 2010 FIRE SPRINKLERS FULLY MIXED-USE OCCUPANCY B OCCUPANT LOAD 9.00 1ST FLOOR SQUARE FOOTAGE ---------------------------------------------------------------------------- 900.00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 72.00 Plan Check Fee 46.80 Issue.Date . . . . Valuation ... . . 5000 Expiration Date 2/25/12 Qty Unit Charge Per Extension BASE FEE 45.00 3.00 9.0000 THOU BLDG 2,001-25,000 ------------------------------------------------------------=--------------- 27.00 Permit . . ELECT - ADD/ALT/REM Additional desc . . Permit Fee . . . . 18.75 Plan Check Fee 4.69 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/25/12 Qty Unit Charge Per Extension BASE FEE 15.00 5.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 3.75 -----------7---------------------------------------------------------------- Special Notes and Comments' 900SF OFFICE TI/VB/B-OCC/9-OL/FULLY SPRINKLED (DR ABEL RODRIGUEZ].CONTROLS FOR LIGHTING TO BE INSTALLED IN EACH AREA PER ENERGY CODE. THIS PERMIT DOES NOT INCLUDE BUILDING SIGNAGE, EXTERIOR ALTERATIONS OR CHANGE IN OCCUPANCY. 2010 CALIFORNIA BUILDING CODES. August 18, 2011 10:22:50 AM AORTEGA -------------------------=--------------------------------------=----------- Other Fees . . . . .. . . ACCESSIBILITY PLAN REVIEW 4.68 BLDG STDS ADMIN (SB1413) 1.00 ENERGY REVIEW FEE 4.68 Fee summary Charged Paid Credited ---------------------------------------- Due - ----------------- Permit Fee Total 90.75 .00 .00 90.75 Plan Check Total 51.49 .00 .00 51.49 LQPERMIT LQPERMIT Application Number 11-00000863 Other Fee Total 10.36 .00. .00 10.36 Grand Total 152.60 .00 .00 152..60 Bin # City of LA Quinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Per 't Project Address: 6 Owner's Name: A. P. Number: Address: '1$ d Legal Description: City, ST, Zip: Contractor: :><::< telephone: v%x; >:IN :.:.. Address: Project Description: wp t_L City, ST, Zip:?ML -M 1�r1 �DbiLS —Tu C4L1V- 2 Telephone:-7j..,�': ' ``"' ` N� w ar'''FI Lf S State Lie. # : City Lie. #.: 1:Q4 Arch., Engr., Designer: (!7 Address: ') Li $3b U ulo Sv . City,, ST, Zip AL SECL� G, g22tdp . — Telephone�� b � f f-: ? Construction Type: OccupancyQ State Lie. #:�s�3f<s;:<;::fs`:::z>:.;:.:`<'»r;<><::..:; Project type (circle one): New dd'n ter Repair Demo Name of Contact Person: C hl -U> Its Sq. Ft.: 01 b O # Stories: #Units: Telephone # of Contact Person:. bb 2550 ?! O-1 %,4 Estimated Value of Project SI o 00 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit �.. Truss Cates. Called Contact Person Plan Check Balance Title 24 Cates. Plans picked up Construction ���ww 1� Flood plain plan Plans resubmitted Mechanical --� Grading plan 2°" Review, ready for corrcetionsfissue Electrical Subcontactor List Called Contact Person Plumbing +� Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading ^ IN HOUSE:- 3" Review, ready for correction iss O � �11 Developer Impact Fee � Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees (, Total Permit Fees VAI to Ift (A � ► K .: "n I L/9. 0i �a ,q.�/ 0 � .- - . - . ... �V-w PROUDLY SERVING THE UNINCORPORATED AREAS OF RIVERSIDE COUNTY. AND THE CITIES OF: ' BANNING BEAUMONT CALIMESA CANYON LAKE i COACHELLA DESERT HOT SPRINGS EASTVALE INDIAN WELLS INDIO JURUPA VALLEY LAKE ELSINORE LA QUINTA MENIFEE MORENO VALLEY PALM DESERT PERRIS RANCHO MIRAGE RUBIDOUX CSD SAN JACINTO TEMECULA WILDOMAR BOARD OF SUPERVISORS: BOB BUSTER DISTRICT I JOHN TAVAGLIONE DISTRICT 2 JEFF STONE DISTRICT 3 JOHN BENOIT DISTRICT 4 MARION' ASHLEY DISTRICT 5 RIVERSIDE COUNTY RRE DEPARTMENT IN COOPERATION WITH THE CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION John R. Hawkins - Fire Chief 210 West San Jacinto Avenue - Perris, CA 92570 (951) 940-6900 - www.rvcfire.org August 24, 2011 RE: TENANT IMPROVEMENT PLAN CHECK -Non Structural LAQ-I I -TI -028 Dr. Abel Rodriguez Chiropractic 78-370 Hwy 111 #160 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/process or, store any materials in this occupancy that would classify it as an "H" occupancy per Sec. 307 of the 2010 CBC. THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO INSPECTION: Install door hardware and exit signs as per Chapter 10 of the 2010 CBC. A minimum 2AIOBC 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. 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. 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. 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. An approved audible interior notification alarm device shall be provided in approved location. A C-10 licensed contractor must submit plans, designed in accordance with NFPA 72 to the Fire Department for review and approval prior to installation 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. Sincerely, By: \Jasn Stubble Fire Safety Specialist LI 0 P.O. BOX 1504 BUILDING & SAFETY DEPARTMENT 78-495 CALLE TAMPICO (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 a. To: Greg Butler, Building & Safety Director From: Les Johnson, Planning -Director Permit #: 11-863 To PD: August 11, 2011 Due Date: August 17, 2011 Status: 1 St Building, Plans Approval (This is an approval to issue a Building Permit) The Planning Department has reviewed the Building Plans for the following project: Description: Tenant Improvement Address or General Location: 78-370 Highway 111 Ste. 160 Applicant Contact: Candice Noto (760) 880-3016 The Planning Department finds that: I] ...these Building Plans do not require Planning Department approval. 1K ...these Building Plans are approved by the Planning 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 Planning Department for review. nson, Virecior-manning F FeCON AUG 11 ?011 City of La Q rota Planning DOP&I 13nt Date