11-1215 (RC)i. R
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253'
Application Number: C~11-00001215
Property Address: 78370 HIGHWAY'111 STE 185
APN: 604-050-068- - -
Application description: REMODEL - COMMERCIAL
Property Zoning: COMMUNITY COMMERCIAL
Application valuation: 18000
Ta�14'4Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S 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 Class: 13 License No.: 853780
C ractor: /4? i AQi to
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—) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_) I am exempt under Sec. B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.)•
Lender's Name:
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
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
-VI'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 STATE FUND Policy Number 0000195-2010
_ 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 1 should become. subject to the workers' compensation provisions of Section
3700 ;�Zthebor Code, I shall forthwithh comply with those provisions.
: ie?..Y
/WARNING: FAIL RE 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 and county ordinances and tate laws relating to building construction, and hereby authorize representatives
of thi county to enter upon a above-mentioned property for inspection purposes.
te: Si ature (Applicant or Agent): a�J
Date: 11/30/11
Owner:
POINT HAPPY REALTY, LLC
260 S BEVERLY #201
BEVERLY HILLS, CA 90212
D
NOV 3.0 20i�
Contractor:
ULTRA CONSTR & DEVELOPMENT INC
CITY OF LA QUINTA
3065 E. VERONA ROAD
FINANCEr)EPT
PALM SPRINGS, CA 92262
----�
(760)320-2113
Lic. No.: 853780
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
-VI'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 STATE FUND Policy Number 0000195-2010
_ 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 1 should become. subject to the workers' compensation provisions of Section
3700 ;�Zthebor Code, I shall forthwithh comply with those provisions.
: ie?..Y
/WARNING: FAIL RE 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 and county ordinances and tate laws relating to building construction, and hereby authorize representatives
of thi county to enter upon a above-mentioned property for inspection purposes.
te: Si ature (Applicant or Agent): a�J
Application Number . . . . . 11-00001215
Structure Information 1,200SF TI/VB/B--OCC/35-OL/FULLY SPRINKLE -----
Other struct info . . . CODE EDITION
2010
FIRE SPRINKLERS
FULLY
MIXED-USE OCCUPANCY
B
OCCUPANT LOAD
35.00
1ST FLOOR SQUARE FOOTAGE
------------------------------------------------------ ----------------------
1200.00
Permit BUILDING PERMIT
Additional desc
Permit Fee . . . . 189.00 Plan Check Fee
'122.85
Issue Date . . . . Valuation . .
. . 18000
Expiration Date .. `5/27/12
Qty Unit Charge Per
Extension
BASE FEE
45.00
16.00 9.0000 THOU BLDG 2,001-25,000
----------------------------------------------------------------------------
144.00
Permit . . . ELECT - ADD/ALT/REM
Additional desc .
Per Fee 21.00 Plan Check Fee
5.25
Issue Date . . . . Valuation
0
Expiration Date 5/27/12
Qty Unit Charge Per
Extension '
BASE FEE
15.00
8.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
----------------------------------------------------------------------------
6.00
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . . 27.00 Plan Check Fee
6.75
Issue Date Valuation . .
. . 0
Expiration Date 5/27/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
2.00 6.0000 EA PLB FIXTURE
12.00
---------------------------------------------------------- -----------------
Special Notes and Comments
1,200SF TI/VB/B-OCC/35-OL/FULLY
SPRINKLED [YOGA ROOM] APPROVED WITH
COMMENTS - THIS PERMIT DOES NOT INCLUDE
BUILDING SIGNAGE OR CHANGES TO THE
EXISTING SUITE ADDRESSING. 2010
CALIFORNIA BUILDING CODES.
LQPERMIT
c
LQPERMIT
Application Number
. . . . .
11-00001215
r
--'--- ----------------
Special Notes and
-----------
Comments
---------------
--=----------
--------------
November 29, 2011
4:10:06 PM
AORTEGA
Other Fees . . .
. . . . . .
ACCESSIBILITY
PLAN REVIEW
12.29
BLDG STDS ADMIN
(SB1473)
1.00
Fee summary
Charged
Paid —Credited
Due
Permit Fee Total
237.00
.00
.00
237.00
Plan Check Total
134.85
:00
.00
134.85
Other Fee Total
13.29
.00
.00
13.29
Grand Total
385.14
.00
.00
385.14
c
LQPERMIT
4:f
P.O. BOX 1504 BUILDING & SAFETY DEPARTMENT
78-495 CALLE TAMPICO (760) 7 77-70 12
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
To: Greg Butler, Building & Safety Manager
From: Les Johnson, Director -Planning
Permit #:
To CDD: //- 6- //
Due Date: //- 15 - /I
Status: 166 044�-
Bulldhg Plans Approval
(This is an approval to -issue a Building Permit)
The Planning Department has reviewed the Building Plans for the following
project:
Description: 7. /.
Address or General Location: 79-370
Applicant Contact: Zio '
The Planning Department finds that:
❑ ...these Building Plans do not require Planning Department approval.
V/ ...these Building Plans are approved by the Planning Department.
C
...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.
v �o
Les Johnson,
-Planning
�' c10
�
Q `f
city of La
s'ki'nning Oej :�r?rnont
Date
Bin #.
.
City of La •Quinta
Building & Safety Division
P.O. 'Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
,
Permit #
11 21
mill
Project Address: — �O
Owner's Name:
A. P. Number: V� ►viivlr�
Address:
Legal Description:
City, ST, Zip:
Contractor: L
Telephone:
Address: !-
� s_�A- fp
Project Description:
City, ST, Zip:
Telephone:
-,
State Lic. # : d City Lic. #:
Arch., Engr.; Designer:
Address:
r Lt
City, ST, Zip.
Telephone:
State Lic.:
4 0:
_.,
1077
.:Construction
>rx rr;.:
Type: Occup
• Project type (circle one): New Add' Alter Repair Demo
Sq. Ft:(/�� # Stories: #Units:
Name of Contact Person: ���j l
El
Telephone # of Contact Person:W43
(Vq
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted I'[v
item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
.-.
Truss Cates.
Called Contact Person
Plan Check Balance
SS
Title 24 Calcs.
Plans picked up
Construction
BD
�ON. �.
Flood plain plan
Plans resubmitted
Mechanical
^
Grading planZ°"
Review, ready for correctionstissue
Electrical
Subcontactor List
Called Contact Person I 1
Plumbing
Grant Deed
Plans picked up
S.M.I..
�-
H.OA. Approval
Plans resubmitted
Grading
IN HOUSE:-7rd
Review, ready for. correctio rssue
Developer Impact Fee
�—
Planning Approval
Called Contact Person Ill.,A.I.P.P.
Pub. Wks. Appr
Date of permit issue
tt7
School Fees
1 'lot
Total Permit Fees
5 �,
UAMW *1011) WAILAS IJ
p �laa. vac,�,b
PROUDLY SERVING THE
UNINCORPORATED AREAS
OF RIVERSIDE COUNTY
AND THE CITIES OF:
BANNING
BEAUMONT
CALIMESA
CANYON LAKE
C OAC H E LLA
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 1
JOHN TAVAGLIONE
DISTRICT 2
JEFF STONE
DISTRICT 3
JOHN BENOIT
DISTRICT 4
MARION ASHLEY
DISTRICT 5
RvERsim 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
November 14, 2011
RE: TENANT IMPROVEMENT PLAN CHECK -Non Structural
LAQ-1 I -TI -040 Yoga 78-370 Hwy 111 #185 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 2A1 OBC Fire Extinguisher, (State Fire Marshal Approved) must be mounted in a
visible location within 75' walking distance from any point in your building or suite. Fire
extinguishers can be installed by a licensed extinguisher company with a State Fire Marshal
service tag attached to the extinguisher, or purchased from a retail store with a sales receipt
attached. A licensed fire extinguisher company must service extinguisher yearly.
All breakers must be labeled and a clearance of 36 inches must be maintained around the panel
at all times.
Approved suite addresses shall be placed in such a position to be plainly visible and legible from
the street: Said numbers shall contrast with their background.
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
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.
J
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.
Sincerel ,
By:
Jaso tubble
Fire Safety Specialist