08-1892 (RC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Apglicatjon •Number:_. =0.8=000.0-1.89.2.
-
PropertyAddress: --
� 78370 HIGHWAY 111 STE 285
APN:
604-050-048- - -
Application description:
. REMODEL - COMMERCIAL
Property Zoning:
COMMUNITY COMMERCIAL
Application valuation:
6000
T a
iat 4 4-Q"
Applicant: Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Bus• ss and Professionals e, and my License is in full force and effect.
License Class: 13 Li an a No.: 925797
Date: % Contractor:
OWNER-BUILDronrtra�ct�cr's
TION
I hereby affirm under penalty of perjury that I am exempt from 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).:
(_) 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.).
1 _ 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 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
Owner:
MADISON PTM LA 'QUINTA
78370 HIGHWAY 111, STE
LA QUINTA, CA 92253
Contractor:
RYAN, PAMELA
43810 CARMEL CIRCLE
PALM DESERT, CA 92260
(760)636-1074
Lic. No.: 925797
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/31/08
-----------------------------------------------
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 EXEDRT Policy Number EXEMPT
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 ould become'subje'c,�t• �to the workers' compensation provisions of Section -
3700 of the Laborde, I shall forthwirli�omply with those provisions.
_ r — 1 f _., __ -A I _ 11 ,l /J
WARNING: FAILURE TO SECURE WORKERS' COMPENS ION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ANDICIVIL 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 t e above information is correct. I agree to comply with all
city and county ordinances and state laws relating to b i ing construction, an reby authorize representatives
of this county to enter upon the above-mentioned pro y for insp ction u -p s
Date: Signature (APPlicant-or-Agent):
Application Number .
. . . . 08-00001892
------ Structure Information
SUITE 285 T.I.
-----
Other struct info
CODE EDITION
2007
FIRE SPRINKLERS
YES
MIXED-USE OCCUPANCY
B
OCCUPANT LOAD
25.00
----------------------------------------------------------------------------
2ND FLOOR SQUARE FOOTAGE
1235.00
Permit . . .
BUILDING PERMIT
Additional desc
SUITE 285 T.I.
_
Permit Fee . . . .
81.00 Plan Check Fee
52.65
Issue Date . . .
Valuation
6000
Expiration Date
6/29/09
Qty Unit Charge
Per
Extension
BASE FEE
45.00
4.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
36.00
Permit . . .
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . .
39.7.0 Plan Check Fee
9.93
Issue Date . . . .
Valuation . .
. . 0
Expiration Date . .
6/29/09
Qty Unit Charge
Per.
Extension
BASE FEE
15.00
1235.00 .0200
----------------------------------------------------------------------------
ELEC GARAGE OR NON-RESIDENTIAL
24.70
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . .
32.50 Plan Check Fee
8.13
Issue Date . . . .
Valuation . .
. . 0
Expiration Date
6/29/09
Qty Unit Charge
Per
Extension'
BASE FEE
15.00
1.00 4.5000
EA MECH VENT INST/ DUCT ALT
4.50
2.00 6.5000
EA MECH VENT FAN
13.00
Permit . . .
PLUMBING
Additional desc .
Permit Fee . . . .
61.50 Plan Check Fee
15.38
Issue Date . . . .
Valuation
0
Expiration Date
6/29/09
LQPERMIT
Application Number . . . 08-00001892
Permit . . . . . . PLUMBING
Qty Unit Charge Per
Extension
BASE FEE
15.00
6.00 6.0000 EA PLB FIXTURE
36.00
1.00 7.5000 EA PLB WATER HEATER/VENT
7.50
1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00
------------------------7---------------------------------------------------
Special-Notes and Comments
INTERIOR TENANT IMPROVEMENT TO SUITE
285- POINT HAPPY MASSAGE. 1235 SF, B
OCC. TYPE VB CONSTR. OCCUPANT LOAD = 25.
2007 CODES
----------------------------------------------------------------------------
Other Fees . . . . . . . ACCESSIBILITY PLAN REVIEW
5.27
ENERGY REVIEW FEE
5.27
Fee summary Charged Paid Credited
----------------------------------------"
Due
-----------------
Permit Fee Total 214.70 .00 .00
214.70
Plan Check Total 86.09 .00 .00
86.09
Other Fee Total 10.54 .00 .00
10.54
Grand'Total 311.33 .00 .00
311.33
LQPERMIT
Riverside County Fire Department Fire Protection Planning Section
Riverside Office: 230arket St., Ste. 150, Riverside, CA n92501 Ph. (951) 955-4777 Fax (951) 955.4886
Murrieta Office: 39493'�l:os Alamos Rd., Ste A, Murrieta, CA 92563 Ph. (951) 60D-6160 Fax (951) 60D-6164
Palm Desert Office: 77-933 Las" MontaRas Rd., # 201 Palm Desert, CA 92 21 1-41 31 Ph. (760) 863-8886 (760) 863.7072
Fire Department Clearance/Release
Date:
To: d Q1nt h�a �iA i If� IV1 d Sd�e�y ;
II
Fax:
Tract/Parcel Map #:
Permit/Lot #:
-1 Job Site Address: 0 I h
t
Final For Recordation
Release For Building Permit(s)
Shell Final Only (No Tenant)
Final For Occupancy
Building Plan Check Fees Paid
Building Plan Check Fees Not Paid
Other Fees
Fees Not Required
If you should have any questions, please contact the appropriate Riverside County F a Protection
Planning office for further assistance.
Auri ing i nature Release
N b�
Print Name
Form C — Revised 11/12/2008
JAN -19-2006 THU 12:18 PM RIVERSIDE COUNTY FIRE
Craig E. Anthony
Fire Chief
roudly setvin8 the
nincoiparntcd
teas of Riverside
;ounty and the
.hies of:
Banning
Beaumont
Calimem
.�
Canyon Lake
Coma
6
Desert Hot Springs
oe
Indian Wella
4
Indio
Lake Elsinore
la Quints
Moreno Valley
Palm Denert
Perris
Rancho Mirage
San Jacinto
Temecula
130PA of sapervisors
Bob Duster,
District l
John Tavagliaec,
District 2
Jeff stone,
District 3
Rny Wilson,
District A
Unrlon Ashley,
District 5
January 19, 2006
FAX NO, 17608637072
RWERSIDE COUNTY
FIRE DEPARTm-ENT
. ax
City of La Quinta
Building Department
Ref Point Mappy
LAQ-05-TI-065 (Ste 285)
LAQ-05-TI-105 (Ste 270 or 275)
Riverside County Fire Department is granting a fire tnal. For the following
Project located at 78370 Hwy I I l Ste 285 and Ste 0.
By
Terry DeSoucy
Fire Systems Inspector
FEAEROENCY SERVICES DIVISION • PUWNIN(3 SECTION • INDIO OFFICE
82-6T5 HIBIwsY t11, 211 86 F., Indlo, CA 92201 • (760) 883.98•Fax (76o) 863.7072
P. 01/01
I
J
a
Certificate of Occupancy
4-
B6filding.& SafeDepartment
This Certificate is issued pursuant to the requirements of Appendix Chapter 1 Section 110 of the
2007 California Building Code, certifying' that, at the time of issuance, this structure was in
compliance with the provisions of the Building Code and the various ordinances of the City
regulating building construction and/or use.
BUILDING ADDRESS: 78-370 HIGHWAY 111 # 285
Use classification: COMMERICAL (POINT HAPPYMASSAGE THERAPY) Building Permit No.: 08-1892
Occupancy Group: B Type of Construction: VB Land Use Zone: CR
Sprinklers Installed: YES Sprinklers Required: YES Occupant Load: 25
Building'Official
Owner of Building: MADISON PTM LA QUINTA
Address: 78-370 HIGHWAY 111 STE. 200
City, ST, ZIP: LA QUINTA, CA 92253
By: STEVE TRAXEL
Date: JANUARY 29, 2009
A CONSPICUOUS
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