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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 ...z...r. �. v v:?..w.,. .,s..hr.�-. _z �+�x.a'.-..i-T. S:'.,. -•::: c, ��� 'it:;;" .... . , kc._,. ............a.. .:...,. �M.x.,._�.... .....•,.t._ .. .M,.:..., , r�......_.1S �.. �....i. et:�: ']..r �`.=:Ys. �..:'...:.r'i>i::ic.�a�...,......:�at✓1Fs':.d.-�...< '" .. ..