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0103-050 (CSCS)N i� N U) W o�c') W IZ o Z r CJD O.o Ho J CL U) Z LICENSED CONTRACTOR DECLARATION ;I hereby affirm under penalty of perjury that I am licensed under provisions of Chapt& 9 (commencing with Section 7000) of Division 3 of the Business and DATE Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date JOB SITE y P ADDRESS Ji�'�ry3,:.R`�6ir� � � 76�QJrGt 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). �(y) I, as owner of the property, am exclusively contracting with licensed Ontractors to construct the project (Sec. 7044, Business & Professionals Code). O I am exempt under Section B&P.C. for this reason Date Signature', of Owner {WORKER'S COMPENSATIOMDEGLA, A 9N� a 1 hereby affirm under penalty of perjury one of the following declarations: () I have,and will maintain wcetificate of consant 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 Policy No. ST..A"t'F FA.:N 14:144 (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, 11 ` hall 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 Wit -t ooseprovlslons. Date: Applicants ', _ arnin : 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 'fk of the Labor Code, interest and attorney's fees. `r 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, indemn��yp & hold harmless the City of La Quinta, its officers, agents and employee's�r 2. Any permit issued as -a result of this application becomes null anq YOid�f . work is .riot commenced within 180 days from date of issuance 9 �uoh 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 aboveinformation 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. {\yl i Signature (Owner/Agent), , t' dam.. Date' OWNER BUILDING PERMIT VALUATION LOT 90, 8 lAOMT-rAIN001TUE ORTARIO USE OF PERMIT dr C;OIWE'1 CIPII PERMIT# 01Y.3 -Ow TRACT APN CONTRACTOR/DESIGNER/ENGINEER �i ):: (Aq nwzr comes t.ucly.*< 1 , INC. 1 C�Yt7l�"t l 10.9 CA.. 91762F9a�"�tt RARil�fC�3 CA 9226,2 (760)322-1.553 CHIX 3962 C0N1:M1r,R1CJ L B'f_t1L_r,%JN0 n20 SQUARE, ftRT SPI~'1'PiXL•Ss?. 7,920.00 S? AM'— C'0MMZRC1AL 7,220.00 sy +1t5i41'RAC7'.�. iJLz�it %q .122.0 L 1 g 2001 sj JAW PREP ISM LA *TOTAL FKRWIT FEES DUE NOW RECEIPT DATE r BY DATE JINALED _ 441,7.72.-S0 $�13,77,2 �n &U,1,7222 INSPECTOR 9 �j�{'Yy� �j y�1� p K t ,,�y'9 A IVEM IUD 5 olvi" V.�it COWS 1L7LilCl IO C10NS7 a'E1C?" :OAFFE9 101 -000.4 1 ft -000 %1,3309 i%UNC,H.E•�d:,`K FEEtd�1-f)t0.43w9-319 $if3t;0.�g 1ss1 L°'1`1.�C Li, tl'i °1tr fl 12 �Gt3i3 Y2t s ? $105.00 STR0 -410 MOTION 3+ER - COMM 100-000-241 -000 3112,77 . 0R W)1W0 nX 101.000-423-•00,0 an.fJmQ DEVELCiPER IMPACT F1141 .Alb, 1H Pt11,41AC,1L4CXS°i4COMP 701-000-2.55-000 Wh,' DUa HAT , ° 1ft3.-CIi14 3g„; 1 •S1,500,00 1 g 2001 sj JAW PREP ISM LA *TOTAL FKRWIT FEES DUE NOW RECEIPT DATE r BY DATE JINALED _ 441,7.72.-S0 $�13,77,2 �n &U,1,7222 INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE TINSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air _ Steel Combustion Air Roof Deck 0. K. to Wrap Exhaust Fans F.A.U. Framing _ Compressor Insulation Fireplace P.L. l_Gl d( _ - Vents Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final _ �— POOLS - SPAS BLOCKWALL _ APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pibg. 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 Piaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: As Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G. F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) _04S ��. Mb W�O • , �/� o� 41�- v 1 V P.O. BOX 1504 { ' /[J.�/1 / t 78-495 CALLE TAMPICO APP'CAT-0*ONLY Q� IN I Address Building _---+—�LA QUINTA, CALIFORNIA 92253 N41 V 0a 'V ! Owner C Q, Mailing BUILDING: TYPE CONST. VN GR�404� Address N, MoUPTM N AV A.P. Number o City Zip Tel. �j FL22(.j AT�i Legal Description r �ii'C. � . 2 Contractor Project Description lAT -r � Address N w C-09 PG91, T-R) City Zip Tel. ' State Lic. City & Classif. Lic. # Sq. Ft. No. No. Dw. Arch., Engr., Size Zo Stories Units Designer 1'l�f�sT , VVK1S11 G ��c�{�j�C,'('S New ❑ Add O Alter O Repair ❑ Demolition D Address p � Tel. �ov� 0, �F /�.�5%i`tW • 1 ids • ` ��°� � City Zip State M Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and;Professions Code, and my license is in full force and effect. ( SIGNATURE DATE; I f [ OWNER -BUILDER DECLARATION Estimated Valuatio •►J I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 703 1.5, Business and Professions Code: Any city or county which requires a _ permit to the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT construct, alter, improve, demolish, or repair any structure, prior to 'its issuance also AMOUNT requires %'� // the provisions of the Contractor's ,License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis / v for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. subjects the applicant to a civil penalty of not more than live hundred dollars ($500)• I: I, as owner of the property, or my employees with wages as their sole compensation, will PIanChk. Bal. do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, Mech. provided that such improvements are not intended or offered for sale. If, however, the building r or improvement is sold within one year of completion, the owner -builder will have the burden Electrical t of proving that he did not build or improve for the purpose of sale.) I1 I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. such projects with a contractors) licensed pursuant to the Contractor's License. Law.) Grading 11 I am exempt under Sec. 8. & P.C. for this reason _ Driveway Enc. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation. Insurance, or a certified copy thereof. (Sec. 3900, Labor Code.) Policy No. Company ' n Copy is filed with the city. O Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg 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. Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances: comply with such provisions or this permit shall be deemed revolved. Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. fSec. 3097, Civil Code.) Side Setback from Property Line Lender's Name Lender's Address This is a building permit when properly tilled out, signed and validated, and is subject to FINAL DATE INSPECTOR expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. Issued by: Date Permit I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above- mentioned property for inspection purposes. Validated by: Signature of applicant Date Mailing Address Valliidati1on: r l /1 Coity, State, Zip 4 l 1 I ' /-f+'' I Cj Y( L) Y)✓, -rU J 1 WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Notice: Document Cannot Be Duplicated Date 3/15/01 No. 21765 Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 760-771-8515 CERTIFICATE OF COMPLIANCE Owner NameMadison Development APN # 604-050-044 Jurisdiction La Quinta No. 78-430 Street Highway 111 city La Quinta Zip 92253 Tract # T29736 Type of Development Commercial Comments Building Lot # 5 Permit # 0 103 -050 Log # Study Area Square Footage 7220 No. of Units 1 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 7,220 or $ 2,382.60 the property listed above and that building` permits and/or Certificates of Occupancy for this square footage in this proposed project nay now bssued Fees Paid By CC / First Community Bank - Ed Alderson `T ephone T� Name on the check +� By Dr. Doris Wilson Superintendent Fee collected /exem ted by Annette Barlow Signature Payment Received $2,382.60 Check No. 098972 NOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1998) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above 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 collect them on the District('s)(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 J CioLa oQuinta . 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 Departmentonly after approval. Contact applicant for resolution of conditions preventing or delaying approval. Project: Point Happy - Bldgs 45 T29736 Highway 111 - (see atta ed plans) Applicant Contact: Madison Development - Ed Alderson Application / Circulation Date: Community Develo ment par Christine Di Iorio, Planning Manager is Works Department Engineer Building and Safety Department Greg Butler, Building and Safety Department Manager Nickie Gormley Counter Technician Building & Safety X01 . Date . Da 3�G0 ate Date NOV-13-01 TUE 1:12 PM RIV,-•CO. FIRE P&E INDIO FAX N0, 1 760 863 7072 P 1 TOM Tisdalo - Fire Chief Proudly serving the unincorporated areas of Riverside County and the Citi.es of: Banning Beaumont CaRiracsa o;. Canyon bake Cgitchellu Desert I for Springs .a Indian Wells .1 Indio 4. Lake Elsinore La Quinta Moreno Valley r,. Palm Desert Perris 44 Rancho Mirage 4. San Jacinto Temecula Board of Suporvisors Bob Bustor, 17s11rict t John Tavag hone. Dietrict 2 Jim Venable, Distrix 3 Roy Wilson, . tiWAI4 Tom Mullet, Distrid s r RIVERSIDE COUNTY FIRE DEPARTMENT 1 In cooperation with the California Department of Forestry and Fire Protection 21OWest an Jacinto Avenue erns, Friday 9, 2001 To: City of La Quinta Building Department Re: The Falls Steak House The Riverside County Fire Department hereby releases the above referenced project for issuance of a building permit at the discretion of the Building Department. Respectfully, FRANK. KAWASAKI Chief Fire Department planner ...... By:. Terry DeSoucy , Fire Safety pector FMfROEfVGY SEFnAGES DIV184ON • PLANNNG GEGTIp� • RiPIa Gff�'r� ` Tom Tisdale Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of: Banning 4. Beaumont .;. Calimesa Canyon Lake • ,v Coachella 4. Desert Hot Springs •3 Indian. Wells Indio ... Lake Elsinore 4. La Quinta 40 Moreno Valley PahnDesert .- Penis Rancho Mirage. 4. San Jacinto +3 Temecula Board o€ Supervisors Bob Buster, District 1 John Tavaglione, District 2 Jim Venable, District 3 Roy Wilson, District 4 Tom Mullen, District 5 RIVERSIDE COUNTY FIRE DEPARTMENT In cooperation with the h` California Department of Forestry and Fire Protection 210 West San Jacinto Avenue • Perris, California 92570 • (909) 940-6900. Fax 909) 940-6910 February 27, 2001 To: Prest Vuksic Architecture 74-020 Alessandro, Ste C Palm Desert, CA 92260 Re: Building Plan Review - Non -Structural Point Happy / SDP 2000-688 - Bldg. 5 gie(J,*. Fire Department personnel have completed a review of the plans you submitted for the above referenced project. Please be advised the following conditions apply as a part of the conditions for the issuance of a building permit. 1) These conditions are for a shell building and will receive a shell final only.- No fire and life safety clearance will be issued for a tenant space until the specific occupancy classification has been established and tenant improvement plans have been reviewed and conditioned by the Riverside County Fire Department. 2) Fire Department approval is based upon the 1997 UBC requirements for Group B occupancies. It is prohibited to use, process or store any materials in the occupancy that would classify it as a Group H occupancy per Sec. 307 of the 1997 UBC. 3) The Fire Department is required to set a minimum fire flow for the remodel or construction of all commercial buildings using the procedure established in California Fire Code. A fireAow of 1,500 gpm for a 2 -hour duration at 20 -psi residual operating pressure must be available before any combustible material is placed on the job site. 4) The required fire flow shall be available from a (Standard/Super) hydrant(s) (6" x 4" x 21/2" x 2'/2") located not less than 25' or more than 165' from any portion of the building(s) as measured along approved vehicular travel ways. 5) Prior to the issuance of a building permit, applicant/developer shall furnish one blueline copy of the water system plans to the Fire Department for review. Plans shall conform to the fire hydrant types, location and spacing, and the system shall meet the fire flow requirements. Plans must be signed by a registered Civil Engineer and/or the local water company with the following certification: "I certify that the design of the water system is in accordance with the requirements prescribed by the Riverside County Fire Department". 6) Install a complete fire sprinkler system per NFPA 13. The post indicator valve and fire department connection shall be located to the front within 50' of a hydrant, and a minimum of 25' from the building. System plans must be submitted to the Fire Department for review, along with a plan/inspection fee. The approved plans, with Fire Department Job card must be at the job site for all inspections. 7) Install a monitoring system as per NFPA 72, which must include a water flow monitor, control valve tamper and continuous monitoring service. System plans must be submitted to the Fire Department for review, along with a plan check/inspection fee. 8) Install Knox Key Lock boxes, Models 4400, 3200 or 1300, mounted per recommended standard of - the Knox Company. Plans must be submitted to the Fire Department for approval of mounting location/position and operating standards. Special forms are available from this office for the ordering of the Key Switch, this form must be authorized and signed by this office for the correctly coded system to be purchased. EMERGENCY SERVICES DIVISION - PLANNING SECTION - INDIO OFFICE 82.673 Highway 111, 2' Fl., Indio, CA 92201 - (760) 863-8886 - Fax (760) 863-7072 9) If the building/facility is protected with a fire alarm system or burglar alarm system, the lock boxes will require "tamper' monitoring. 10) Install portable fire extinguisher's per NFPA, Pamphlet #10, but not less than 2A1 OBC in rating. Contact certified extinguisher company for proper placement of equipment. 11) Approved building address shall be placed in such a position as to be plainly visible and legible from 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. Minimum of 6" lettering is required for suite identification. In strip centers, businesses shall post the business name and suite number on back doors as well as the front. All addressing must be legible and of a contrasting color with the background. 12) Electrical room door shall be posted. "ELECTRICAL ROOM" on the outside of door. Please contact the Fire Department Planning & Engineering staff for final inspection prior to occupancy. Applicant/installer shall be responsible to contact the Fire Department to schedule inspections. Requests for inspections are to be made at least 24 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, I FRANK KAWASAKI Chief Fire Department Planner By Walter Brandes Fire Safety Specialist I H:\PEZWPDATA\LAOUINTA\PROJECTSIBLDG_PCLSDP2004688 Bldg 5(b).doc YOUNG ENGINEERING SERVICES Engineering Architecture -Surveying- Building & Safety Services Letter of Transmittal To: City of La Quinta Attn: Greg / Ed Tel No.: We are forwarding: No. of Copies 1 1 1 1 1 1 Date: 2/27/01 Project: PC # 0101-192 (2 nd check) Bldg. #5 — Point Happy , W.O.. Tract No.: By Messenger By Mail X Your Pickup Description: Plans (V submittal) Plans (2" submittal) Structural calculations Truss calculations Soils report Structural calculations addendum Comments: All structural plan check comments have been addressed adequately. This Material Sent for: Your Files X Per Your Request Your Review Approval Checking At the request of: Other By: John W. Thompson Phone # 760-342-9214 47-159 Youngs Lane, Indio, CA 92201 (760) 342-9214 Bronz Young Tom Tisdale Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of - Banning Beaumont 4- Cahmesa Canyon Lake Coachella - 4. Desert Hot Springs Indian Wells 4 - Indio Lake Elsinore La Quinta 4. Moreno Valley Palm -Desert Perris 4. Rancho: Mirage.. -. ❖ San Jacinto Temecula Board of Supervisors - Bob Buster, Distrid-l- John Tavaglione, . DistricL 2 - Am Jim Venable, District.3: Roy Wilson, District 4 Tom Mullen, District 5 RIVERSIDE COUNTY FIRE DEPARTMENT In cooperation with the California Department of Forestry and Fire Protection 210 West San Jacinto Avenue • Perris, Ca l omla 92570 909) • Fax 909) 940-6910 January 9, 2001 To: Prest Vuksic Architecture 74-020 Alessandro, Ste C Palm Desert, CA 92260 Re: Building Plan Review - Non -Structural Point Happy / SDP 2000-688-aBfidgg. 5v_� Fire Department personnel have completed a review of the plans you submitted for the above referenced project. Please be advised the following conditions or corrections must be completed and approved by the Riverside County Fire Department before a building permit can be issued. 1) Sheet T1.1 — Note on plans that the building is a shell building. It is suggested to note the allowable occupancy classifications permitted in the building other than just a Group B occupancy. ('.e. A3, M, S, etc.) 2) Sheet T1.1 - Provide proper notations for door hardware requirements specific to occupancies other than Group R Occupancies. The referenced Code sections and noted door hardware specifications are in conflict with the 1997 UBC. o cillo K SC44 -r(•( 4I-P€osv'g2ea 1133 re T'b TI•"2 All questions regards g the meaning of these conditions should be referred to the Fire Department Planning & Engineering staff at (760) 863-8886. Sincerely, FRANK KAWASAKI Chief Fire Department Planner By Walter Brandes Fire Safety Specialist H:\PE2\WPDATA\LAOUINTA\PROJECTS\BLDG_PC\.SDP2000-M Bldg 5(a).doc EMERGENCY SERVICES DIVISION • PLANNING SECTION • INDIO OFFICE 82.673 Highway 111, god Fl., Indio, CA 92201 • (760) 863-8886 • Fax (760) 863-7072 TEMPORARY 30 DAY CERTIFICATE OF,OCCUPANCY Certificate of Occupancy City of La Quinta 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: 78-430 HWY 111 Use Classification: COMMERCIAL Bldg. Permit No.: 0103-050 Occupancy Group: B Type of Construction: VN Land Use Zone: COMMERCIAL Owner of Building: MADISON DEVELOPMENT Address: 938 N MOUNTAIN VIEW AVE City: ONTARIO CA 91762 By: KIRK KIRKLAND Date: 11-14-01 Building Official POST IN A CONSPICUOUS PLACE