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0010-189 (RC)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of HCl �,,pter 9 (commencing with Section 7000) of Division 3 of the Business and k'P1C,fes�ionals Code, and my License is in full force and effect. �j f� License# Lic. Class Exp. Date r 270844 14 Date rl 2r� C2' — Signature of Contractor 1 /° `�� "" i 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). ( ) I, as owner of the property, am exclusively contracting -with �licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ( ) I am exempt under Section B&P.C. for this reason Date Signature of Owner 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 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. ST6I'>i E FUND (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, 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 become subject to the workers' compensation, p[ovisions of Section 3700 of the Labor D te- II hal forthwith comply with,those-pro'vlsion�s ,). , k. Date: "S.-,��,o Applicant tip ^^g>' Lf,i r 1/s' i Warning: 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 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safetyq,...., for a permit subject. to the conditions and restrictions set forth onOhs)1. 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, indemnify & hold harmless the City of La.Quinta, its officers, agents and employees r 2. Any permit issued as a f4sult of this application becomes null and void If work is not commenced within 180 days from date of issuance of such] r permit, or cessation of work for 180 days will subject permit to cancellation t I certify that I have read this application and state that the above information i correct. I agree to comply with all City, and State laws relating to the building Ii construction, and hereby authorize -representatives of this City to enter upon LJ the above-mentioned property for inspection purposes. nature ,Inent) 4 F Y r,�r�'��";`sa Date .BUILDING PERMIT PERMITk DATE J VALUATION LOT 00.10,,189 TRACT (� JOB SITE APN ADDRESS a �t ,�fi 1��dyyVy� ty g q p p i.Yir-w-q / .N F_t..4:�'1L`dD'O',;1: A. d.4% 10.9tL ,PY, �, .• OWNER. CONTRACTOR/DESIGNER/ENGINEER r MAWt�3� ,i �y�n� �py* �+�y � �{ ,� t�� A y pt y y /y �VYk�iyT�.R x�x.6i.PV��:��gg�+'S'.yyaTlir../1+�A�..wyCl'�d11.yV+y1'tIFY.T�aFN71.4 T 1 3 y �p�v� p�,�,�i p 1, pyy p-� I,�y.,y� `i',..�.�14DF,4Yy1_7'��,�+yO �y.y.'li.�,.1gN�CJaal�,lg'C�S(^a�'a1eX��s'`F S 5 .nlcy-..T u��a"'C+R'.A.' 1./�ni Ia JE.t R_ 5 �t , 3 #aJ�� DO YS.S•L•INIAJLOb"Y :CS.t%l” D , SAI -T DrEGO CA 92113Y, CAJ N, CA 92024 R, E USE OF PERMIT , 2055 S.F. T)E'f A,,4T ,ilv7PR.OVrl Uli,)4T (RU8110-3 9,AJA ( RILL) WNT RALn AIMOi.'1`i`i` U Mn67.Y,r.+•.I,YhKA!1..f D Ci.ISA Y Ci.i.CGISMJ'S.i R+16o.l"T �i%yRw.JTv�:7' 1��f 9y gay: L �12rYg,i �7a COA43'i'1tU CION FEL 101.000-411-000 MAO .PLAN C1. EX.r, FRY 101-000-439-:318 $Itol.86 1�,':i? I'.>E11091T 101.000439-3781 -12&0,00 Tt E'4; ,'NIuiia, cif ii 101•-000-421-000 $136.50 'qAA,, , n P%.W . L WER 101-0-00-420-000 $1$0.60 PLlJAIDIND fW, 101.000-419-000 V32.50 S a RO•I 0 MOTION FRE •COMM 100.000-241-.000 55,4 :1;'Q'.t �C3t" h'i 3CilO$S 1fi'9 PI -W C1i1=Xd LMS PRr, -PAD 11 4250,00 A.isdTA�: Is DUE HO W Ci JUL 2 0 2001 R RECEIPT DATE' BY a DA FI ALE INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel _ _ Combustion Air Roof Deck gj//'f/p� Exhaust Fans O.K. to Wry; Framing �,�iFyl/ _ _ _ G7 Jl—/ Q�i9d� F.A.U. essor Insulatio, Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath 8l10A - _ Final OX0, _ BLOCKWALL APPROVALS Final POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final . Gas Piping PLUMBING APP .OVALS Waste Lines/I/�,a�—'� = Water Piping Gas Test Electric Final Heater Final Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Gas Piping Gas Test Encapsulation - Appliances Final COMMENTS: //i.� i��a✓ C2� t�! ��/ 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) tit lz� r P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 July 9, 2001 Catherine Shearer M&H Property Management LLC 12555 High Bluff Drive, Suite 385 San Diego, CA 92130 Dear Catherine: (760) 777-7000 FAX (760) 777-7101 Please be advised of an address change for the following structure. The structure formerly addressed as 78-437' Highway 111; APN: 604-050-016, Parcel 5; Parcel Map 19028; the construction for which building permit #0003-017 was issued, will now be addressed as178=447'Highway-111. Please note this change and contact me directly at (760) 777-7019 if I may be of further assistance. Thank you. Sincerely, C Diane Aaker Senior Secretary Building& Safety Department 1 478-947 Nw�'ti�►, s+� A u'�� P O BOX 1504 Building UINT CA Address—��T�T7V'P7 TirT—"�cT-"T LA QUINTA, C Mailing X224 Address G City �� , f� Zip />1L.0_ _V .ARA• 3. �Dt ►�c-s ro►� Address 3330 �1E �t.t_ow City Zip (0L-\ye_1QAANrJ CM102 State Lic.. & Classif. `&.1 �j !344 Arch., Erff. Designer A. ,94-�,�3 �iu1a y C�A mes:v Z�ZIe: 2oAn LLE TAMPICO APPLICATION ONLY ALIFORNIA 92253 / BUILDING: TYPE'CONST. V `�► OCC. GRP. A �, kPi'Number Tel. Legal Description""' Project Description Tel. &58 �15L,r» �G. ,6,�>�i n e t��lS City Lic. q Sq. Ft. No. No. Dw. Size �� Stories Units el. IP l', Tg60p 1415 State Lic. H LICENSED CONTRACTOR'S DECLARATION 71; I here affirm that I am licensed A]fider provisions of Chapter 9 (commencing with Section i o f`v sio oht a Bus'in`ess , d role 11 Code, and my license is in full force and ,Q T V • , � l/^ ADi/7 ata 7\1 GNATU - DATE � *%� OWNER-BUILDER.DECLARATION --1 hereby affirm that,.) am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5.Business and Professions Code: Any city or county which requires a --permit.,ro consfrucf, alter, improve, demolish, or repair any structure, prior to 'Its Issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to 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 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 (5500). •fit: 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, Buisness and 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, provided that such 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 did not build or improve for the purpose of sale.) I 1 I, as owner of the property, am exclusively contracting with licensed contractors to con. 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 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) I'J I am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION Ihereby 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. 3800, Labor Code.) Policy No. Company r7 Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM 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 4Owner NOTICE TO APPLICANT: d, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. 1 certify that I have read this application and state that the above information is correct. 1 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. Signature of applicant Date Mailing Address City, State, Zip Add ❑ _Iter 1 r. I . . 1 ' r Estimated Valuation PERMIT «�✓ AMOUNT Ian Chk. Dep.�"� . Plan Chk. Bal. i ,Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE } INSPECTOR a eft Issued by: Date i Validated by: 9 D00 Validation: 41 111 WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Bin # ' a, City of LdQuinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (619) 777-7012 Building Permit Application and Tracking Sheet Permit # 0010 IS9.1 Project Address: 7f3 445 14 I& S-1 Owner's Name: Rj#,bS 1465 Avt4wrYS >`tx. A. P. Number: Address: 1902 WtL\(.NT ;1► �n Legal Description: City, ST, Zip: CA,��9A,0 GA. 8200$ Contractor: 16 iG Ow3T Telephone: 60o �1 $ Address: X330 VbgC— l,40%.w 0%0 �¢ Project Description: _ L1t7Q..•%S. City, ST, Zip: Gu�IF�-11r1A�wa CA, QZDZ4 Tele P hone: Sb 3 ew7 #3 State Lic. # : 2757044 City Lic. #: " Arch., Engr., Designer: FMCP Am (.t4 \TEZ'CS Address: 3484-6 City, ST, Zip: CO,:)TP VA%054 CA. AZ624P Telephone: one: 4 ` 9tofvl4I S Construction Type: P e: (.019ccu Pan 3 Y S cY. A i B Z Lic. # Project type �circleone : Add'n n Alter r i ReP aDemo Name of Contact Person: lzoo&m Sq. -Ft.: Z, OcpS # Stories: I # Units: r Telephone # of Contact Person: (11601(0(.—t445 Estimated Value of Project: 40,000 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 Calcs. Called Contact Person Plan Check Balance Title 24 Coles. Plans picked up Construction Grant Deed Plans resubmitted Mechanical School Fees 2"d Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Planning Approval Plans picked up S.M.I. Pub. Wks. Appr Plans resubmitted Grading H.O.A. Approval 3rdReview, ready for corrections/issue Developer Impact Fee A.I.P.P. Date of permit issue : - J Total Permit Fees T Desert Sands Unified School District 47-950 Dune Palms Road Notice: , La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 CERTIFICATE OF COMPLIANCE Date 12/4/00 APN # No. 21278 Jurisdiction La Quinta Owner NameM & H Realty Partners No. 78� Street Highway 111 City La Quinta zip 92253 604-050-016 Permit # 0003-017 Log # Study Area Tract # Lot # Square Footage 6300 Type of Development Commercial No. of Units 1 Comments ial bldg. is a retail building. 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 6,300 or $ 2,079.00 the property listed above and that building. permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued Fees Paid By CC / Union Bank of California / Ron Rehnquist Telephone Name on the check ? rl r By Dr. Doris Wilson Superintendent Fee collected /exempted by Annette Barlow Payment Received $2,079.00 / ^ \ Check No. 7288071 Signature IA GV NOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) 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 Distdct('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 uttyUJ La Liutnta 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 Department only mer approval. Contact applicant for resolution of conditions preventing or delaying approval. Project: Rubio's Restaurant - TI in Pad 5 Building 78-437 HIGHWAY 111 Applicant Contact: Lorenzo Reyes (714) 516-1010 Application / Circulation Date: 10/30/00 Community Development Departmen r \ e l Christine Di Iorio; Planning eager to Public Works Department. Steve Speer, Senior .Engineer Building and Safety Department Greg Butler, Building and Safety Department Manager Health artmen Fire Departme Schools Fees Paid Date e Date Date Date TWY� 4�Q�rw MEMORANDUM TO: GREG BUTLER, BUILDING AND SAFETY DEPARTMENT FROM: STAN B. SAWA, PRINCIPAL PLANNER VIA: CHRISTI DI IORIO, PLANNING MANAGER SUBJECT: FINAL INSPECTION FOR PAD 5, PLAZA LA QUINTA (SDP 2000- 667 M&H REALTY) DATE: JUNE 15, 2001 The Community Development Department has inspected the above noted project and finds it acceptable as completed. I have signed off the job card of the contractor. Should you have any questions, please call me at extension #7064. c: Danny Crawford, Building and Safety Department 1 � p:\Stan\memo to b&s sdp 2000-667.wpd f"' —7,9-w,-- 1111,W— ASSESSOR'S PARCEL NUMBER COUNTY OF RIVERSIDE.HEAL-TH SERVICES AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM• APPLICANT. Submit this form with four copies of a SCALED plot plan (1-20 SCALE) drawn to County specifications as indicated on the attached, check list. A non-refundable filing fee is required when the application is submitted. Check must be made payable to the County of Riverside. Approval of this applica- tion shall remain valid for a period not to exceed one Year from date of payment. LMS # Agent, Contractor, Contact-Person Address City State Zip Telephone LQC°✓`v17 11@,R� �Zt` E, 1(Ca�p.`1•c\ �V¢t��r (,if'1'\•i4 C'i-Z�4?' Si1�-)D/U Owner s Address City j State • Zip Telephone Q , Rvto b y S-iYw4P. 4, A1C g0"Z t,,)ir c�,t f lnc2._u�AL �c.() C..cls6c e 9-Z'c of ^,5�pZx10 Z Job Property Address .. ' City�/�� Zp C, `�K C, J , 1i"}' LUU Lot Size Water Agency/Well{ Use of Permit, P/P, SUP, PUP, etc. Legal Description !G 1J(0'c�'�r'�"'f s Dwelling, MH Site Prep., etc. Signature of Applicant . Data CHECK BOX IF REQUIRED �+ If any box is checked, this application shall be considered rejected until ❑Detailed Contour Plot Plans Required (1 to 5 foot interval) the information is provided and the fee paid. Resubmittals lateF than 90 days after date noted below may require repayment of fees. ❑ Staff Specialist Lot Inspection Required m ❑ Holding Tank Agreements Completed _ Thomas Bros. Page Grid z r O 0 ❑ Certification of Existing S.D.rS.yste�em Required , ❑ Date'Kotnspection Completed: Initials U ❑ WOCB Clearance Required .., LU (Attach for DOH-SAN-007, Santa Ana Region Only) ^�.,�Remarks: ❑ Soils Percolation Report Required " 4. �`�nt ❑Maintenance__ Booklet Provided r ❑ Special Feasibility Boring Report Required - "*1 ,., ❑ Rereview Required Initialst i ❑ Final Inspection by Department of Environmental Health is required. Please call 24 hours PRlOR,to inspection. -D s C/42 / Soils Percolation Boring Report by Lic/Project # �' Date t 1 r Soils Map Page Soil Type Approved By Date No of Systems ' T pe of System(s) No. Dwelling Units (1) Septic Tank Soil Rate Grease/Sand t Holding Tank ❑ Replacement (mew ❑ Addition Bedrooms, Fixture Units Grease Intcp/kJnt Trap ❑ Existing "btu Gal. r S 10 n Gal. Sq. Ft. Total Linear Sidewall Allowance Leach Bed sq. ft. of Bottom Area Ft. £ Bottom Area ft. rock/ sq. ft. running ft.. Install Lines) ft. long ft. wide with Inlet Tested Depth ❑ NA min. inches rock below drainlines or U Proposed Bottom Tested Depth Z Leach lines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Inlet (BI) Seepage Pit Maximum Other: O Total Depth Allowable F- Applicable Depth LU N/A Overburden Factor ❑ 5' ❑ 5 TD Well Review Approved: Date: Well Drilling Permit.# SIGNATURE - Grading Plan Approved: Date: Si Ata.('~Date: Sewer Verification Approved: lo�:y�i'/Q�./ r Plan Check Only Approved: Date: REMARKS:` :!N 15t K? $ I1 1. 1 Ft- � 1't c +.� , ^.' �r . n-t t , s - c 1 .✓r�te l (' ,1 M-1 l el, C e Ct {...•<-. -_ P e- � .'�S � 'Y . X , \. t "C �-.,,, i? � `- \ �+- � ♦ S� i I : )` T 'i: fts%, A��f�tUn n+, c. Y�rls2l ell r, 1 t ti y 1 y This application is APPROVED/DENIED for the category checked in SECTION B FOR OFFICE USE ONLY above, regarding the design of a subsurface disposal system as indicated on the acompanied plot plan, using the requirements set forth in. SECTION C above. A build- ing is for permit necessarythe installation of the above-designed sy%eM. _No canc Revenue code Fee structlon Is nermltted ln'4he requlied reserved 100% eiceanelon area." "'� ' j - _ (1) Septic Tank must be 100' minimum from any wells. ® Check # Z (2) 'Leach lines must be 100' minimum from any wells, including expansion area. Date / / / ^.,ti Initial 17 (3) 1.Sewer lines must be 50' minimum from any wells. Z (4) Seepage pits must be 150' minimum from any wells, including expansion area. ' U ft LVCn a Signature of Health Official ~ Date t r SAN -122 (Rev 9/e8) Distribution: WHITE—Office File; YELLOW—Applicant; PINK—Bldg. Dept.; GOLDENROL—Plans/Records f City bf La Quinta 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 Department r ly after approval. Contact applicant for resolution of conditions preventing or delaying approval. Project: Rubio's Restaurant - TI in Pad 5 Building 78-437 HIGHWAY 111 Applicant Contact: Lorenzo Reyes (714) 516-1010 Application / Circulation Date: 3 00 Community Development Department s Christine Di Iorio; Planning Manager Public Works Department 4 (D� r S kve Speer, Senior Engineer Building and Safety Health Department Fire Department Schools Fees Paid s and Safety Department Date Date Date Date Date Date WED 12:21 File' EI?, CC, FIRE P&E !010 Larry Benson Fire Mel ?AX N0, 1 ?6-. 863 7012 I%w MSIDE COUNTY FIRE L, 'ARTMENT In cooperation with the California Department of Forestry and Ftre Protection 21 U West W J"to AvenLIQ •Perrip, California Fax (900) 940 -Mi Cl 20, 2000 The Reyes Group, Inc. 1224 E. Katells Ave, Suite 105 Orange, CA 92867 Proudly serving the Re: Architectural Building Plan Review uninoarporated Rubio's Baja Grill / LAO -00 -BLDG -001 areas of Riverside County aid the Fire Department personnel have completed a review of the plans you submitted for the above referenced Cities of:I project. Please be advised the following conditions apply as a part of the conditions for the issuance of a Banning building permit. Bcaurnorlt 1) Fite Department approval Is based upon the 1994 UBC requirements for Group B occupancies. it is prohibited to use, process or store any materials in the occupancy that would classify it as an H CBlirncsa occupancy per Sec. 307 of the 1994 UBC. canyotl I,Ake 2) Fire sprinkler system plans for the tenant improvement area must be submitted to the Fire Department s'for review, along with a planAnspection fee. The approved plans, with Fire Department Job card must Coachella be at the job site for all inspections. od Th seat I1A Springs ,y 3 Install portable fire extinguisher's ) p 9 per NEPA, Pamphlet #10, but not less than 2A1 OBC in rating, Indian WeUs Contact certified extinguisher company for proper placement of equipment. Indio 1 4) Install a Hood/Duct automatic fire extinguishing system. System plans must be submitted, along with a ?• plan check/inspection fee, to the Fire Department for review_ Lake Elsinore v 1 La 5) Approved buliding address shall be placed In such a position as to be plainly visible and legible from Q"'n the street and rear access If applicable. Building address numbers shall be a minimum of 12" for Mnre�no Valley building(s) up to 25' in height, and 24" in height for building(s) exceeding 25' in height. Minimum of 8" 1 4, lettering is required for suite identification. In strip centers, businesses shall post the business name Palm Dcscrtand suite number on back doors as well as the front. All addressing must be legible and of a 0 1 contrasting color with the background. Perris 4 6) Verify that existing door hardware on the kitchen exit door (#7) is compliant with the 1998 California Rancho Mirage Building Code for common knowledge hardware requirements Replace/repair as required. Baa Jacinto 4 Please contact the Fire Department Planning & Engineering staff for final Inti etion prior to occupancy: Temecula Requests for inspections are to be made at least 24 hours In advance and may be arranged by calling (760) 863-8886. Board ofs„perviwr6 All questions regarding the meaning of these conditions should be referred to the Fire Department Planning & Engineering staff at (760) 863-8886. [lob Buxar, Sincerely, John Tavaglione, rJistrial a FRANK KAWASAKI J'un Vortablo, Chief Fire Department Planner . I Distrid 3 Rey Rlilaott, r �/ Di4 ZT[ By Tnm Mull''m Walter Brandes mftd s Fire Safety Specialist ENIERCENCY SERVICES DIV(,9ION " P1.AWM SECTION • VMto oFFM 12.673 IbOMay 111, %W n,,12ft CA 92201 • (760)169-16x6 " Fax (760)163-7071 -'dale 0% DAt.e ftjftisow 11;28/00 TUE 10:44 FAX 619 390 6889 AMERICAN FIRE i lj j 002 CALIFORNIA DEPARIWM OF FORESTRY and FIRE PROTECTION OFFICE OF THE STATE FIRE MARSHAL REGISTERED FLAME RESISTANT PRODUCT Product:' Registration No. X-238 C-•16301 Product Marketed By: AMERICAN FIRE RETARDANT CORP 9337 BOND AVE EL CAJON CA 92021 - This product meets the minimum requirements of flame resistance established by the California State Fire Marshal for products identified in Section 13115, California Health and Safety Code. The scope of the approved use of this product is provided in the current edition of the CALIFORNIA APPROVED LIST OF FLAME RETARDANT CIIMUCALS AND FABRICS, GENERAL AND LDv= APPLICATIONS CONCERNS published by the California State Fire Marshal. Expires: 06/30/8001 Deputy State Fire Marshal FR -8 11/28/00 TUE 10:45 FAX 619 390 6889 AKERICAN FIRE vj. `10 3 MATERIAL SAFETY DATA SHEET ***I. PRODUCT IDENTIFICATION: FIPLEX X_238*x* :SUPPLIER'S NAME AVIEP.TCAN FLRE RETARDANT CORPORA'nom ADDRESS: 1 1 0 BRUSH R -AD, BROUSSARD, L; 70518 PHONE NUMBER FOR INFO: (31 9) 837-1 1 11-8 • DATE PREPARED: 2/93 ***II< HAZARDOUS IN(3REDi�TS*** CHEMICAL NAMES CAS NUMBERS PERCENT'' -EXPOSURE LIMITS IN AXR (UNITS) _ACGIH TLV OSHA PEL O" HER ( SPECIE '- -'ROPRiETARY INFORMATION ?dE NE (TRADE SECRET STATUS) E = NOT ESTABLISHED NA NOT \PPCICASLE ***III_ PHYSICAL PROPERTIES*** VAPOR DENSITY: (AIR = 1) NE MEL'T'ING POINT OR RANGE: OF VA SPECIFIC GRAVI`T'Y: 1 ; 1 ti -1.20 BOILING POINT OR RANGE: OF I`II`^IAL BOILING 90INT 212°F SOLUBILITY IN WATER: APPRECIABLE EVAPORATION RATE: (BUTYL ACETATE = 1) NE VAPOR PRESSURE: mmHg @ 20°C: 17 mmttg AT 20'C APPEkRANCE AND ODOR: WHITE LIQUIC WITH SWEETISH ODOR FSH 'RANGE : 7- 9 ***IV. FIR; AND EXPLOSION*** FLASH POINT OF (GIVE�i::THOD) :ABOVE 212°F PENSKY MARTEENS CLOSED CUP AUTO IGNITION TEMPERATURE °F NE FLAMMABLE LIMITS IN AIR: NE FIRE EXTINGUISHING MATERIALS: X WATER SPRAY X CARBON DIOXIDE _OTHER X FOAM X DRY CHEMICAL SPECIAL FIRE FIGHTING PROCEDURE=S: FIRE FIGRTERS MUST USE' SELF-CONTkINED BREATHING APPARATUS UNUSUAL FIRE'AND EXPLOSION HAZA-RDS: ON COMBUSTION, WATER, NITROGEN OXIDES, a CARBON MONOXIDE, HYDROGEN CHLORIDE, PHOSPHOROUS OXIDE AND OTHER TOXIC SUBSTANCES MAY BE FORMED. ***V_ HEALTH HAZARD INFORMATION:*** ' SYMPTOMS OF OVEREXPOSURE FOR EACH POTENTIAL ROUTE OF EXPOSURE INHALED: DIZZINESS, NAUSEA, LOSS OF CONSCIOUSNESS CONTACT WITH SKIN OR EYES: SLIGHT IRRITATION ABSORBED THROUGH SKIN: SLIGHT IP.RITATION SWALLOWED: MODERATELY TOXIC IF SWALLOWED 1 11/28/00 TLIE. 10:46 FAX 619 390 6889 AMERICAN FIRE y 10 004 HEALTH EFFECTS OR RISKS THROUGH EXPOSURE: ACUTE: WARNING: _MA.Y.CAUSE SKIN SENSITIZNTION OR OTHER ALLERGIC RESPONSE. CHRONIC: BLOOD CHOLINESTERASE ACTIVITY DECREASED ATTER PROLCNGED ANIMAL F; STUDIES. SIGNIFICANCE TO HUMANS HAS NOT BEEN ESTABLISHED. FIRST AID AND F-4ERGENC`_' PROCEDURES: EYE CONTACT: WASH EYES WITH WATER FOR 15 MINUTES, CONTACT PHYSICIAN. SKIN CONTACT: WASE{ OFF WITH WATER, :'EASE{ WITH SCAP AND (NATER. IF REDNES PERSISTS, CONTACT Pt{YSICAN. INHALED: NOT EXPECTED TO BE PROBLEM, REMOVE TO FRESH AIR. SWALLOWED: IF CONSCIOUS, GIVE LARGE AMOUNTS OF WATER, CONTACT P!{YSI._ It"IMEDIATELY. TREAT SYMPTOMkTICP%LLY, DO NOT INDUCE VCM_rTz: PUMPING STOMAC!{ TO RE:40'x; CONTENTS , i".'=•� BE li\(DICAT .D. NE11- GIME: FLUIDS TO AN UNCONSCIOUS PERSON. SUSPECTED CAINCER AGENT? NO: IJTS PRODUCTS lNGR_DT_EN T.'S ARE NOT FOU -NO !,N THE LESTS SE_,OW `SES. XX . FEDERAL OSHA NTP _!IARC CCNT .=NS LESS THAN 0. 8 ; DS:"Z- _ � ORri:1..+ . AND LESS T?:=.N 7 2 ?PD1 Vrt'YL7!{LO!?rDE, 30Ti{ SJS?LCTED C:{EMIC,Ai. C.,RCINOGENS. MEDICAL CONDITIONS AGGRAVATED BY EXPOSURE_ ALLERGY AND ECZ£N?A ***VI_ REACTIVITY DATA*** STABILITY:,STABLE CONDITIONS TO AVOID: DO NOT cEP.Z^ OR ?Cru INCOMPATIBILITY (MATERIALS TO AVOID): ACED3, PRODUCTS THAT REACT VIOLENTL'_ ,JIT!{ WATER, STRONG OXIDIZING GENTS. HAZARDOCS DECOMPOSITION PRODUCTS (INCLUDING COMBUSTION PRODUCTS): CARBON MONOXIDE, CARBON DIOXIDE, HYDROGEN CHLOR :L'E, PI{OS'Pf{OROUS OXIDES, CARBON, NITROGEN •OXIDES. HAZA ECUS POLYMERIZATION: WILL NOT OCCUR ***Vxi. SPILL, LEAK, AND DISPOSAL PROCEDURES*** SPILL RESPONSE PROCEDURES (INCLUDE EMPLO''EL PRcT C'^ION MEASURES_) IF PRCG:, IS SPILLED,VENTILATE ?IDEA, CONTAIN, ABSCRE vN INERT iKATERI?.L (DIaTOMAC='0-_ EARTH) AND DRUM IN CLOSEABLE DRUMS. SPILLED MATERIAL IS VERY SLIPPERY. AVC FALLS. WEAR SAFETY GOGGLES, CHEMICAL RESISTANT GLOVES, CUEMICAL RESISTANT BOOTS. WASH CONTAMINATED CLOTHING IN SOIP._ .AND WATER. IN CASE OF ACCIDENT C ROAD SPILL, NOTIFY CHEMTRAC AT 800-424-5.00. IN CASE OF SPILL THAT COULD 7 ANY WATER;'�AY CONTACT U.S. COAST GUARD (300) 4Z4-8002. DISPOSE OF ABSORBED MATERIAL IN LANG Fr_L..OR INCINERATE IN ACCORDANCE ,JIT!' APPLICABLE FEDERAL, STATE, AND LOCAL REQ-LATIONS.•(INCINERATION IS PREF_Rr NOTE: DISPCSE OF ALL WASTES IN ACCORDANCE 'WITH FEDERAL, STATE AND LOCAL REGULATIONS.' 11/28/00 TUE 10:48 FAX 619 390 6889 AMERICAN. FIRE 0-005 ***VIII'. SPL• CIAL H XNDI.INC- INFORMATION--*** VENTILATION AMD ENGINEERxNG CONTROLS: US_ OUT OF DOORS, USE, LOCAL EXHAUST VENTILATION INDOORS. PAY CLOSE ATTENTION TO GOOD VENTILATION WHEN CONTAIN ARE OPENED. FORMALDEIiYDE MAY BE RELEASED_ RESPIRATORY PROTECTION TYPE: PAINT RESP:RATOR EYE PROTECTION TYPE: SAFETY GOGGLES GLOVES: CHEMICAL RESISTANT PLASTIC OR SYNT'Ii';TIC RUB-Eft GLOVES. OUTER ZLOlHING AND EQUIPMENT_ WEAR COVERALLS. IF SPILLED ON CLOTIMiG, REQ: WASH WITH SOAP AND 'WATER BEFORE RE--USE. WORK PRACTICES, HtiGIENIC PRACTICES: DO NCT rNGEST, KEEP OUT -OF EYES, OFF AND CLOTHING.. WASH BANDS BEFORE EATING ?.N4b SMOKING. SHOWER OR BATHE DAILY OTHER HANDLING AND S'T'ORAGE REQUIR'E24ENTS: STORE !N COOL PLACE, AVOID FRLr= PROTECT'IV'E MEASURES DURING THE ,`dAIPI'1ENANCz O!' CUN'rAmIi ATED EQUIPMENT: US= t E mT t T S{t 7M �.T r , ,n - GOOD ! N. _LATL ON WHEN CLE .NISdG EQUIP ,E i_ . lh:.R OGGL_S AND yRME Iv£ G:... WHEN CLEANING EQUIPMENT: BE SURE .'TO WASH HANDS BEFORE EATING :`:NO S.KOKI�IG- M&H PROPERTY MANAGEMENT, INC. October 15, 2001 Mr. Daniel P. Crawford, Jr. City of La Quinta 717 7-495 Calle Tampico La Quinta, CA 92253 ( Re: 78-447 Highway 111 Site Accessibility Pad 5 Plaza La Quinta Dear Mr. Crawford, CITY OF I_A 01 IINTA OCT 2 2 RECD BUILDINU ANN z hAFETY 12555 High Bluff Drive Suite 385 San Diego, California 92130 Ph: 858.350.1977 Fax: 858.259.8886 exT 32s This letter is in response to your letter regarding an accessible route of travel from the bus stop located at the Highway 111 frontage through the Rubio's public sidewalks and leading to the Orchard Bakery. M&H Property Management is currently evaluating all properties in our portfolio to determine any upgrades/ repairs necessary to comply with current ADA Standards. We anticipate that Plaza La Quinta will be evaluated in the weeks to come and any upgrades/ repairs would be scheduled to begin by the end of the calendar year. We thank you for bringing this matter to our attention. If you have any questions, please feel free to give me a call. Thank you. Sincerely, M&H PROPERTY MANAGEMENT INC. elennGoodma ConstrUcti6n. Manager cc: David Geiser, M&H Jim Houghton, M&H eArgxa ✓ sfkA,2- 11-1 to V, P.O. Box 1504 78-495 CALLE TAM PI CO LA QUINTA, CALIFORNIA 92253 October 2, 2001 M & H Property Management LLC 12-555 High Bluff Dr., Ste 285 San Diego, CA 92130 Attn: Mr. Glen Goodman RE: 78-447 HWY 111 (Pad 5) Site Accessibility I 1A� 0- a Y. C U; AU40 (760) 777-7000 FAX (760) 777-7101 Dear Mr. Glen, This letter is a follow-up as requested to document our discussion on the afternoon of October 1, 2001. The Building Official has determined that an accessible route of travel within the boundary of the site shall be provided. The accessible route of travel shall be provided from the public transportation bus stop located at the HWY 111 frontage thru the public sidewalks located west of Rubio's and extend an identifiable accessible crosswalk across the parking lot/street to the Orchard Bakery. . Please contact me when you receive this letter. If you have any questions I am available to meet with you at any time on site to address the accessible route of travel required. Please provide us with an estimated time of completion. Your cooperation in this matter is greatly appreciated. Building inspector Il dpc cc: file r 0 �-1 /r. P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 January 8,_2001 (760) 777-7000 (TDD) (760) 777-1227 Mr. James Ruddock c/o Lindsey Construction 22642 Lambert Street, Suite 409 / Lake Forrest, CA 92630 �-" YY7 Subject: :'Tim- r& Use Permit 2000=278(Temporary Construction Trailer for M&H Properties) Dear Mr. Ruddock, The Community Development Department has approved your -request for a temporary construction trailer in the Plaza La -Quints Shopping -Center -for Pad , subject to the enclosed plan and the following conditions: l< �abuil&ngpermit including an electrical permit for temporary power. 2. Trailer shall have restroom facilities to accommodate personnel. 3. Mounted on the exterior of the trailer close to the front door shall be a written notice providing emergency personnel your 24-hour emergency phone number they can call in case problems arise that need your prompt attention (i.e., minimum 1 " high letters). 4. Install one 2A1013C'fire extinguisher inside the trailer.by the front exit door. 5. No temporary signs are approved unless separately approved by this Department. 6. Removal of the temporary construction trailer is required upon completion of this project. 7. Any permits required by the Public Works Department shall be obtained prior to any work proceeding. 8. The City may elect to add Conditions to this application request to mitigate any problems that arise not previously addressed herein. @ This decision may be appealed to the Planning Commission provided the necessary paperwork and filing fee of $175.00 are filed with this office within 15 days. If you have any questions, please contact me at 760-777-7064. Very truly yours, JERRY HERMAN COMMUNITY DEVELOPMENT DIRECTOR STAN B. SAWA Principal Planner c: ✓Building and Safety Director Public Works Director Code Enforcement Department Fire Department i PASTANVtr ago tup 2000-278.wpd 'ON 3Stl3 1181HU loll 3 J 0 A8 1d301 3W 1300 A1Mn"03 A8 o3noaddd p COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH SERVICES SUPPLEMENTAL REPORT TO SAN. FORM # DATE 7 lo 'SUBJECT PERMIT NO. 1 DDRESS INSPECTOR REMARKS: r P 4eco-, liJ 1'�� tti v�S v� PSs r Uvl u sy 6Q� �rc�t�� e•e- fe cei�ecQ �. \ A i. I/ - W 0 �Jl . r . Of A- _ A 'DEH -SAN -118 (Rev 2/96) Distribution: WHITE—Office; CANARY—Owner; PINK—Office �tiTMICATa OF 111110MIRID 1WHY01t Internatlot�al 'CIT�►OIISIMM 1MtVtcT,ON 1P6PA; s .....• o I Conference of U11din Ici AMMO ,03 i 7-1-2000 20.00 , 1 t.61Tt fPRCtAL I1,1!<PiIOTan e tARlS C081CRtiT! o : ; 1s1i4 jDmon WC Z ASTY fTANpARDS The .Individual nam .d hereon is CERTIFIED, to the r 'category shown, h�Y g, been so certifiep'0 t o0 Will W. g0 d . t successful compte>;1 ,n of the prest ten 159 E 1 231st Street: �'. ,`r, i 'r s `examination. i Expiration date: Ma 113,1ositi CarBCui, CA No. 62237 Notv $t + ;1 icatlon attesu to OmMent knowledge of codes and'SWIdI& I f experience Mal Oe verified by local lwfsdiclfarit AMERICAN CONCRETE INSTITUTE Iolternetiotsai This is to aoaty ttrt Cgnforence of Building Officials d�W'K CERTFIM SPECIA�INSPECTOR belttnwledst: ad s011iS' by "="I STRNC .� 8i�t. i Yy�L`DfPIG o�PN°08 AQ a�ti6casiaa auuo 1887 uld BWLDWG CODE i00os I The 4 CERTIFIED In the oa tegoty`altoMm,', IgitfljQ ACI CONGWIM FIELD TESTING bead so cedtlbd pumuwt to' ti compikon of the Ofuc me TECiWIC1AP1— ORS I vAin.examination. Expirellon date. September 21,20n No.080198f EASNA C. Der 4-17.0 INot wild unless oatlilcate lf3paifrstirasttireew,tris e/arfir/rM�rrltA/rRsfiyitriwabtf/1 tujss A" IGN sibelyi•yiirlitY Gry of Bud" CommunnyI Dereloment Department Internaponal WIWIfls p uIon Date 9 30 -9g, Confirence of Building OfflcWB VA IAM W KOPP (818) —W9 8--wra.crZ �" rJ 0 CERTIFIED 80ECI(IL INSPECTOR • S ECIRL INSPECT08 1 Smuc uRA�MAsauRY 1887 UNIF M BUih0JN0t6DE Based on certification from LO O The.individualnamed hereon CERTIFIED 14 the catom shown,hevinp epecisttferi91. Jf LGt a W ko (� been so cwttW pursuant to Name A M ai is authoo Special inspector in the fotowing ExpirBoIdab: y16,209 2 o ,iooinpletion or u�e' .prescribed OBT9319 sf "' Nal wlid unlea signed Building Oificiai ��+ :rt>rl.awta.rl�i eetTieiyis�fifittdkti •. . by iic�(�C,�otyod lets SUILOIste AND SAM" p1 �Q�] S aYftjN VALIDATED, 0090 UNTIL JUNE STN LI.O. o. 1117 Tyre WORK CMW o • KQPPWILL-IA14 159E 231$T &T CARSC CA 9A� � r �► A X101-8,4-04EM o 0 0 I x ;Ji hn GO c o Intern atlonal Conference of Bi1llell 9 Officlals IAM W KOPP CERTIFIE SPECIAL INSPECTOR REINF RCED CONCRETE 1887 UNI ORM BUILDING CODE The individual named heraoa CERTIFIED In the calep q iJmwn; having been so aertttled pu lent to successful completion cf dt a prescribed written examinati Explratlan date: January 1e, No. W0319.89 Nat valld u s n fCBOeert(Jtcationatreatr caspetsrntknowls�gsof=desddModdrA Ahrlcx bli srpsrl * i 3hoald verj�ed bytaolprtrdiafotrs Y REG WIJTY in 12 t .t INONNI V160,ENSE REN FFR4EPM 62 BUILDING PBCTORC - N98-3582 /D earn W. FOOD 3 '1 tea„ r 19-00 07:39A CITY OF CATHEDRAL CITY 7 60 202 1460 international Conference of Building Officials -WLLIAM W KOPP ' ' CERTIFIED SPECIAL INSPECTOR STRUCTURAL STEEL & WELDING .1997 UNIFORM VAimO CODE jmW he�aril, having The Whiduat nli ow fi CERiIFIW m the aNe9otY Ceeri se cenlflel# piir>r++afit to suocesdul completion d Ole prescribed ' �' vamen ckajo..' japternt-.25, 2002 No. 0870819 tVot vatld unieaf certificate holder. i ✓olwa✓M✓irlc., �'��b' � . v �gpar.Te.6i eats rae�MbpWi► tenii✓y�+►�� ' international: Officials zonference of Building iam W Kopp CERTIFIED edConcre�CIAL EC[OR 1897 UBC & ASTM Standards The individual named hereon is CMRED In the category oWn, having been so certified pursuant towtioe l completion of the prescribedWAS �n exam Expiration date: older. No. os7os19�e Notnlessk��ge o f � and standards. Icso certification attests to corrrPetM sdkdons- Applirable v0en;enre shoufd be verified by local i --- - - international Conference of'Building Officials WILLIAM W KOPP e CERTIFIED SPECIAL INSPECTOR STRUCTURAL MASONRY 1997 UNIFORM BUILDING CODE The individual named hereat is CERTIFIED In the category shown, havhl9 been so calHted pursuant to successful Completion of the presuibed written examination. Expiration date: May 18, 2002` No. 0870318.84 _ s Not valid unless signed M9ce • A71D eEMraYeryskarb w-fadn"' andarc 4pivll wNiies"b t�ly�w►�.rirmua international Conference of Building Officials WILLIAM W KOPP CERTIFIED SPECIAL INSPECTOR REINFORCED CONCRETE 1997 UNIFORM BUILDING CODE The individual named hereon is CERTIFIED In the calegory sh0vm. having been so eertiifed pursuant to succ met comPletlon of the prescribed written examination. Expiration date: January 18, ZO 3 No. 08703198 �� l d Not valid un ess s n catttis�t fCBO oerrijication attestr to competent krowkdge of codes and standank Applicable experience should be venfted by local junsdictions SPECIAL INSPECTION SERVICE REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY ❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑ POST TENSIONED CONCRETE ❑ ASPHALT ❑ REINFORCED MASONRY ❑ FIRE PROOFING ❑`� L) 1 ❑ OTHER (%� / 37630 Medjool Ave. (; — eE3 ;"? r \r � i/o/+ i6--li CX3(�' Palm Desert, CA 92211 TYPE ^OF STRUCTURE Y1 1 V L Office (760) 772-7192 PE MIT7�NO.\ I`1 k V LJ V { Fax (760) 772-7193 DAY OF WEEK Pager (760) 776-3338 ARCHITECT TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑ POST TENSIONED CONCRETE ❑ ASPHALT ❑ REINFORCED MASONRY ❑ FIRE PROOFING ❑`� L) 1 ❑ OTHER (%� / JOB LOCATION, (; — eE3 ;"? r \r � i/o/+ i6--li CX3(�' REPORT SEQUENCE N0. TYPE ^OF STRUCTURE Y1 1 V L ( _ ` i B'GJ PE MIT7�NO.\ I`1 k V LJ V { SATEl1/ j -�'I% / 1 I �! OI DAY OF WEEK MATERIAL DESCRIPTION ARCHITECT INSPECTOR — -- HRS. CHARGED ENGINEER ASSISTANTS HRS. CHARGED INSPECTION DATE GENERAL SUB CONTRACTOR f ' J 5 � \f CONTRACTOR U J S'' �� v>. +J ,.S (.1-, 9 s COPY SENT TO CLIENT ❑ CONTINUED -ON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. . r i l I SIGNATURE OF/REGISTERED INSp�CTOR DATE OF REPORT I REE"jGIST'EER NUMBER _A ., . REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY I: k 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑ POST TENSIONED CONCRETE O ASPHALT ❑ REINFORCED MASONRY ❑ FIRE PROOFING ❑ -0 O OTHER JOB LOCATION99-4+Y7 fY7 i , - * K/ LA Qvy � REPORT SEQUENCE N0. T PE OF STRUCTURE`^A 6 -4 S • �/ i PE 11T NO . a 6 ' U 1T 3 pqT S 0' "d�j DAV OF WEEK MATERIAL DESCRIPTION ARCHITECT INS TOR HRS. CHARGED ENGINEER • K ,�• ASSISTANTS MRS. CHARGED INSPECTION DATE GENERAL1 I �` CONTRACTORt. Q SUB CONTRACTOR $ SOO L -T =a.D bXc COPY SENT TO CLIENT O CONTINU NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT 1 HAVE INSPECTED TO THE BEST OF MV KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS, AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. S 1_51 S E`O F REGISTERS TOR ATE OF EPORT REGISTER NUMBER 911 Y Continuous Inspection & Materials Testing ®V 1 J1JT 0_ ®e®� �� .�� ..., � IJ Inspection & Testing 10826 South Norwalk Blvd., Santa Fe Springs, CA 90670 (562) 941-2990 • (714) 526-8441 -.FAX (562) 946-0026 BUILDING AND SAFETY DEPARTMENT DEPUTY INSPECTION DIVISION DEAR BUILDING INSPECTOR: ENCLOSED YOU WILL FIND COPIES OF DAILY INSPECTION REPORTS AND/OR COMPRESSIVE STRENGTH TESTING RESULTS FOR JOBSITES IN YOUR JURISDICTION. THESE REPORTS ARE FOR YOUR RECORDS. IF YOU FEEL YOU HAVE RECEIVED ANY REPORTS IN ERROR, PLEASE RETURN THEK ATTN: KATHRYN. IF YOU HAVE ANY QUESTIONS PLEASE DO NOT HESITATE TO CALL US. THANK YOU, SOUTHWEST INSPECTION & TESTING � - v SOUTHWEST INSPECTION AND TESTING INC. 10826 S. Norwalk #A Santa Fe Springs, 'CA 90670 562-941-2990 ' 714-526-8441 Fax -562-946-0026 FIELD DATA ON -TEST SPECIMENS --- ASTM C31, C138, C143, C1727 C173, C231, C1064 --- CONCRETE: X GROUT: MORTAR: SHOTCRETE: CORES: GUNITE: ' � ADDRESS: 78434 HWY 111 IN LA QUINTA JOB #: DATE: 01/26/2001 JOB NAME: PLAZA LA QUINTA-PAD 5 PERMIT #: ISSUED BY; ARCHITECT: ANTHONY -TAYLOR ENGINEER: J.K.L. ' CONTRACTOR: LINDSEY ______________________________________________--_________________________________ SUB CONTRACTOR: / LOCATION IN STRUCTURE: -.SLAB ON GRADE; 15 FT WEST OS S/W CORNER CONCRETE SUPPLIER: SUPERIOR PLANT: INDIO MIX #: D3625P TYPE -OF CEMENT : ADMI�TURE: POZZ TICKET #: 7166825 SLUMP : 5" WATER ADDED: 0 GAL AIR TEMP: 48 F CONCRETE TEMP: 67 F MIXING TIME: 30 MIN TIME CAST: 7:50 AM _______________---_______________________________________________-____________ DATE CAST: 12/21/2000 RECEIVED AT LAB: SPECIMENS MADE BY: JERRY CATANIA ____________________________________________-_________�______________ . SPECIFIED PSI: 4000 FIELD IDENTIFICATION| A i B .| C | D .| . E LAB IDENTIFICATION : OT05866: -------------------------------------- ----- - OT05866 : OT05866 : : AGE DAYS :7 : ___------------- �_____�___________ 28 :'28 DATE TEST 12/28 : 01/18 : 01/18 SIZE -IN. ': 6.005X12 : 6.013X12 : 6.001X12 : : AREA-SQ.IN. : 28.32 : 28.40 : 28.28 CRUSH LOAD -LBS : 84950 : 122201 : 122640 COMP-STR.-PSI. : 3000 : . 4303 : 4337 : � � | ' H/D . CORR FACTOR CORR.STR.-PSI : ' : : TIME TESTED : � ' �technicians not employed by our firm. They were either ' : . . : delivy or l5lcked up by our driver. ---'-'----� BREAK TYPE . : A : A : C We will accept no responsibility for the inspection made C.T. M. USED : FORNEY : FORNEY : FORNEY on th5 jobsite, results of thege tests, any error orom ssron on the jobsite by the iiispector, furthermore we do not take responsibility for any information on this --- --- _______________ --- _________report other than the strength as tested and reported REMARKS: ' ASTM C39, C174, C192, C470,- C617, C42 ' COMPLIES: X . DOES NOT COMPLY: ____________-_____-________-________________________ THIS REPORT SHALL NOT BE REPRODUCED, EXCEPT IN FUL. WITHOUT THE APRO-AL OF SITI T-TBMI D ` SO ST PECTION OD AND TESTING SAMPLES CAST BY OTHERS., . . . �u �|u p� CASTILLO MANAGER ' ASTM C39 BREAKS A= cone B= cone 0 and sp8it C= cone DTC=shear E=columnar . . SOUTHWEST INSPECTION AND TESTING INC. n 10826 S.'Norwalk #A Santa Fe Springs, CA 90670 562-941-2990 714-526-8441 Fax -562-946-0026 ================================================================================ ^ ' FIELD DATA ON -TEST SPECIMENS �-- ASTM C31, C138, C143, C172, C173, C231, C1064 --- CONCRETE: X GROUT: MORTAR: SHOTCRETE: CORES: _GUNITE: ADDRESS: 78437 HWY 111 IN LA QUINTA JOB #: DATE: 01/26/2001 JOB NAME: PLAZA LA QUINTA PERMIT #: ' ISSUED BY: ARCHITECT: ENGINEER: J.K.L. CONTRACTOR: LINDSEY _______�______________________—____—__________—_________________________________ SUB CONTRACTOR: . LOCATION IN STRUCTURE: __________ SLAB ON GRADE ,@ NORTH WEST CORNER . . - _ ___________________ ____________-__ �_________________-------------------- CONCRETE SUPPLIER: SUPERIOR PLANT: INDIO ___ MIX #: D3625P TYPE OF CEMENT : ADMIXTURE: POZZ TICKET #: 7166859 SLUMP : 4" WATER ADDED: 0 GAL AIR TEMP: -60 F CONCRETE TEMP: 66 F MIXING TIME: 40 MIN . TIME CAST: 10:10 AM DATE CAST: 12/21/2000 -------------------------------------------- RECEIVED -AT LAB: SPECIMENS MADE BY: JERRY ------------------------------------ ,-_______________—__________—____________ CATANIA ' SPECIFIED - -`-------------------------------------------- PSI: 4000 FIELD IDENTIFICATION}` _________________________—_____________________________________________________ --- A | B �� | C | D | E LAB IDENTIFICATION : ___________________________________________________________________________ OT05865 : OT05865 : OT05865 : : AGE DAYS : 7 28 : 28 DATE TEST : 12/28 : 01/18 : 01/18 ' SIZE —IN. : 6.007X12 : 6.018X12 : 6.002X12 AREA—SQ.IN. : 28.34 : 28.44 : 28.29 CRUSH LOAD—LBS` : 93184' : 132366 : 129836 COMP—STR.—PSI. : 3288 : 4654 : 4589 —tesors or | H/D '-'---se te(linicians not employed by -.our firm. They were either CORR FACTOR : 'CORR.STR.—PSI : :delivered to our laboratory cked up by our*driver.or or the inspection made ''~'ili accept no responsi4typfion: the jobsite, results of 1�hese tests, any error or- TIME TESTED � : : � � : ': mv jobsite by 'he inspector, furthermore we nformation on - ""'=~^ '~~~~ ireport BREAK TYPE : A A ' : C other than tAe strength gis tested and C.T.M. USED : FORNEY : FORNEY : FORNEY : : � ASTM C39, C174, C192, .C470, C617, C42 COMPLIES: X DOES NOT COMPLY: _________________________________________________—____________________________ THIS REPORT SHALL NOT BE REPRODUCED, EXCEPT IN FULL WITHOUT THE APROVAL OF SITI ____________________________________ —___—______—____ BM I. TTED �S U EST I PEC ON AND TESTING � SAMPLES CAST BY OTHERS: STO P. CASTILLO L . MANAGER ASTM C39 BREAKS A= cone B= cone and s°lit C= cone D=shear E=columnar , RIVERSIDE COUNTY FIRE DEPARTMENT f FIRE PROTECTION ' JOB CARD THIS INSPECTION RECORD MUST 8E AT JOB SITE WITF+ AN APPROVED SET OF PLANS Owners Q 7 s Date o i Location Case No. 51).> Sprinkler .Company Z' Z?�(� _ �, .. ... Underground Static Date - (200 PSI For 2 Hrs. Prior to Inspection T --m1_) lnsP.^rtor (rF Hier Lsu FfiPe Only, Joints end ThrustBr,?� :, ;19e1;j? veli c:ress;l), • d ,fir i f Underground Flush Date ns r erhead Static Date (200 PSI For 2 Hrs. Prior to Inspection Time) Ins or i i Overhead Final Date I inspector i . Fire Main Installer I Underground Static (200 PSI F Date In or 2 Hrs. Pi r to Inspection Time) sPector (Center Load.'Pipe Only, Joints and Thrust Blocks Must Be Exposed). f Underground -Fl Ush Date lnspector txtinguishing System Installer j I ----------------------- I Final Date Inspector Fire Alarm Installer Fin Ai Date � Inspector i Tank InstallAr 4'12P Final - - � - t Tank Installer _ r n Final ri �. i. I ' • i n inspector__._ Date . !fir` '�<�'•' �_I -OY THIS SI'HUCTURE UNTIL -E'.- wTION. «,-Iod (nev,ors7) , Jor inkler Cc .... parn; �. --uerground Static Date (200 PSI For 2 Hrs. Prior to Inspection Time) inspector (Center Load Pipe Only, Joints and Thrust Blocks Must Be Exposed). Underground Flush f DateIns Roverhead Static Date (200 PSI For 2 Hrs. Prior to Inspection Time) Ins c or Overhead Final Date Inspector Fire Main Installer Underground Static Date (200 PSI For 2 Hrs. Prior to Inspection Time) Inspector i (Center Load Pipe Only, Joints and Thrust Blocks Must Be Exposed). Underground Flush Date Inspector Extinguishing System Installer Final Date Ineoector Fire Alarm Installs: Final - - � - t Tank Installer _ r n Final ri �. i. I ' • i n inspector__._ Date . !fir` '�<�'•' �_I -OY THIS SI'HUCTURE UNTIL -E'.- wTION. «,-Iod (nev,ors7) , � r NUNN AT fifiraftf Xra. r �vrs of la. r�oo REGISTERED ISSUED By t • APPLICATIONDate work performed CONCERN No. ANTI-FLAME FINIS•HING!! ;CO, INC. �r�►�� 2929 CENTURY BOULEVARD Ftp' L(��-2 SOUTH GATE, CALIFORNIA ca-i (213) 567-5512 -1 May 7 , 2001 r This Is to certify, that the materials described hereof have been flame- retardant treated (or are inherently nonflammable). FOW-Palapa Kings AT 2741 Highland Drive CITY` Carlsbad STATE CAI 92008 i. Certification is hereby made that: (Check "a" or "b") z ,r J(a) The articles described on this Certificate have been treated with a flame-retardant chemical approved and rejistered by the State Fire Marshal and that the application of said chemical was done in conformance with the laws of the State of California and the Rules and Regulations of the State Fire Marshal 1 Ii Name of chemical used FR-JW ` C19901 Chem. Reg. No. Method of application Immersion' ®(b) The articles described hereof are made from a flame-resistant fabric registered and approved r by the State Fire Marshal for such use. Trade name of flame-resistant fabric used I Reg. No. The Flame Retardant Process Used--mill I Be Removed By Washing ,r,,,0 will will not) Joseph A Nailgh-on By: -OAK- � i Name of Applicator � Title it •:. " 9 For V Ce*rtificate of Flame Reser-stance REGISTERED FABRIC ISSUED BY Date treated or manufactured boa CA- OR CONCERN NUMBER PALAPA KINGS INC-) 8-14-01 "Take a permanent vacation GAL -1296.01 2741 Highland Dr. GJL.12WJDI Carlsbad, CA 92008 This is to certify that the 'materials here described have been flame retardant treated (or are inherently nonflammable). ,Rubio's Baja Grill Address 78437 Hwy 114 A; V La Quinta State Ca. 3. Certification is hereby made that: (check a or "b") (a) The articles described on this certificate have been treated with a flame retardant chemical appioved and registered by the State Fire Marshal and that the application of 'aid chemical was done in conformance with the laws of the state of California and the Rules and Regulations of the State Fire Marshal. Name of Chemical Used Firextra 238 Chem. Reg. No. C-163.02 Method of Application Spray (b) The articles described on this certificate are made from a flame resistant fabric or material regiitered and approved by the state fire marshal for such use. Trade name of flame -resistant fabric or material used: k Reg. No. I 4 The Flam'e'"'Retardant Process Used will not be removed by washing Glenn Smith By: Vice President Name of Applicator or Production Superintendent Name Title Customer Order No.: 1—ch I 3683r Customer Invoice No.: I Enter the Customers Invoice Number. V 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: . 78-447 HIGHWAY 1 1 1 STE A/B Use Classification: COMMERCIAL/RUBIO'S BAJA GRILL Occupancy Group: B Type of Construction: Owner of Building: M & H PROPERTY LLC 30 DAY TEMPORARY CERTIFICATE OF OCCUPANCY Building Official c vni Bldg. Permit No.: 0010-189 Land Use Zone: CC Address: 12555 HIGH BLUFF DR STE 285 City: DAN DIEGO, CA., 92130 By: DANIEL P. CRAWFORD JR. Date: 9/17/01 (EXPIRES 10/17/01) POST IN A CONSPICUOUS PLACE