14-0324 (RC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
t
Application Number: 14-00000324
Property Address: 78474 HIGHWAY 111 STE
APN: 604-050-041- -
Application description: REMODEL - COMMERCIAL
Property Zoning: COMMUNITY COMMERCIAL
Application valuation: 22000
Applicant:
T4'yl 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
A PACIFIC FALLS LLC
74130 COUNTRY CLUB D
SUITE 101
PALM DESERT, CA 92260
Architect or Engineer:
0 INL_ .
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: B License No.: 740276
Date: Contractor: y,.�.
/ OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_) 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 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
i
Contractor:
CONSTRUCTION ZONE, THE
43036 MADISON STREET,
INDIO, CA 92201
(760)772-3585
LiC. No.: 740276
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/28/14
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 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 SECURITY NATL Policy Number SWC1017594
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 provisions of Section
3700 of the Labor Code,4 shall forthwith comply with those provisions.
.iDate: � ' • Applicant: � [A_—\
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1 . Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for in pection purposes.
Date: Yt Signature (Applicant or Agent): f. 4�
Application Number . . . . . 14-00000324
Permit . . . ELECTRICAL 2013
Additional desc .
Permit Fee . . . . 115.83 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 10/20/14
Qty Unit Charge Per
Extension
1.00 107..2500 LS ELEC NEW COMM, FIRST 2 KSF
107.25
.24 35.7500 EA ELEC NEW COMM, ADD'L 2 KSF
----------------------------------------------------------------------------
8.58
Permit . . . PLUMBING 2013
Additional desc .
Permit Fee . . . . 23.84 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 10/20/14
Qty Unit Charge Per
Extension
1.00 11.9200 EA PLBG FIXTURE/TRAP
11.92
1.00 11.9200 EA PLBG WATER.HEATER/VENT
--------------------------=-------------------------------------------------
11.92
Permit . . . REMODEL 2013
Additional desc . .
Permit Fee . . . . 150.94 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 10/20/14
Qty Unit Charge Per
Extension
1.00 48.6200 LS MISC REMODEL, 1ST 100 SF
48.62
4.77 21.4500 EA MISC REMODEL, ADDL 500 SF
102.32
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Special Notes and Comments
TENANT IMPROVEMENT SUITE "A" "SYNERGY
INFORMATION SOLUTIONS" REMODEL TO
EXISTING 2488 SF "B" OCCUPANCY TYPE V -B
CONSTR. DEMO / ADD NEW INTERIOR WALLS, -
LIGHTING,. MODIFY HVAC DUCTWORK. 2013
CODES 2010 ENERGY.
- ----------------------------------------
Other Fees BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, ELECTRICAL
47.66
PLAN CHECK, REMODEL
214.95
PLAN CHECK, MECHANICAL
4.77
PLAN CHECK, PLUMBING
30.99
Fee summary Charged Paid Credited
Due
LQPERMIT
1
Application Number .
. . . .
14-00000324
Permit Fee Total
290.61
.00
.00
290.61
r Plan Check Total
.00
.00
.00
.00
Other Fee Total
299.37
.00
.00
299.37
°} Grand Total
589.98
.00
.00
589.98
Bin #
City 6f La Q uin to
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 9225'3 - (760)'777-7012
Building Permit Application and Tracking Sheet
Permit #
1
Address: I/ 5:7e
)sAProject
Owner's Name: ' P4C W c !r,, /)s-
. P. Number:
A.
Address:
Legal Description: 2/ a ��,, ,,, ��7 a , o (� S
City, ST, Zip:
Contractor: (17 C C o a /' Cd/G'-i 4�01 e
Telephone:
Address: q3-63( o /j�Q/,�7� 5r C
Project• Description: 2-11141, Je f -fes
City, ST, Zip: -Tj C Q 9 Z-W 3
p- -wcLj1 oC C r o A 2 Li
Telephone:
�-2— S"
1"Cr,TS_
StateLic.#: -74102:76
City Lie. #c
f—e �L d vc � 5� f�J A @
Arch., Engr., Designer:
/ ` Ao, 5
Address:
City., ST, Zip:
Telephone: P
...>...�............>.......:....
nstruction Type: T. � , Occupancy: [�
State Lic. #:
Project type circle one): ,New Add, n A er Repair Demo
Name of Contact Person: J rr �r. �f '�
Sq. Ft.: qpr#
Stories:
# Units:
Telephone # of Contact Person: �(� - S6 % — S7 $ 7
Estimated Value of Project: z 2 600
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted a
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss C91Cs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for correctios/issue
lectrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
V
a1led Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
dxj
Total Permit Fees
•
PROUDLY SERVING THE
UNINCORPORATED AREAS
OF RIVERSIDE COUNTY
AND THE CITIES OF:
BANNING .
BEAUMONT
CALI M ESA
CANYON LAKE
COACHELLA
DESERT HOT SPRINGS
EASTVALE
'INDIAN WELLS
INDIO
JURUPA VALLEY
LAKE ELSINORE
LA QUINTA
MENIFEE
MORENO VALLEY
NORCO
PALM DESERT
PERRIS
RANCHO MIRAGE
RUBIDOUX CSD
SAN JACINTO
TEMECULA
WILDOMAR
BOARD OF .
SUPERVISORS:
KEVIN JEFFRIES
DISTRICT 1
JOHN TAVAGLIONE
DISTRICT 2
JEFF STONE
DISTRICT 3
JOHN BENOIT
DISTRICT 4
MARION ASHLEY
DISTRICT 5
RIVERSIDE COUNTY FIRE DEPARTMENT
IN COOPERATION WITH
THE CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION
77-933 Las Montanas Rd., Ste. #201, Palm Desert, CA 922114131 • Phone (760) 863-8886
• Fax(760)863-7072
www.rvcfire.org
April 25`,2014
RE: TENANT IMPROVEMENT PLAN CHECK -Non Structural
- . LAQ-I4-TI-014 Synergy Info. Solutions 78-474 Hwy 111,#A8, La Quinta, CA
You have been issued a release for a tenant improvement on an existing building. THIS IS NOT AN
OCCUPANCY PERMIT.
It is prohibited to use/process or store any materials in this occupancy that would classify it as a "H"
occupancy per Sec. 307 of the 2010 CBC.
THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO INSPECTION:
Install door hardware and exit signs as per Chapter 10 of the 2013 CBC.
A minimum 2AlOBC Fire Extinguisher, (State Fire Marshal Approved) must be mounted in a visible
location within 75' walking distance from any point in your building or suite. Fire extinguishers can
be installed by a licensed extinguisher company with a State Fire Marshal service tag attached to the
extinguisher, or purchased from a retail store with a sales receipt attached. A licensed fire
extinguisher company must service extinguisher yearly.
All breakers must be labeled and a clearance of 36 inches must be maintained around the panel at all
times.
Approved suite addresses shall be placed in such a position to be plainly visible and legible from the
street. Said numbers shall contrast with their background.
An approved audible interior notification alarm device shall be provided in approved location. A C-
10 licensed contractor must submit plans, designed in accordance with NFPA 72 to the Fire
Department for review and approval prior to installation
A durable sign stating "This door to remain unlocked during business hours" shall be placed on or
adjacent to the front exit door. The sign shall be in letters not less than one inch high on a
contrasting background.
Provide key(s) to the tenant space for inclusion in the main building Knox Box. Key(s) shall have
durable and legible tags affixed for identification of the correlating tenant space. Key(s) shall be
provided at time of final inspection.
As may be necessary to maintain proper fire sprinkler protection due to constructions changes, fire
sprinkler system plans for the tenant improvement area may be required to be submitted to the Fire
Department for review.
Applicant/installer shall be responsible to contact the Fire Department to schedule inspections. A re-
inspection fee will be required if more than one (1) inspection is necessary. Requests for inspections
are to be made at least 72 hours in advance and may be arranged by calling (760) 863-8886.
All questions regarding the meaning of these conditions should be referred to the Fire Department
Planning & Engineering Staff at (760) 863-8886.
Sincerely,
By.
Lisa Nottingham
Fire Safety Specialist
WNTRACTOR NOTES FOR TENANT PIPROVEIIENTS
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