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9902-052 (RC)s 'LICENSED CONTRACTOR DECLARATION I hereby affirm Venderpenalty 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. i License# ,' Lic. Class Exp. Date 10747 :t B 5/1U99 D e '/ � i Signature of Contractor D , { g 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 () 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: Cartier 1 Policy No. �' !`.•Y'TA' 1' T / - •CSI'+ - 'l'!'Y7Y ryryN'!'•F ��!! { Y'dS,A/'`.�CA1l4 I-I2CzC. i:.dl1411 ,..J!`VI (This section need not be completed if the permit valuation is for $100.00 or less). O 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 f Section 370.' of, he Labor Code, I shall forthwith comply with thoselprouisio s. � /Date—' A ' Applicant A %i t _ °' � !;?� � VWai ning:'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 Safety fora permit subject to the 'conditions 4 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, indemnify & hold harmless the City of La Quinta, its officer's, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work isnot 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 State laws relating to the building construction, and hereby adthoriz•e representatives of this City to enter upon the above* mentioned ` property for ffispectio\n p�uvrrp?+oSees,; Sig ature (Owner/Agent) ''•�tstt 9'� Date 711114 0_ BUILDING PERMIT PERMITy�'�� 91� DATE /''� II VALUATION LOT TRACT JOB SITE ADDRESS rrlHV'.t� APN - OWNER CONTRACTOR / DESIGNER / ENGINEER nq�"w nd17 A �17f e -N -i) V{Irv%l A• �.I.�r, rli.IV 01, -Orli". IV r,!)w"k A,J>ul 2750 WLTi r:Ti.FORD ROAD, SCII'.C4: 1©i 12 f4 -AUC H s 131lM7 C ICL.S43t#r:: CA 9,1W8 IRVINE Cts 92618 t949Y155-1400 CS1114 USE OF PERMIT OA1.MERC;.I/Z.1., KEMO.l WL AAfd,t'i �•. .',� 5e�..n.4 M�0..!Y.� 'i'OA— R VQ1V f ��iVii+W l�Y ,! p �;'!''� � 4.} �7'� �5 �';ge`f �i.�'�ta��T �•�it:+S:!Y'bd��.l1�F1Y,6�v ,PLAN r.:l-!);l''K, FEE 5313.30 t(7�1't t21 i1; t'tf )'�f F}rf+ _ ! f�) •(t(?fi.. # 1 (){1fi iii d a.it 403" S741,(fti tif:Kt;'3 :it:A d rs.l3 Itii tthr 2Ci fl i �'iv.c, .0,IAtuli3iNU FID3 10:1 13s01119•'4t)II � ► :;•i�+7�f3��14)i'd,t�?�t't%�'i°�..(^t'��w9 4t11t-f!3I'1().'�?rty-fr(tti �+1:1,C,s Si' 1Ft-IXTFAI, (''0''i_S'4 0U(,,"'t7GNT AND KA 'HUC%. $1,06 Ft •Y.,��,5 �7..1 ��la'k'1.�f 7.•.��.5}'9'Jk�N:l 'i,i+.,�ij/ S�T�7• �.451g:�#d+1➢3, RECEIPT DATEBY ` T ! ' DATE FINALED INSPECTOR i) lr 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 Exhaust Fans O.K to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL APPROVALS 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 APPROVALS Gas Test Electric Final Waste Lines —/ Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test �- Appliances Final 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) COMMENTS: City of La Qu i nta Building & Safety Division P.O. Box 1504 78-495 Calle Tampico La Quinta, CA 92253 Building Permit Application and Tracking Sheet Project Address: �- �L�'a. ` Owner's Name: A. P. Number. Address: j7 v• rFc� S Legal Description: City,ST, Zip:✓15 a -�� a coo Contractor: Telephone: h ne: � OQ/ a0 O Address: Project Description: GD etr City,ST, Zip: 1 f\)\V►�e v GA oto i>3 c��n�, i5hl� ,r, h 1✓'l ( -D d► t'1' r ASSESSOR'S PARCEL NUMBER COUNTY OF RIVERSIDE HEALTH SERVICES AGENCYY 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- shall r/e/�fm)ain valid for a/1period no/t to one year from date of payment. tt�i 1o11��n 7e-x•)ceed Y Or Agent�r ntractorT Contact Person Address City State } Zip frA3,z/Ec Z -4tv fS"'1 ��ciE �ufrF*s) �1Ar D,FfF1? 644.94-z60 Telephone 76 G/ 3j(Y-.3s'a�' Owner Address1 3t? State Zip )Iral 46,04 N • �. :: �?3 b i> rNt�FD/l. 1 j44,0, �A. �'�?0( Telephone(7G0 �4 v -0 2.2 Z OF Job Property Address '78 W 11i'61J rlAy /�l �i1qOw"VrIl v Z;p WLot U Size Water Agenc pel oAr/;� �r. � r < , Use of Per it, P/P, SUP, PUP, etc. Ah dao �'i�n►�1;f1l,�i ,>�r Legal Description dl / F'rZ• �S'�,. [ c ' IUng.MFI-Site.2cepr� Signature of App f v Z-2> 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 later than 90 1. 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 0 ❑ Certification of Existing S.D. System Required F. F_ ❑ WQCB Clearance Required ❑Date Lot Inspection Completed: Initials W [n (Attach for DOH -SAN -007, Santa Ana Region Only) Remarks: ❑ Soils Percolation Report Required ❑ Maintenance Booklet Provided ❑ Special Feasibility Boring Report Required ❑ Rereview Required Initials Date ❑ Final Inspection by Department of Environmental Health is required. Please call 24 hours PRIOR to inspection. C/42 / Soils Percolation Boring Report by Lic/Project # Date Soils Map Page Soil Type Approved By Date No of Systems � T pe of Systems) W HoIA ank ❑ Replacement New LJ Addition � No.•Bweftg Units 1} oeSts.$ixt�re lJr�its SFGj/1N6 . ov�%y RtaK �. ()Septic Tank �I Soil Rate � Grease%S5hd_ Grease IntcpA1l;txTrap y^ • ❑ Existing � n Sq. Ft. ottom Area Total Linear Ft Sidewall Allowance 6F C"v 'Leach Bed sq. ft. of Bottom rock/ sq. ft. running ft. Install Line(s) ft. long ft. wide with Area Inlet Tested Dept ❑ NA Proposed Bottom Tested Depth min. Ie4g<below drainlines or U Z O Leach lines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Inlet (BI) Seepage Pit Total Depth Maximum Allowable Other: UApplicable_ W N/A Overburden Facto 4 ❑ �, �bept� �•, "f 5' G TD�• Well Review Approved: SIGNATURE Date: Well Drilling Permit # • Grading Plan Approved: Date: SI �i Sewer Verification A roved: PP Ca��L1/�r� •iyCY/• Date: I'a7I- 47/ - �,rr 991 d�j / (��//-/ Plan Checkbb Approved: .�G,C, a •C .y%i,�l Date: �/j"'�� `�9q�/ REMARKS: :rk,!.rjG'/j� �i•Ci.E%i� �!'L—t .s ib"GZ�h.��.C%X ` C;dTiiQirm G�ir� MV), ,�/�L'Y/�O ./6'rrG'�L.i� �� �-.G.�.�/'�/� �� �!i'(ii•�./K.,'� l.11 ..tdt�.AJ� � v This application i� APPROVED/ ENIEDWor,-pe*eategery-Ghecked-in S€&T� [ON -B above, regarding b si o e subsurface■disposal system as indicated on the UT FOR OFFICE SE ONLY % F�� lr' n;rn-� F�!f; 3}•00 acompanied plot plan, using the requirements set forth in SECTION C above. A build -c ing is necessary for the installation C�9r_4 /� �iaTt!k permit of the above -designed system. No con- Is Revenue code ..'/3S- ` e; $ f!i}• 00 structlon permitted in the required reserved 100% expanslon area. (1) SepticZ^ank must be 1,0.0' minimum from any wells:!!; is, 'A Til 6. w4r/lo, �r� P,- Check #1/ r, 1 40 ik (2) Leach lines must. be 100' minimum from any wells, including expansion area. Date,) � �1 I r1 EA Initial SL-- Oerg .14 rA 1 C U 3) Sewer lines must be 50' minimum from any wells!l / ib r, bra w4,4t y Z g (4) Seepage pits must be 150' minimum from any wells, including expansion area. F- 0 UJ U Signature of Health Official i Date --, •+'�.,,.....,.. .,mom—vnwo rnn, Tccwvv—r,ppncant; FINK—wag. Uept.; UULUENHOL—Plans/Records James M. Wright Fire Chief Proudly serving the unincorporated areas of Riverside County and the cities of: Banning e Beaumont G Calimesa Canyon Lake Coachella Desert Hot Springs e Indian Wells Indio e Lake Elsinore a La Quinta Moreno Valley H Palm Desert 4 Perris 0 Rancho Mirage 0 San Jacinto Temecula Board of 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 California Department of Forestry and Fire Protection 210 West San Jacinto Avenue* Perris, California 92570 #(909)940-6900 • FAX (909)940-6910 February 2, 1999 To: GLS Associates 74-854 Velie Way, Suite #5 Palm Desert, CA 92260 Re: Building TA Plan Review Quizno's Classic Subs SDP 98-626 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. Fire sprinkler system plans for the tenant improvement area 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. 2. Provide either a separate Knox Key Lock box, Models 4400, 3200 or 1300, mounted per recommended standard of the Knox Company or provide key(s) for inclusion in the general building Knox Box. Special forms are available from this office for the ordering of the Knox Box, this form must be authorized and signed by this office for the correctly coded system to be purchased. 3. Install a 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. 4. Approved building address or suite/unit number shall be placed in such a position as to be plainly visible. Said numbers shall contrast with their background. Please contact the Fire Department Planning & Engineering staff for final inspection prior to occupancy. Applicantrnstaller shall be responsible to contact the Fire Department to schedule inspections. A reinspection fee will be required to be paid if more than one (1) inspection is necessary. 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, FRANK KAWASAKI Chief Fire Department Planner By Walter Brandes Fire Safety Specialist F:IPETWPDATA% AC JINTAVAISC%TN_IMPRVQUOOOS.WPD EMERGENCY SERVICES DIVISION O PLANNING SECTION O INDIO OFFICE 82-675 Highway 111, 2nd FI., Indio, CA 92201 %- (760) 863-8886 6 Fax (760) 863-7072 �1 South Coast Air,�p4lity Management Distrid 21865 E. Copley Drive, Diamond Bar, CA 91765-4182 (909) 396-2000 http://Www.agmd.gov Cleairance Letter January 14, 1999 CITY OF LA. QUINTA BUILDING AND SAFETY DEPARTMENT, SUBJECT: Building Permitting under California State Government Code 65850.2 i This is to confirm that the facility listed below bas met or is meeting the requirements of Section 42303 of the•Health and Safety Code and the South Coast Air Quality Management District (AQMD), as of the above date, by fulfilling one of the following: Applicant has ermit s from. the SCAQMD Applicant has filed for permit(s) with the SCA MD Applicant is exempt from permit reguirements FACILITY NAMEAND LOCATION: EQUIPMENT: Quizno's 78742 Highway I I I La Quinta, CA 92253 Sinrerel Sm Business %since (800) CUT -SMOG SaIdddd oriand WdT2:20 66. bZ Ndf 1 4 .I Certificate of Occu anc . City of La Quinta. Building and Safety Department OFti 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 fol%wing: BUILDING ADDRESS: 78-738 HWY 111 Use Classification: COMMERCIAL Bldg. Permit No.: 9902-052 Occupancy Group: B Type of Construction: VN Land Use Zone: CR Owner of Building: QSD DEVELOPMENT L.L.C. Address: 2736'RUTHERFORD RD SUITE 101 City: CARSBAD CA 92008 By: KIRK KIRKLAND Date: 4-8-99 Building Official POST IN A CONSPICUOUS PLACE