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14-0157 (DEMO)cr P.O. BOX 1504 4 • �� 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: Property Address: APN: Application description Property Zoning: Application valuation: 14-00000157 78965 HIGHWAY 111 643-020-056- - DEMO - COMML/OTHER REGIONAL COMMERCIAL 50000 Owner: WASHINGTON 111 LTD 80618 DECLARATION AVENUE INDIO, CA 92201 Contractor: Applicant: Architect or Engineer: ERDMAN COMPANY 1 ERDMAN PLACE MADISON, WI 53717 (608)410-8000 Lic. No.: 194614 ----------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: B License No.: 194614 KDate: o? --I / contraaor. �aem OION I hereby affirm under penalty perjury that I am 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).: 1 _ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, _ and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). , 1 _) 1, 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.). I—) I am exempt under Sec. , B.&P.C. for this reason Date:,,-2-075' 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/20/14 WORKER'S T 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 and policy number are: Carrier THE HARTFORD Policy Number 41WNQUI190 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, I rthwith comply with those provisions. r a �y mate: Applicant: WARNING: FAILURE TOS E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYE 0 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 ction purposes. q J Date: o/ GK Y Signature (Applicant or Agent): - LQPERMIT Application Number . . . . . 14-00000157 ------ Structure Information INTERIOR DEMO ONLY ---------------------------------------------------------------------------- ----- Permit . . . DEMO PERMIT Additional desc . . Permit Fee . . . . 35.75 Plan Check Fee 00 Issue Date Valuation . . . . 50000 Expiration Date 8/19/14 Qty Unit Charge Per Extension 1.00 35.7500 LS MISC DEMOLITION, INT 35..75 ---------------------------------------------------------------------------- Special Notes and Comments INTERIOR NON-STRUCTURAL DEMOLITION IN PREPARATION OF SEPARATE TENANT IMPROVEMENT PROJECT FOR PROPOSED URGENT CARE FACILITY. THIS PERMIT DOES NOT INCLUDE CONSTRUCTION OR ALTERATION TO THE EXTERIOR OF THE BUILDING. DEBRIS MANAGEMENT PLAN AND DOCUMENTATION REQUIRED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. February 20, 2014 1:33:50 PM AORTEGA ---------------------------------------------------------------------------- Other Fees . . . . . . . PLAN CHECK, DEMOLITION 95.81 Fee summary Charged Paid Credited Due_ --------------------------------------------------------- Permit Fee Total 35.75 .00 .00 35.75 Plan Check Total .00 .00 .00 .00 Other Fee Total 95.81 .00 .00 95.81 Grand Total 131.56 .00 .00 131.56 Bin # V City of La Q uin to Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # 14 151 Project Address: 7 8- !gwy ill Owner's Name:e i. A. P. Number: Address: - J Legal Description: City, ST, Zip: ^ Contractor:Tel � e h ne: 7 0 P 7 Y c� Address: G ��.�� 1.�C Project Description: �C3O Sl w City, ST, Zip:t la� GJ1 -53-7 % 7 1 em v C MCrL •/ Telephone: a \P IIo R dO rC , ale- StateLic.#: City Lie. #t on Arch., Engr., Designer �w vw ei► tkti Address: -r) 00S. J01--t- City., ST, Zip:; s e� W S 3 717 Telephone: /0 • F)dC) tog L '+ ;: Construction T e: Occupancy: YP State Lic. #: q Y (� l Y Project type (circle one): New Add'n Alter epair Demo Name of Contact Person: �� Ste, �+ Sq. Ft.: 3,5M I #Stories: ( 17 #Units: Telephone # of Contact Person: -393-31-3- y S 3' 1 Estimated Value of Project: ,-OO O 0 6 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 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Dced t Plans picked up -S.M.I. H.O.A. Approval Plans resubmitted Grading IN IiOUSE:- '"' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees - - D1 CA Total Permit Fees � 4113-- C�� Y-�� -r�%�7-� •� CGS t��p1_.� Csl�` fW *MF I mo, VO- 1 iC. r UJ 1.4 ZU 14 CITY OF LA QUINTA . COMMUNITY DEVELOPMENT f WASHINGTON III, LTD 30240 Rancho Viejo Road, Suite B 949.443.1234 PHONE F San Juan Capistrano, CA 92675 949.661.6971 FAX February 11, 2014 J . Erdman C/O Joel Santos Project Construction Manager 5000 Birch Street, Suite 3000 Newport Beach, CA 92660. ` RE Landlord's Authorization to Process Demolition Permit For Former Tenant Improvements Premise: 78-965 HWY 111, La Quinta, CA 92253 Mr. Santos, You are hereby authorized to process a demolition permit for the former tenant improvements at the premise listed above. The approved demolition shall be limited to the scope listed on the plans prepared by Erdman Company dated 11/13/13. Prior to commencing any demolition activity, you must contact me to schedule an onsite pre -demolition meeting. At this meeting, you must provide proof of insurance listing the landlord as additional insured. You must provide a copy of a valid demolition permit issued by the City of La Quinta. Please contact me should you have any questions. Sincerely, Bill Sanchez Construction Manager 760485-5308 bsanchez@cs-gretailmamt.com CC: Jack Tarr, Jack Tarr Development CITY OF LA QUINTA - PUBLIC WORKS DEPARTMENT GREEN SHEET PUBLIC WORKS CLEARANCE FOR RELEASE OF BUILDING PERMIT Form updated & effective 9/25/2009 Ureen 5neet approvals are torwarded to the buddinaA batety Department directly bV Public Works. Please DO NOT submit the Green Sheet (Public Works Clearance) racket to the Public Works Department until ALL requirements listed below are complete. Incomplete applications or applications which cannot be processed will be returned to applicant. Date: oC / I /� Developer: �rd.� &L.. M p..• .� Tract No.: -32C83-/ qTract Name: (�/ b,,,/Ie., �e.rlC Lot No.(s): J-07- Address(s): '78*- . ! 6 S--Tk-j / I I 1 L,6. Phone Number: The following are the requirements for Public Works Clearance to authorize issuance of a building permit from the Building & Safety Department: Q CUSTOM HOMES: PROVIDE ITEMS #2, #3, #4, #5 & #7 BELOW C ❑ TRACT HOMES: PROVIDE ITEMS #1, #2, #3 & #5 BELOW ❑ COMMERCIAL BUILDINGS/OTHER: PROVIDE ITEMS #1 #2 #3 #5 & #7 BELOW WALLS, SIGNS, OTHER: PROVIDE ITEM #6 BELOW 1. Attach Pad Elevation Certificates in compliance with the approved design elevation for building pad (maximum allowable deviation of +/- 0.1 foot). Pad Elevation Certificates must be current (within 6 months of current date). If a precise grading plan creates the pad for approval, please withhold green sheet submittal until a Pad Elevation Certificate can be provided. 2. Attach geotechnical certification of grading plan compliance including compaction reports from a licensed Soils Engineer. Recently rough graded residential developments which have a previously approved geotechnical certification are exempt from this requirement. 3. Attach recorded final map or title information/grant deed showing proposed building locations are legal lots. 4. Complete the attached <1 acre per lot or infill project Fugitive Dust Control project information form, PM10 plan & agreement or provide alternative & valid City approved PM10 plan set reference number or hard copy plan. PM10 plans for commercial & residential developments (beyond 1 lot) are submitted separately with grading plans & are subject to additional requirements. A current PM10 certification number is required. 5. Attach a copy of the rough or precise grading plan to the Public Works Department showing building location(s) for pad elevation verification. AO flood zone developments will require an approved flood plain development plan. Attach supporting documentation for wall plan, monument sign, grease trap or special facility installations. 7. Complete and sign the attached water quality management plan (WQMP) exemption form, if applicable. PW approved building construction projects require either a WQMP or a completed WQMP exemption form. Approved maps/plans may be viewed at the following link: http://www.la-guinta.org/PlanCheck/m search.aspx I have reviewed and confirmed the requirements listed above as presented and find the improvements to be sufficiently complete for construction of the proposed buildings/structures/walls/signs on the subject lot(s). Pursuant to my findings, the above project may be released for building permit issuance. This section completed b ty staff. Recommended by: Date: V—/ f kl 2.0 /` f Public Works Distribution: ( ) Green Sheet to Building & Safety ( ) Green Sheet to Planning Department Declined for approval for reason(s) as follow(s), please correct and resubmit: Ci y o - PM10 Fugitive Dust nor Construction Phase ement (<1 acre/lot or Infill P Pro'ect Informatio Pro'ect Contractor: T: c lists - Forms & Applications\Fonns & Applications\GREEN SHEET cover & PM10 less than 1 Acre Revised 10-02-12.doc ation Page 1 of 1 DEMOLITION PLAN NOTES & SYMBOLS DEMOLITION SYNISDLS EXI5TINIG WALLAND DOOR TO REMAIN II 4� IuII y WALL AND DOOR TO BE DEMCLISFEE❑ A•DEMOLFWN NOTES 1. SGLID LINE INFORMATION 19 EXISTING CONSTRUCTION TO REMAJN. 2 HEAVY DASHED LONE INFORMATION IS EXISTING CONSTRUCTION TO BE REMOVED. S. STRUCTURAL ELEMENTS SHAH REMAIN UNLESS NOTED OTHERWISE. 4. REMODELLED AREA CONSTRUCTION MTERIAL$ SHALL BE L19TED AS NEW. IDESIGWBLII LDER'S FIELD PERSONNEL SHALL WE14TORY $ALVAGABLE ITEMS TG BE RELISED AND ADJUST TiE BILL OF MATEIIIAL 5 AOCARDINOLY II II II I la II II II !I I. li II II I1 II I II II II ,k II II II II II-i I I I r--__-------- I k IJ II it II Ij —JL JL---""'...—«-- AREA OF DEMOLITION IN THIS PROJECT. II II Ik � II --- --- _.'fJ-------------_ i:,'—____—__ - _—_ — _--- I LD, II II I'I I L___ L__ �r i51h ;7 LINE INDICATES ___ - •`. rr I1 DEMARCATION 0F r "NO DEiUIQLITION �4 - rr I � r — — — — — — — — — — — — � -- I �4� rr I � ram' rl �tti !rr I I I r � ` jl �� LAll�Tjl CIT , _ ' N1 7.. 1 ill I I BUILDING A �E I Y DEft.- _ I • -� • 'E ,� 'i II /nii� r r - 5 Id '�i `IFOR C6N TRU TiOM I 1 I III I�f ❑1 I I I 1 I F: I Up ! iLI I I�k Ei { 11 II 11 ri 1�1 it II 11 I iL----------------— _ — — —u\ s DEi')LITION PLAN SCALE: 10 = T-V 112' TO I}.I�r ROOF FLASHING AT PIPE PENETRATION SCALE. Y =1'-U' NOTE 14} LN PRE•PAHR ICATED PIPE $EAL G4NNQT BE INSTALLED, LISE ALTERNATE FIELD FABRICATED P Pr= SEAL WON -CURING SEALANT PRE -MOLDED PIPE SEAL MUST— HAVE VIA'T RIB AT TOP EDGE, REGARDLESS C� PIPS pIA &TER STApNLESS STEEL EXPANDABLE CLAMPING RING (BY ROOF ING CONTRACTOR) PRE-MOLI1 'ED PIPE SEAL EN -SEAM SEALANT CAP SEALANT SPUDNG DEMENT ROOFING MEMBRANE I L ROOF FLASHING AT EXHAUST FAN SCAM! 3" = V-0' CONTYNUDIJS DEAD OF NUN -CURING SEALANT LXHAUSTFAN MEMBRAINE FLASHING OVER BON01NG ApHF-$IVE PREFASNCATEC CURB AS&EMBLY BY HVAC CONTRACTOR. PROVIDE AODIT30NAL MATERIALS AS NOTED. (SHADED ITRG INCLUDED WITH CURB ASSEMBLY,) SPLICING CEMENT EASTENINrs PLATE WITH FASTENERS AT IT U.C. SPLICE TAPE ROOFING MEMBRANE EXIVNG ROOF SHEATHING EX}ST1NG TRUSSES BEYOND WOOD BLOCIANGAS REQUIRED BETWEE14 TRUSSES 07&M.135 I R F PLAN NOTE: 1. SEE SHEET A001 FOR ARCH17ECTURAL NOTES AND SYMBOLS_ SCALE; 1iB" = 1.v 2. SEE DETAIL 4 ON SHEET A565 FOR SURFACE MOUNTLQ ACCESSGRIES. A 5221 North O'Connor 31vd.1 S u s 885 Irving, Texas 75039 Phone: (972) 501.6900 FAX. (972) 501.6920 Arc h i tectu ra I Service s Provided By: ERDMAN IMPANY urtis M. H - - un, Architect, California L! ense C32212 Engineering Service - Provided By: ERDMAN CC MPANY Contractor Services Provided By: ERDMAN CC. MPANY Lic. No. 194- 114 NATIONAL URGENT CARE HOLDINGS, INC. URGENT CARE CENTER 78-965 HWY. 111 LA GUINTA, CA 92253 ��1W +A �T 4 �J 2 1CONSTRUCTIOM 7;A 1 REUIEW SET'No- Desc f� # Date DOCLjmE-_ �� ❑rn:mpieper _ - _hk- $heet Name DEMOL1 ION PLAN ROOF PLANRE - �� I OF LA QLJINTA COMM ITS r_,,E /ELQPMENT scaie:As indicate"_ heet Number oil M O LA QUINTA, Cj0h 601320 P !_ Mw Lis