Loading...
9912-115 (CSCS)LICENSED CONTRACTOR 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 # Lic. Class Exp. Date Date 4 Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: (;cj, 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. 7/044, Business & Professionals Code)..' i, /r / Om ex'emp under Section B&P.G'for this rea fo ,Date f� !?rte Signature of. Owner /1 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.' (y) I have and will maintain workers' compensation insurance, as required by S66fiion 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. SAPTCI i' 114Sta`; AINT05 - k - - -- (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 I1should become subject to jhe workers' compensationprovisions of Section 3700 of the Labor Code I shall_forthwith comply witli-those pruoyi6107s. ��I, i // 1 Date: i� ��/ �� Applicant iei�ll/fid_); ..�1'!°[!�." Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this -application and state that the above information is correct. I agree to comply with all City, and State laws, elating to the building construetiori, and hereby author��representatives of his City to enter up?n the above-mentioned property -for nspecti l n purpose . s. % r I � �i,G� f,8lgnature (Owner/Agent) �'�� �� Date �.,.,- _ BUILDING PERMIT PERMIT#l��� s DATE )) VALUATION SMV4,131.841) LOT J;AR S< TRACT Vq fit no JOB SITE ADDRESS 79-93B .eiil<(. HWA III APN 643,-0180-006 OWNER CONTRACTOR/DESIGNER/ENGINEER Y T C 1v.j'�i'y-(7,wdJl 4 I3`Y •4 �S V�.. t. LY,1 t> I 0,mvm E_0 Buri )r: ii? rt lr''wo1%' C0 9 ! Y�• 1•,il.! kL 11 �'e. 4 •A 28456 CANT C)`t Y SITE.RT c9 e LYW Attie CA 94545 USE OF PERMIT i aRELL GAS e3TAMM(:5550 a`-`iX, CA.M2,3 ,`), COWDUNCE :iTi.j.PM BLIJO,Ss CARWA H. (W8 SF. :t'UivA IM) CANOPY Sl�' i'EWIT FEE SUNINWO' FEE i)fi!%OSIT 101 -WO -439-318 -�i75t3.111i i�E.Aid F1T•,C IR 1 Ft» 10 1-M)-419131$ CS •Y T`JO(' ro0.10" " 1- \.rT✓lVi..t 1. 1,< �If f .0.�f MECO AAL i a 101 -5s�G-421-tii)t;+ $ 29.00 P LEC;T.RICAL i hF: .i01-oti '120-w) X219, i6 t?r UNIIATNO FFF 101 -OM -dig -0(10 S16ry KO ,-.a q �.YN r;l'L 1011 -MG -423-000 v f iT u'[Ct �flA�. � t ..... ru. Vi ROW fvfC)d ,ft,)Itil� i�ls - COMM100.060.241.-(ttiW Akof tN F! i3f.,kC; k'I:.ACES - C (-)M% 701-W)-255-000 �J.i)It►.r�fr \Iei r(YYAt C.''ON>;91 dt`d`!TION A.Nk) PLAIN(741:(3c $i'f1 47 ),l ri RECEIPT DATE BY '— DATE FINALED INSPECTOR I. INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs�fJ Undergro4nd Ducts Forms & Footings ew Ducts Slab Grade - Return Air Steel Combustion Air Roof Deck Exhaust'Fans O.K to Wrap F.A.U. _ Framing _ v Compressor Vents Insulation _ G/ Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath S :a 6 CA A— >ti rA 4— _ Of' d -moi• vv ✓ Final Final POOLS - SPAS BLOCKWALL APPROVALS 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 rfC/ Encapsulation Gas Piping Gas Test _ Appliances r ' Final COMMENTS: ' �c�O,''� 6d /�Z `�{ex ^ ol� I t U A— S� �-- 3 �- Gly �-C to _ (S/ 6 / /:-F C rt_ i..�� j L, _ 2 2 -4v f•6, ®rX� T-ef~- Gvx�U W Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power PoleI Underground Conduit % �j ✓ Rough Wiring Low Voltage Wiring Fixtures Main ServiceSub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final A . r.,t, 6 Utility Notice (Perm) ly-17G�j U'JI'f , ....-. At't �.� • L Owner maning Address •4 " �I P.O.4 a BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 City Zip Tel. Contractor Zip IT61 State Lic. City & Classif. /)R2 124,4M_4A.n Lic. # Arch., Engr., v Designer s kwgIn&�1 l4c, Address • Tel. ZO7 Gt/ dZI-17Ine.0WE 618 84-2 3" City lZip State K lA 171LLic. a LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is in full force and elfect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I 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 to construct, after, 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 lhat.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 ($500). I: 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, 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.) 111, 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 contractors) licensed pursuant to the Contractor's License Law.) i] I am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate -of, Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company 0 Copy is filed with the city. 0 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 Owner NOTICE TO APPLICANT., It, 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. 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 city to enter the above. mentioned property for inspection purposes. Signature of aOplicant Date Mailing Address City, State, Zip APPLICATION ONLY LDING: TYPE"C Tl OCC. GRP. umber 44*2 00 % Description Project Description ly,6- Edo& x _4�-r, Sq. Ft. No. Size Stork No. Dw. Units New;' Add O Alter 0 Repair 0 Demolition O PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 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 INSPECT,OR9 >� Issued by: DatePetm t Validated by: DE0 1 '.' 1998 F. Validation: t 'r WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION T'14fl OJ P.O. Box 1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 January 5, 2000 Mr. Doug Massaro A & S Engineering 207 W. Alameda Avenue Burbank-, Ca. 91502 RE: Shell Oil Station at 78-998 Highway 'l 11 (760) 777-7000 (TDD) (760) 777-1227 Dear Mr. Massaro, The purpose of this letter is to inform you that the plan review for the Shell Oil gas station proposed for construction at 78=998 Highway 111 has expired. ` Submitted in December, 1998, under the 1994 Uniform Building Code, section 107.4 states plan review shall expire by limitation after 180 days. Our office discussed with A & S Engineering the necessity of issuing this permit prior to December 31, 1999, due to limitation of plan review and the adoption of the 1998 California Codes on July 1; 1999. As a courtesy to A & S Engineering and Shell Oil, we extended the plan review through the end_ of the year. You or a representative may pick: up the project materials at our office prior to January 19, 2000, or we will dispose of them for you. Should Shell Oil wish to continue with this project, we will accept for plan review materials revised to meet the requirements of the 1998 California Building, Plumbing, Mechanical, Electrical, and Title 24 energy standards, and a plan check deposit of $750.00. Please feel free to contact me with any questions you may have regarding a new project submittal. Sincerely, Mark Harold Building and Safety Manager c: Tom Hartung, Director of Building and Safety N% Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 CERTIFICATE OF COMPLIANCE Date 1/10/00 No. - 19891 Owner NameShell Oil No. 78-998 Street Highway 111 City La Quinta Tract # Lot # Type of Development Commercial . Comments APN # 643-080-006 Jurisdiction La Quints Permit # Log # Zip 92253 Study Area Square Footage 2615 No. of Units 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: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of .31 X 2,615 or $ 810.65 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 CASH - Richard Toscano Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Ellen Patino Signature Payment Received Check No. Telephone f. .y, $810.6 r�'`^�;r'`- i.r Y - CASH 40TICE: 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 rbove will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to collect them on the District('s)(S') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept./Applicant . Copy - Applicant/Receipt Copy - Accounting fitybf 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 only after approval. Contact applicant for resolution of conditions preventing or delaying approval. Project: Gas station and mini -mart. (plans in Building Dept.) Shell Station. Applicant Contact: A & S Engineering. (818) 842-3644. Application 1 irculation Date: Community Development Dep)5t!, Christine Di Iorio, Planning Manager Public Works Department Steve Speer, Senior Engineer Building and Safety Department Mark Harold, Building and Safety Department Manager Health Department Fire Department Schools Fees Paid Date Date Date 1JQLG iIQLG 21 City of 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 only after approval. Contact applicant for resolution of conditions preventing or delaying approval. Project: Gas station and mini -mart. (plans in Building Dept.) Shell Station. Applicant Contact: A- & S Engineering. (818) 842-3644. f Application 1 4" Date Community Development Department Christine Di lorio, Planning Manager Date Public Works Department ` Steve Speer, Senior Engi eer Building and Safety Department Mark Harold, Building and Safety Department Manager Health Department Fire. Department Schools Fees Paid Date Date Date ldoo Da 0 =1d-99 03:42P A&5 ENGINEERING • GONG, ON B -B is S 7 CONTRACTOR TO CONTACT UNDERGROUND SERVICE ALEFT 1-800-422-4133 CALL USA/SC FOR UNDERGROUND LOCATING 2 WORKING DAYS BEFORE YOU DIG P.02 UTILITY LOCATIONS ARE APPROXIMATE SEE NOTE ON SHEET 1. LEGAL DESCRIPTION - PARCEL 8 OF PARCEL. MAP NO, 25865 RECORDED IN BOOK 172 OF PARCEL MAPS, AT PAGES 21 - 27 IN THE OFFICE OF THE COUNTY RECORDER, ALSO BEING A PORTION OF SECTION 30, T: 5 S., R. 7 E., S.B.M. IN THE CITY OF LA DUINTA, COUNTY OF RIVE=RSIDE, STATE OF CALIFORNIA. ALL EXISTING ITEMS ARE TO REMAIN UNLESS NOTED OTHERWISE. SEE A&S ENGINEERING'S SITE PLAN FOR DIMENSIONS NOT SHOWN ON THIS PLAN \ B.M: - ASSUMED 100.00 ON TOP OF CURB AT SOUTH END OF SOUTH RETURN INTO SHOPPING -CENTER ON EAST SIDE OF HIGHWAY 111 NORTH OF ADAMS STREET, BEARINGS ARE FROM PARCEL MAP NO. 258155 RECORDED IN BOOK 172; OF PARCEL MAPS AT PAGE 21-27 IN THE: OFFICE OF THE COUNTY RECORDER. DIRT QUANTITIES; \ 767+/- CY CUT = 467+/- CY FILL (1.3) \ = 608+/- CY FILL 1 THEREFOR: 159-/- CY EXPORT A I;. ASSESSOR'S PARCEL NUMBER COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH PERMIT APPLICATION FOR A SUBSURFACE SEWAGEMISPOSAL SYSTEM APPLICANT. Submit this form• with four copies of a SCALED plot_ plan (1-20 SCALE) drawn to County s ecifications as indicated on the attached check list. A non-refundable filing fee isorequired when the application is submitted. Check must be made payable o the County of Riverside. Approval of this applica- tion shall remain valid foraa period not to exceed one year from date of payment. tMS=# 1 / T!/ OA' (/i tjLI/ ,07i Agent, Contractor, Contact Person AX 4sf4120 Q « f ' Address City State Zip 7 6f/.1JcaM� ��,�. �u2,�Qn/i� �A.9/�'�, Telephon�e�k/-O F r Q -Owner �u, co�v Address 7� City, State Zip loop Gt/. — Sr.. 0111M 4 /t? r4.. 9/U.A Telephone'90 O4Job Property Address 16H (/t/A Y /11 MVO /40A M f �r City LA t(IWM Zip - W Lot Size ater Agenc 0II A ctrtc t i s rx Use of Per it, P/P, SUP, PUP, etc. N� F�u�p �Ffm c 1j-#Ws*7- Legal Description w W,g M171Ff-Site -Z?TP—etc.�D /j.� "S}11 l ATz�✓2 4 Sr lC"T . i u//T/�iL�esraPr* fl StAfipN '1 Signature of . pplicatit" �2 - q- jg Date --C EC/BOX IF REQUIRED rw 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 days after date noted below, may require repayment of fees. ❑ Staff Specialist Lot Inspection Required co '❑ Holding Tank Agreements Completed Z Z Thomas Bros. Page Grid ❑ Certification of Existing S.D. System Required F., V ❑ WOCB Clearance Required Date Lot Inspection Completed: Initials ❑ ,• LU (Attach for DOH -SAN -007, Santa Ana Region Only) Remarks: f i ❑ Soils Percolation Report Required "" '" ❑ Maintenance Booklet Provided ' ❑ Special Feasibility Boring Report Required ❑ Final Inspection by Department of Environmental Health is required. ❑ Rereview Required Initials Date 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 h . «. No of Systems `�\ T f'System(s) %, �]di Tank ❑ Replacement ❑ New ❑ Addition No. •wel AgT nits (1) Bedre=srF4xture-4JAits �'/` Ssc'tl %I�6. /y6�F (�1) Septic Tank \ '`` Soil Rate Crease/Sand,,44k- r Grease Intcp/UntsTcap ❑ Existin 9 Gal. A'`.rK - / -7 OGal- rT'�ST� r -.re.A.a.•tsrnrn:v�.�r..rnE'/..71Y,-"�. Sq. Ft. Total Linear Sidewall Allowance' +"V�') ,Leach Bed sq. ft. of Bottom Area .Ft. rock/ sq. ft. running ft:. Inlet Tested Depth t' ❑ NA o�-/� 9/ Install Lines) ft. long ft. wide with min. in s rock below drainlines or Bottom Area, U Proposed Bottom Tested De tk>, Z O Leach lines/bed special design for slope: (3 Pit Diameter No. Pits Pit Below Inlet (BI) Seepage Pit Maximum Other: UJ Applicable � < . v Total Depth TD Allowable Dept UJ N/A Overburden actor ❑ 5' TD Well Review Approved: Date: Well Drilling Permit # SIGNATURE Grading Plan Approved: .> ." Date: SIGNATURE // // r ,r� p 04o4CAEt a `� VAt i•FY f t�Ll71j J/:CT/t7C? Sewer Verification Approved: K% !�C/ G� 3'�- 9/ (((/�j J7M /V,a '-$C1� X Date: /F/FO uif Z'NkMZ-'-"K4 - . Plan CheckrOilfy Approved: !, 1.41 IP" &404t—/!A'—Dat,: -3-1. /�/ �/ at, �J REMARKS:Cc.CJ' r .�f/4eI!'if �.ril.✓i� `h L�7�1P.ri! C1f� -✓v' 7! n ~/ ' �. This application is APPROVED DENIED:forzthe•catego y-checkedxinSECTION=B Cv -.der . FOR OFFICE USE ONLY above, regarding the eslgn of a subsu fdeefdlsposal system as indicated on the acompanied plot plan, using the requirements set forth in SECTION C above. A build- { S/ tCF_?7,,,.AJ'70 NJ a` [: Jq 3/ 0b ing permit is necessary for the installation of the above -designed system. No can Revenue coded 2i (73}t j C A-rnr, L,,,,, IFee; s l ,7i'% Q 6 structlon Is permitted In the repaired reserved 100% expansion dhjPFt'p fi�Y s0 (1) Septie.Tank must be 400' minimum from any wells.4 SA1fa• 64641 Wa7'-'9 (r't'rf© T�7n( r� : /1 �� ao `w Check #om (2) Leach lines must be 100' minimum from any wells, including expansion area. Date i ` © Initial 0 t (3 Sewer lines must be 50' minimum from any wells;,/ I "d' t Z O (4) Seepage pits must be 15Y minimum from any wells, including expansion area. IL t i '~ Signature of Health Official f 3-9 Date ...�•�,........... .., ,,,—vnwo r -no, ��wrr—nNNneam, rmn—Diuy. Utept.; UULUruvnUL—rlans/ttecoras F41 Larry Benson Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of: Banning Beaumont Cahmesa Canyon Lake Coachella Desert Hot Springs Indian Wells Indio Lake Elsinore La Quinta Moreno Valley Palm Desert Perris Rancho Mirage 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) 94043910 May 8, 2000 a City of La Quinta Building Department Re: Fire and Life Safety Clearance The Riverside County Fire Department is granting a fire and life safety clearance for the group M occupancy known as the La Quinta Shell Station located at 78-998 Highway 111. Respectfully, FRANK KAWASAKI Chief Fire Department Planner By "�CL Walter Brandes Fire Safety Specialist H:1PE21WPDATAILAQUINTAIPROJECTSIFINALS\LQ Shell Station.doc EMERGENCY SERVICES DMSION • PLANNING SECTION • INDIO OFFICE 82-675 Highway 111, 2" Fl, Indio, CA 92201 • (760) 863-8886 • Fax (760) 863-7072 41 James M. Wright Fire Chief Proudly serving the unincorporated areas of Riverside County and the cities of: Banning e'+ Beaumont 0 Calimesa e Canyon Lake 0 Coachella Desert Hot Springs 0 Indian Wells 0 ' Indio Lake Elsinore La Quinta Moreno Valley Palm Desert Perris . Rancho Mirage San Jacinto r,. 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 March 8, 1999 To: ABS Engineering, Inc. 207 W. Alameda Ave., Ste 203 Burbank, CA 91502 Re: Building Plan Review SDP 97-616 / Shell Station 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 Department approval is based upon the 1994 UBC. It is prohibited to use, process or store any materials in the occupancy that would classify it as an H occupancy per Sec. 307 of the 1994 UBC. 2. The Fire Department is required to set a minimum fire flow for the remodel or construction of all commercial buildings using the procedure established in Uniform Fire Code. A fire flow of 1500 gpm for a 2 hour duration at 20 psi residual operating pressure must be available before any combustible material is placed on the job site. 3. The required fire flow shall be available from a (Standard/Super) hydrant(s) (6" x 4" x 21/2' x 2'/2') located not less than 25' or more than 165' from any portion of the building(s) as measured along approved vehicular travel ways. 4. Prior to the issuance of a building permit, applicant/developer shall furnish one blueline copy of the water system plans to the Fire Department for review. Plans shall conform to the fire hydrant types, location and spacing, and the system shall meet the fire flow requirements. Plans must be signed by a registered Civil Engineer and the local water company with the following certification: "I certify that the design of the water system is in accordance with the requirements prescribed by the Riverside County Fire Department". 5. Provide written certification from the appropriate water company that hydrants will be installed and will produce the required fire flow. ' 6. Install a Knox Key Lock box, Models 3200,'mounted per recommended standard of the Knox Company. Special forms are available from this office for the ordering of the Key Switch, this form must be authorized and signed by this office for the correctly coded system to be purchased. 7 i 8. 9 If the building/facility is protected with a fire alarm system or burglar alarm system, the lock boxes will require "tamper" monitoring. Install portable fire extinguisher's per NFPA, Pamphlet #10, but not less than 2A10BC in rating. Contact certified extinguisher company for proper placement of equipment. 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. EMERGENCY SERVICES DIVISION O PLANNING SECTION O INDIO OFFICE 82-675 Highway 111, 2nd FI., Indio, CA 92201 0 (760) 863-8886 0 Fax (760) 863-7072 Building Plan Review March 8, 1999 +' c•' SDP 97-616 / Shell Station Page 2 10. Fixed fire suppression systems and underground fuel storage plans must be submitted separately for approval prior to construction. Subcontractors should contact the Planning & Engineering office for submittal requirements. 11. Approved building address shall be placed in such a position as to be plainly visible and legible from the street. Said numbers shall contrast with their background. Please contact the Fire Department Planning & Engineering staff for final inspection prior to occupancy. Applicantlnstaller shall be responsible to contact the Fire Department to schedule inspections. Requests for inspections are to be made at least 24 hours in advance and may be arranged by calling (760) 863-8886. All questions regarding the meaning of these conditions should be referred to the Fire Department Planning & Engineering staff at (760) 863-8886. Sincerely, FRANK KAWASAKI Chief Fire Department Planner By Walter Brandes Fire Safety Specialist c:,.—Eii'Quinta'Building.Dep . F:XPETWPDATAUAWINTA%SMELL\BLDO PC1.WPD Sent By: Vintner's Distributing, Inc.;. 510 293 0908; Jan -10-00 2:52PM; Page 1/1 NAKASH CONVENIENCE MARTS, LLC. January 10, 2000 VIA FACSB41LE (760) 777-7011 City of Laquinta Building Department Attn. 1i4r. Greg Butler RE: Shell Service Station/Carwash 78-998 Highway 111 & Adams St. Dear Greg, This is a letter to advise you that, Richard C. Toscano our agent for Nakash Convenience Marts LLC, will be pulling the permit for the above address. Should you have any questions, feel free to call me at (510) 293-9150. Sinccrcly, Nick Goyal MebE 28466 CENTURY STREET * HAYWARD, CA 94545 * PHONE: 15101293-9150 FAX: 13 101 293-9150 P.O. Box 1504 78-495 'CAILE TAMPICO (7 6 0) 777-7000 LA QUINTA, CALIFORNIA 92253 (TDD) (760) 777-1227 December 14, 1999 To Whom..1t May Concern: This letter is to certify square footage calculations 'for the convenience store, carwash, and fuel island to be built at 78-998 Highway 11.1, La Quinta, CA. - Owner: -Shell Oil 2255 N. Ontario St. Burbank, CA 91504' Site: 78-998 Highway I I I APN: 643-080-006 Square footages: Convenience. Store: 2615 s.f. Carwash Tunnel: 091 S S.f. Fuel Island.Canopy: 3850 s.f Please call me directly for -any questions regarding this matter: . Thank you. Greg Butler Counter Technician Building & Safety Department (760) 777-7012. •t 'i a A & S ENGINEERI.NG INC. PLANNING • ENGINEERING • CONSTRUCTION MANAGEMENT 207 W. kMEDA AVE, STE. 203 • BURBANK, CA. 91502 • PHONE 818-842-3644 • FAX 818-842-376 Permit Letter Date: Wednesday, December 15, 1999 To: Charlie Toscano Toscano Construction 235 W. Pueblo St. Reno NV 89509 From: Doug Massaro Site Location: Shell, Hwy 1 1 1, La Quinta Attached are the following permits and approved permit plan sets: Permits Permit Number 1. AQMD permit to construct 350530 Granted as of 3/18/1999 Legal Owner ID 118730 or Operator: EQUILON ENTERPRISES 2255 N ONTARIO ST BURBANK, CA 91504 Equipment Location: 78-998 HIGHWAY 111, LA QUINTA, CA 92253 Equipment Description: Fuel Storage and Dispensing Facility Consisting of.. 1) 12 - GASOLINE DISPENSING BELLOWS -LESS NOZZLES, EQUIPPED WITH PHASE II VAPOR RECOVERY SYSTEM, GILBARCO VAPOR VAC (G -70 -150 -AD). 2) 2 - GASOLINE UNDERGROUND STORAGE TANKS, 15,000 -GALLON CAPACITY, EQUIPPED WITH PHASE I VAPOR RECOVERY SYSTEM (G -70-97-A), 2 METHANOL COMPATIBLE. Conditions: 1. OPERATION OF THIS EQUIPMENT SHALL BE IN COMPLIANCE WTTH ALL DATA AND SPECIFICATIONS SUBMIT TED WITH THE APPLICATION UNDER WHICH THIS PERMIT WAS ISSUED, UNLESS OTHERWISE NOTED BELOW. 2. THIS EQUIPMENT SHALL BE PROPERLY MAINTAINED AND KEPT IN GOOD OPERATING CONDITION AT ALL TIMES. 3. EXCEPT FOR DIESEL TRANSFERS, PHASE I VAPOR RECOVERY SYSTEMS SHALL BE IN FULL OPERATION WHENEVER FUEL IS BEING TRANSFERRED INTO STORAGE TANKS. 4. EXCEPT FOR DIESEL TRANSFERS, PHASE II VAPOR RECOVERY SYSTEMS SHALL BE IN FULL OPERATION WHENEVER FUEL IS BEING TRANSFERRED INTO MOTOR VEHICLES, AS DEFINED IN RULE 461. 5. ALL PHASE I AND PHASE II VAPOR RECOVERY EQUIPMENT AT THIS FACILITY SHALL BE INSTALLED, OPERATED AND MAINTAINED TO MEET ALL CALIFORNIA AIR RESOURCES BOARD CERTIFICATION REQUIREMENTS. 6. AT LEAST TWENTY-FOUR HOURS PRIOR TO BACK -FILLING ANY UNDERGROUND STORAGE TANK OR PIPING, THE SCAQMD SHALL BE NOTIFIED AT TELEPHONE NUMBER (909) 396-3886. SUCH NOTIFICATION SHALL INCLUDE THE NAME OF THE OWNER OR OPERATOR; THE NAME OF THE CONTRACTORS; THE LOCATION OF THE FACILITY; AND THE SCHEDULED START AND COMPLETION DATES OF THE BACK -FILLING PROCEDURE. FILE COPY W 7. PHASE H VAPOR RECOVERY SYSTEMS SHALL BE INSTALLED, OPERATED, AND MAINTAINED SUCH THAT THE MAXIMUM ALLOWABLE PRESSURE DROP THROUGH THE SYSTEM INCLUDING NOZZLE, VAPOR HOSE, SWIVELS, AND UNDERGROUND PIPING DOES NOT EXCEED THE DYNAMIC BACK PRESSURE RATES DESCRIBED BY THE CALIFORNIA AIR RESOURCES BOARD EXECUTIVE ORDER BY WHICH THE SYSTEM WAS CERTIFIED: NITROGEN FLOWRATES (CFH) 40 60 80 DYNAMIC BACK PRESSURE (INCHES OF WATER) 0.16 0.35 0.62 WITHIN THIRTY DAYS OF THE ISSUANCE DATE OF THIS PERMIT OR WITHIN THIRTY DAYS OF THE START OF OPERATION OF THE EQUIPMENT, DYNAMIC BACK PRESSURE TESTS SHALL BE CONDUCTED TO DETERMINE THE PHASE II SYSTEM VAPOR RECOVERY BACK PRESSURE RATES. THE TESTS SHALL BE CONDUCTED IN ACCORDANCE WITH CARB TEST PROCEDURE METHOD TP -201.4. RESULTS SHALL BE SUBM=D TO THE DISTRICT, OFFICE OF STATIONARY SOURCE COMPLIANCE, WITHIN THIRTY (30) DAYS OF TESTS. THE AQMD SHALL BE NOTIFIED AT TELEPHONE NUMBER (909) 396-3886 AT LEAST TWENTY- FOUR HOURS PRIOR TO TESTING. SUCH NOTIFICATION SHALL INCLUDE THE NAME OF THE OWNER OR OPERATOR; THE NAME OF THE CONTRACTORS; THE LOCATION OF THE FACILITY; AND THE. SCHEDULED START AND COMPLETION DATES OF THE DYNAMIC BACK PRESSURE TEST. 8. WITHIN THIRTY DAYS OF THE ISSUANCE DATE OF THIS PERMIT OR WITHIN THIRTY DAYS OF THE START OF OPERATION OF THE EQUIPMENT, A STATIC PRESSURE LEAK DECAY TEST SHALL BE CONDUCTED TO DEMONSTRATE THAT THE STORAGE TANKS, THE REMOTE AND/OR NOZZLE VAPOR RECOVERY CHECK VALVES, ASSOCIATED VAPOR RETURN PIPING AND FITTINGS ARE FREE FROM VAPOR LEAKS. THE TEST SHALL BE CONDUCTED IN ACCORDANCE WITH CARB TEST PROCEDURE METHOD TP -201.3. RESULTS SHALL BE SUBMITTED TO THE AQMD, OFFICE OF STATIONARY SOURCE COMPLIANCE, WITHIN THIRTY (30) DAYS OF TEST. THE AQMD SHALL BE NOTIFIED AT TELEPHONE NUMBER (909) 396-3886 AT LEAST TWENTY- FOUR HOURS .PRIOR TO TESTING. SUCH NOTIFICATION SHALL INCLUDE THE NAME OF THE OWNER OR OPERATOR; THE NAME OF THE CONTRACTORS; THE LOCATION OF THE FACILITY; AND THE SCHEDULED START AND COMPLETION DATES OF THE STATIC PRESSURE LEAK DECAY TEST. WITHIN THIRTY DAYS OF THE ISSUANCE DATE OF THIS PERMIT OR WITHIN THIRTY DAYS OF THE START OF OPERATION OF THE EQUIPMENT, AN AIR -TO -LIQUID RATIO TEST SHALL BE CONDUCTED TO DEMONSTRATE PROPER INSTALLATION OF THE GILBARCO VAPOR VAC (G -70- 150 -AD) SYSTEM. THE TEST SHALL BE CONDUCTED IN ACCORDANCE WITH CARB TEST PROCEDURE METHOD TP -201.5. RESULTS SHALL BE SUBMITTED TO THE AQMD, OFFICE OF STATIONARY SOURCE COMPLIANCE, WITHIN THIRTY (30) DAYS OF TEST. . FILE COPY 21865 East Copley Drive, Diamond Bar, CA 91765 PERMIT TO CONSTRUCT pagc J Application No. 350530 THE AQMD SHALL BE NOTIFIED AT TELEPHONE NUMBER (909) 396-3886 AT LEAST TWENTY- FOUR HOURS PRIOR TO TESTING. SUCH NOTIFICATION SHALL INCLUDE THE NAME OF THE OWNER OR OPERATOR; THE NAME OF THE_ CONTRACTORS; THE LOCATION OF THE FACILITY; AND THE SCHEDULED START AND COMPLETION DATES OF THE AIR -TO -LIQUID RATIO TEST. 10. ALL DAILY INSPECTION RECORDS SHALL BE COMPLETED IlVIIv1EDIATELY AFTER THE DAILY INSPECTION. 11. ALL RECORDS AND TEST RESULTS THAT ARE REQUIRED TO BE MAINTAINED BY RULE 461 SHALL BE KEPT ON SITE AND MADE AVAILABLE TO DISTRICT REPRESENTATIVES UPON REQUEST. 12. THE MAXIMUM QUANTITY OF GASOLINE DISPENSED FROM THE STORAGE TANKS AT THIS FACILITY SHALL NOT EXCEED 400000 GALLONS IN ANY ONE CALENDAR MONTH NOR 4800000 GALLONS IN ANY ONE CALENDAR YEAR. 13. RECORDS OF MONTHLY AND ANNUAL FUEL RECEIVED SHALL BE PREPARED, SHALL BE RETAINED FOR TWO YEARS, AND SHALL BE MADE AVAILABLE TO DISTRICT REPRESENTATIVES UPON REQUEST. Approval or denial of this application for permit to operate the above equipment will be made after an inspection to determine if the equipment has been constructed in accordance with the approved plans and specifications and if the equipment can be operated in compliance with all Rules of the South Coast Air Quality Management District. Please notify RANDY MATSUYAMA at (909) 396-2551 when -construction of equipment is complete. This Permit to Construct is based on the plans, specifications, and data submitted as it pertains to the release of air contaminants and control measures to reduce air contaminants. No approval or opinion concerning safety and other factors in design, construction or operation of the equipment is expressed or implied. This Permit to Construct shall serve as a temporary Permit to Operate provided the Executive Officer is given prior notice of such intent to operate. This Permit to Construct will become invalid if the Permit to Operate is denied or if the application is cancelled. THIS PERMIT TO CONSTRUCT SHALL EXPIRE ONE YEAR FROM THE DATE OF ISSUANCE unless an extension is granted by the Executive Officer. DMB/jm04 FILE COPY By g&dg DORRIS M. BAILEY Principal Office Assistant MAY -10-2000 0330 PM LA QUINTA SHELL 760 564 9258 P.01 COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY DEPARTMENT QF4 ~ONMENTAL HEALTH HAZARDOUS MATERIALS MANAGEMENT DIVISION Underground Stodge Tank Installation Inspection Name/DBA Plan Check No. Address_ City Contractor Name_______ s Telephone Number of UST(s) Installed ; Type of Tank(s) YES NO N/A 1. SETTING OF UST(S) A. Approved plans on site. B. UST(s) type Indicated on approved plans. C.. UST(s) arrived on site with vacuum or holiday test. D. Approved backfill used. E. Distance between UST(s) as per manufacture's specifications. F. Letter stating B, C. D, and E, from contractor. 2. PRIMARY PIPING' A. California Forms A, B, and C issued. B. All piping sloped back to UST. C. All lines tested hydrostatically at 150%, or pneumatically at 110% of designed operating pressure for a minimum of 30 minutes. D. All joints soaped and checked. E. All connections to stationary objects consist of approved flexible connectors. F. Manifolded vapor to leaded regular UST. • 3. SECONDARY CONTAINMENT A. Approved secondary containment in place to grade. B. Secondary containment system tested as per manufacturers specifications. C. Containment drained into a monitored sump. D. All exposed steel double wrapped (10 mil). E. Impact valves present and secured. F. Secondary containment for suction system. 4. FINAL INSPECTION A. Valid UST Integrity test submitted. B. Electronic monitor in place and operational C. Operational probes in annular(s) and sump(s) D. Operational leak detectors on turbines. E. Approved spill catchment basin in place. F. Corrosion protection in place and operational. G. Overfill protection for positive shut-off or flow restrictions. H.. Unauthorized release response plan submitted. I. Financial responsibility statement submitted. J. Fill pipes and monitoring well(s) labeled. K. All projections into manway(s) / sump(s) sealed L Forms A e and C com leted and submitted L.1 LlL]0 Lf ❑ Li&: DATf' :v Li 0 LJ�- _ Qg ❑ L); .,. 0 Wr s p ! la U DATE-' INSPECTOR:RECEIVED h Riverside Office San Jacinto Office Indio Office / P.O. Box 7600 1370 S. State Street, Suite 101 46209 Oasis Street, Room 203 Riverside, CA 92513-7600 San Jacinto, CA 92583 Indio, CA 92201 (909) 358-5055 (909) 654-3878 (760) 863-8976 DEH-HEH-020 (Rev 10/97) Web Site — www.riveh.org DISTRIBUTION: WHITE -Hazardous Materials Management Branch; CANARY. SOUTH COAST CONCRETE CONSTRUCTION, INC. 3300 l'l Dmvc Riverside, CalifoaTia 92503 (909) 351-7777 Fax (909) 351-7783 E7 URGENT El FOR REVIEW © PLEASE COMMENT ❑ PLEASE REPLY ❑ PLEASE RECYCLE NOTES/COMMENTS: KKrk, Please loop at these nAl certs and specs to clarify the reasons for the # 4 that you are seeing on the steel. Please call me if you have any questions. "17Iank You, Lonnie flyers Td WdZS:VO 000E 22 'ulef - 282-2-ZSEGOS : 'ON 3NOHd '1SN00 1Sd00 Hinos : woaj LETTER OF TRANSMITTAL SHEET TO: FROM: R Kirk Kirkland Lonnie Ayers COMPANY. VATS: City of La Quinn 1/26/00 FAX NUMBER: AT NO. OF PACES INCLUDING COYER 760-777-7011 3 PHONE NUMBER: SENDER'S REFERENCE NUMESR: 760-777-7016 RE: YOUR REPRkENCE NUMBER: La Quetta Shell Sta m, E7 URGENT El FOR REVIEW © PLEASE COMMENT ❑ PLEASE REPLY ❑ PLEASE RECYCLE NOTES/COMMENTS: KKrk, Please loop at these nAl certs and specs to clarify the reasons for the # 4 that you are seeing on the steel. Please call me if you have any questions. "17Iank You, Lonnie flyers Td WdZS:VO 000E 22 'ulef - 282-2-ZSEGOS : 'ON 3NOHd '1SN00 1Sd00 Hinos : woaj '_9' 7M 1r.:35 FR M0R5'P-PPCrF1C 3223 ?06 ee_.S TO 9190962i54E F.29/11 :NL'LUR STEEL OF UTAH HILI, CERT page I of 1 Lq Customer Add:css C:tf Statc ,7_ -r -- Nucor Steel of Utah bill Cert GEORGIA, PACITIC SALES CE:vTE'R- DENVER 304 LN-vTIRNESS DRIVE SOUTH Heat r ENGLEWOOD Dat -- C Q Timc 297679 12/1'99 16;5]:43 'I h� testing wu ccniucted ir. accor4=ce Y i+n the rpquir=erts of fnis $pacif'cation All mclt'ng and manufaamring rroc=9es performed in the L'—ited states of America Scott Laurend - Signature on File Nucor Steel -Utah is an A,13.S. Certified ML11 Ed WdTs:vo 000E ZE -ulef Ea.TS2606 : 'ON SNOHd '1SN00 1SHOD Hinos : wodi Ism- -- CC)RCRETE REINFORCING ._ STESL INSTITU ■ E 1,. =' COKCRSTE REINFORCM0 . ' STEEL INSTITUTE __P 993 I'1• plum Grcvo iioad, SchaLrtirurS• iL 6Q175 �-. '� rret:ei C' S;nb01 µj11 Phone: (847) 617-1200 1pt Pr6-^ iairQ . .w jj1e:6+d':A6;G! vle- o' $ymwl u.Q Sto.$Wl to EIf!! r IgM rv�+ YI 56ik6 Mn w a . Frod,,ehlp Mill 1 C,radQ.Ing (ane I,ne 011111 l im 7ypE 9tee:' r,/ MOn rubs GmWin pilrrk , AfL% 01�; ! H 1 ,�Ba� 5ra 1'14 4 Llne 19!es Poe onm •�,,, �$ 13fr,. ea�,M w;h f n b SIC W Toalwnr�0.s>1A+atiYJ.►� GRACIE 420 Ives 3x*:et Of Syrttbol 1 � .• M:, o : Typo Sine) 43 Sara Unss V*) Grcde W% POUND 111WETLA ty!ETAIC i18a5:ti , 0 ro t� o.a7 A13 010 12,? Twts iloes Only) 15.8 ext GRADE 520 917 0.875 125 to 11000 _ g METRIC D!11R1ETiA ialCK•PflliNlr a�A1I11ER �. BAR SIF {mm II AR 97-c R 14 1.643 ?43 014 � �-' 911: g S 43 D.S75 JUNE 199: , 12.7 M4 15.9 !6 0.54' OSS a ' pit M16.1 is 0.7@0 N22 27.2 17 25.d t8 D.675 10@0 925 r �2a 2e 7 119 f32 32.3 1110 1Z7Q 136 35.8 111 1A10 �•Q 443 41.0 114 Ib 1.£93 2,767 £7.3 JUNE 1896 �r r� Ism- -- CC)RCRETE REINFORCING ._ STESL INSTITU ■ E 1,. =' 933 N. Plum GfOVA Road, SCh sumb4ire, IL 60179 . �In phone: (W) 517.1200 te; r R to rret:ei C' S;nb01 µj11 tt 1pt Pr6-^ iairQ . jj1e:6+d':A6;G! c ' Ctade u.Q Sto.$Wl to EIf!! r IgM rv�+ YI 56ik6 Mn J 8fk �� fix Are i�tlT 1 C,radQ.Ing (ane I,ne 011111 l A SIS WAR A TOM MOn rubs }•or et o! SPIN DI ! ar n I I (uP;pC;.cnQ �! ! H 1 ,�Ba� 5ra 1'14 4 � typo Slur, i --- 14 I s it viol I� c+�i 5 Gredc Mark 1 � • GrodOl-1c:e 5 Sara Unss V*) GRADE 75 W% POUND 111WETLA ty!ETAIC OsAA1EiEfl � skA S!Z. pp•1 QAA SIZE 9 t� o.a7 A13 010 12,? Aq x.500 95 Q 25 #16 15.8 ext 19.1 22.2 917 0.875 125 to 11000 �_ 23.4 za.` os 1.128 1 rzs 932 32.3 d } 1.270 K17 1.AiC 096 35.8 R 14 1.643 ?43 014 � 03.0 57.3 2.757 157 JUNE 199: , 2d Wdes:vo 000E ZZ 'u'ef 2&z TS2606 : 'ON 3NOHd '1SN00 1Sd00 H1f10S : WOad TRO Certificate of UCCUPancy 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: 78-998 HIGHWAY 1 1 1 Use Classification: COMMERCIAL Bldg. Permit No.: 9912-115 Occupancy Group: B Type of Construction: VN Land Use Zone: CR Owner of Building: NAKASH CONVENIENCE MARTS Address: 28456 CENTURY ST LLC • r City:. HAYWARD CA 94545 By: KIRK KIRKLAND Date: 5-9-00 Building Officia