05-0217 (RC)T-Wf 4 4 Q"
- 4�,B k1 f 504
95 CALE TAMPICO
CJTYO �JINTA� CALIFORNIA 92253
BUILDING PERMIT
Application Number . . .
Property Address . . . .
APN:
Application description
Property Zoning . . . . .
Application valuation
Owner
------------------------
KLEINE NEIL WAYNE
41910 BOARDWALK A-10
PALM DESERT
PALM DESERT CA 92211
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
CO 5 - 0 0 0 0 0 2 1-7 7-1 Date
79400 HIGHWAY 111 #105
.649-820-002- - -
REMODEL - COMMERCIAL
REGIONAL COMMERCIAL
16000
Contractor
2/25/05
KLEINE BUILDING AND DEV INC
41910 BOARDWALK, SUITE A-10
PALM DESERT 'CA 92211
(760) 776-4840
WCC: STATE FUND
WC: 1769113
12/01/05
CSLB: 390365
03/31/05
CCC: B -C27
------ Structure Information
TUTORING CLUB TI
-----
Construction Type . .
. . . TYPE V - NON RATED
Occupancy Type . .
. . . BUSINESS <50
Other struct info . .
. . . CODE EDITION 2001
FIRE SPRINKLERS YES
MIXED-USE OCCUPANCY B
OCCUPANT LOAD
25.-00
-----------`----------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE 1380.00
-
Permit . . . . . .
BUILDING PERMIT
Additional desc
Permit Fee
.171.00 Plan Check Fee
111.15
Issue Date . . .
Valuation . . . .
16000
Qty Unit Charge
Per
Extension
BASE FEE
45.00
14.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
126.00
Permit . . . .
ELECT - ADD/ALT/REM
Additional desc
Permit Fee
42.60 Plan Check Fee
10.65
Issue Date
Valuation . .
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1380.00 .0200
----------------------------------------------------------------------------
ELEC GARAGE OR NON-RESIDENTIAL
27.60
Permit . . . . . .
MECHANICAL
Additional desc
Permit Fee . . . .
19.50 Plan Check Fee
4.88
P.O. Box 1504• �/:. '
w VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011,
LA QUINTA, CALIFORNIA 92253 4 4 INSPECTIONS (760) 777-7153/
BUILDING & SAFETY DEPARTMENT ip
Application Number: 0S,- .2 / % I Date:
Applicant:
Applicant's Mailing Address:
CDIYTiP,aC-FO A
Architect or Engineer:
Architect or Engineer's Address:
Lic. No..
BUILDING PERMIT DECLARATIONS
IVA
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
ode, and my License is in full force and effect.
License Class 5 C ZZ License No. 11-1, �0 3��
Bate � � Contractor ,/bC (/L.0
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).):
U 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 or 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.).
U 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.).
U I am exempt under Sec. , BA P.C. for this reason
Date Owner.
WORKERS' 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.
X 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
� y edd My w rkers' compensation insurance care and policy numb r are:
tearrier .5l /t 7� (�t� #1 /� Policy Number l7 (0 9 79
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 shall
forthwith comply with those provisions.
A,,plicaM 1.6s -f o -L 7BI a4ls tj l.✓�
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.
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
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 ent upon the above-mentioned property for inspection purposes.
/ate : O Signature (Applicant or Age t .
y 4_
4
Page
2
Application Number . . . . . 05-00000217
Date
2/25/05
Issue Date . . . .
Valuation . . . .
0
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 4.5000 EA MECH VENT
INST/ DUCT ALT
4.50
---------------------------------------------------
Special Notes and Comments
-------------------------
Commercial Remodel (Tutoring Club) TI,
1380 sqft. "B" Occupancy Type VN
Sprinkled, Occupant Load 25
----------------------------------------------------------------------------
Other Fees . . . . . . . . STRONG
MOTION (SMI) - COM
3.36
Y Fee summary Charged Paid
Credited
Due
----------------- ---------- ----------
�_ Permit Fee Total 233.10
--------------------
.00 .00
233.10
Plan Check Total 126.68
.00 .00
126.68
Other Fee Total 3.36
.00 .00,
3.36
Grand Total 363.14
.00 .00
363.14
RIVERSIDE COUNTY
FIRE DEPARTMENT
In cooperation with the
California Department of Forestry and Fire Protection
210 West San Jacinto Avenue • Penis, California 92570 • (909) 940-6900 e Fax (909) 940-6910
Tom Tisdale
Fire Chief
March 10, 2005
Proudly serving the
unincorporated
areas of Riverside
County and the
Cities of:
Banning
Beaumont
Calimesa
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
To: La Quinta Building Department
Re: Final fire Clearance
The Riverside County Fire Department is granting a fire life safety clearance for
Tutoring Club 79=400.Suite-,#_1.05, LAQ04TI132
If you have any questions contact me at 760-345-6954
Respectfully,
Neal Stephenson
Fire Systems Inspector
MAR- 1-05 TUE
Craig E Anthony
Fire Chief
Proudly ,erving the
unincorl)orated,
areas of Riverside
County raid the
Cities of
13annuls;
.o
Beauinrnit
Calif nesse
Canyon ! akr.
�;UBChell�i
1)cst:r1 i -lot Spnitgs
4.
Indian Wells
India
Lake Elsinore
0.
La Cluint.a
Moreno Vallee
Palin Desert
.;.
Pl'lY7S
J.
Rancho Mirage
San Jacinto
i..
'1'ernecul i
Board ol'SupevMOrs
Bob Busier.
Oish'Ict I
John Tavaglione,
Di:vt+ict 2
.lefl� Snmt.
I)islrict 3
D?istiict 4
Marion Ashley.
Oish-iut 5
1
2:20 PM RIV, CO, FIRE PH INDIO FAX VO, 1 760 863 7072 P. 2
RIVERSIDE COUNT,
RIV �
FIRE DEPAIRTMENT
i.
OMS
Ig ay ills 2- FI., Indio, • ax(760) 863-7012
January 25, 2005
Robert Pitchford Architect
74-835 Fox Hits Ct.
Palm Desert, CA 92260
Re: Non -Structural Building T/I Plan Review
LAO -05-31-008 /-Tutoring Club
ub�
7.9-400 Hwy 111 -Ste 105
Fire Department personnel have reviewed and approved 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 permiL
1) As maybe necessary to maintain proper fire sprinkle r protection due to constructions changes, fire' I.
sprinkler system plans for the tenant improvement area may be required to be submitted to the Fire
Department for review, along with a plan/inspection lee. The approved plans, with Fire Department k I
Job card must be at the job site for all inspections.
2) Provide keys 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.
3) Install portable fire extinguishers per Title 19, but not: less than 2A10BC in rating. Contact certified
extinguisher company for proper placement of equipment.
4) Approved building address shall be placed in such a position as to be plainly visible and legible from f
the street and rear access if applicable. In multi -ten ant buildings, businesses shall post the
business name and suite number on back doors as -Nell as the front. Suite numbers or letters must N "
be a minimum of 6" in height. All addressing must to legible and of a contrasting color with the ;F
background.
a c
Please contact the Fire Department Planning & Engineering staff for final inspection prior to occupancy.
Requests for inspections are to be made at least 72 hours in advance and may be arranged by calling
(760) 863-8886. 1
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
Cc: City of La Quinta — Building Dept
HAPEAWP DaWL. OucdalPROJEGI'S%TIUA005-74008.doc
EMERGENCY SERVICES DIVISION • PLj* NING SECTION • INDIO OFFICE
82-675 Highway 111, 2n1 FI., Indio, CA 92201 - (760) 863-8886 • Fox (76o) 863-7072
Certificate of Occupancy0 o
Taf ot
G� OFTBuildin & Safet Department
9► Y p
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at the time of issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
BUILDING ADDRESS: 79-400 Highway 111 Suite 105
off'- 2t 7
Use classification: Commercial "Tutoring Club" TI Building Permit No.: "[Permit number]"
Occupancy Group: B Type of Construction: VN Sprinkled Land Use Zone: CR
Owner of Building: Neil Wayne Kleine Address: 41910 Boardwalk A-10
_ City, ST, ZIP: Palm -Desert, CA 92211
By: Daniel P. Crawford Jr.
_
Date: 3/10/05
Building Official
POST IN A CONSPICUOUS PLACE