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08-1323 (SOTB);4_;;a P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Tjbt 4 4 Q" Application Number: _08,00001323 Propert� y Address: 79513 HIGHWAY 111 APN: 649-030-037-1 -000000- Application description: STRUCTURES OTHER THAN BUILDINGS Property Zoning: REGIONAL COMMERCIAL Application valuation: 35000 Applicant: Architect or Engineer: ----------------- LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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: License No.: Date:� ^ 3 j-60 Contractor: — OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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 (5500).:. 1 _ I 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.). (_) 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 _ 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: LQPER\41T Owner: G & M OIL COMPANY, INC 16868*A STREET HUNTINGTON BEACH, CA 92647 Contractor Owner VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 WORKER'S COMPENSATION DECLARATION Date: 3/31/09 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 Policy Number 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, ' o ecome subject [o workers' compensation provisions of Section %, 3700 of ipe bor Code, I hall forthwith�d' fly with those provisions. �te�� Applip WARNING: FAILURE TO SECURE W KERS' 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. 1 certify that I have read this application and state that the information is correct. I agree to comply with all city and county ordinances and state laws relating t�,I�d�innngggl n, and hereb r.authorize representatives of this county to enter up the above-mentioned p purpose Deat � � ignature (Applicant or Agent) Application Number . . . . . 08-00001323 Permit . . . . . . BUILDING PERMIT Additional desc HEALY TANK & ENCL. Permit Fee . . . . 317.00 Plan Check Fee 206.05 Issue Date . . . . Valuation . . . 35000 Expiration Date.. 9/27/09 Qty Unit Charge Per Extension BASE FEE 252.00 10.00 6.5000 ---------------------------------------------------------------------------- THOU BLDG 25,001-50,000 65.00 Permit . . . MECHANICAL Additional desc HEALY TANK INSTALLATION Permit Fee . . . . 21.50 Plan Check Fee 5.38 Issue Date . . . . Valuation 0 Expiration Date . . 9/27/09 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.5000 --------------------------------------------------------------- EA MECH OTHER MECH EQUIPMENT 6.50. ------------- Permit . . . . . PLUMBING Additional desc . •Permit Fee . . . . 18..00 Plan Check Fee 4.50 Issue Date . . . . Valuation 0 Expiration Date 9/27/09 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 3.0000 L EA PLB FIXTURE DRAIN/VENT REP/ALT 3.00 ------------------------------------------------------------------L------- Special Notes and Comments - INSTALLATION OF HEALY-TANK EVR SYSTEM AND METAL ENCLOSURE (1-3-6 X 7 X 5-6 FT HGT)PER ENGINEERED PLANS. 2007 CODES. ---------------------------------------------------------------------------- Other Fees ... . . . BLDG STDS ADMIN (SB1473) 2.00 STRONG MOTION (SMI) - COM 7.35 Fee summary Charged Paid Credited Due --------------------------- Permit Fee Total ------------------------------ 356.50 .00 .00 356.50 _ Plan'Check Total 215.93 .00 .00 215.93 Other Fee Total 9.35 .00 .00 9.35 Grand Total 581.78 .00 .00 581.78 LQPERNfIT b'° •�� City of La Quinta Building U Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 G Building Permit Application and Tracking Sheet Project Address" j/j Owner's Name: A. P. Number: (� a3� O/ Address: 16p069j X Description: Legal g P City, ST, Zip: L4/*Ww 1&X/77A1,67.CI6pgrl,4 I Contractor.^,, -7.— - Telephone:Z/� Y7s 32 2— f_ Address:'?,085 P/.S5 D/tl /� —� Project Description: City, ST, Zip: uo sl6 Tele hone. k:E'State Lic. # iD sJ? 30 City Lic. #: Arch., Engr., Designer: 2 Address: City, ST, Zip: Telephone: P � Construction Type: Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo ZName of Contact Person: - V q. Ft.: # Stories: # Units: (Y Telephone # of Contact Person: 1V ��� J �.fo imated Value of Project: APPLICANT: DO NOT WRITE B # Submittal Req'd. Rec'd TRACKING PERMTT FEES Plan Sets 3 Plan Check submitted ftog Item Amount Structural Cales. 2. Reviewed, ready for corrections 24 Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Cales. Plans picked up '1/4Construction 2 Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing , Vra Grant Deed Plans picked up + S.M.I. H.O.A. Approval Plans resubmitted ZZL Grading IN HOUSE:- ''" Review, ready for corrections ssue $ Developer Impact'Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees 3 ri Total Permit Fees f: P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT (760) 777-7012 FAX (760) 777-7011 To: Greg Butler, Building & Safety Manager To PD: August 21, 2008 From: Les Johnson, Director -PDD Due Date: AUGUST 29, 2008 Permit #: 08-1323 Status: 1ST REVIEW Building Plans Approval (This is an approval to issue a Building Permit) The Planning Department has reviewed the Building Plans for the following project: Description: HEALY CLEAN AIR VAPOR TANK Address or General Location: 79-513 HIGHWAY 111 Applicant Contact: JIM SMITH (714) 984-3369 • O The Planning Development Department finds that: ❑ ...these Building Plans do not require Planning Department approval. ❑ ...these Building Plans are approved by the Planning Department. ❑ ...these Building Plans require corrections. Please forward a copy of the attached corrections to the applicant. When the corrections are made please return them to the Planning Department for review. Les Johnson" ijector-PD o /Date Ala- #U% w�usi- be srreu�eA mn+k q John R. Hawkins Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of. Banning 4. Beaumont 4. Calimesa 4. Canyon Lake ee - Coachella 44-, Desert Hot Springs Indian Wells Indio Lake Elsinore La Quinta Moreno Valley Palm Desert Perris . Rancho Mirage Rubidoux CSD San Jacinto . 4. Temecula Board of Supervisors Bob Buster, District 1 John Tavagliore, District 2 Jeff Stone, District 3 Roy Wilson, District 4 Marion Ashley, 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 • (951) 940-6900 Fax (951) 940-6910 March 27, 2009 JDS Steel Construction 15777 Valley Blvd. #A.. ,Fontana, CA . Re: Vapor Processing System LAQ-09-M ISC-011 Chevron Gas Station #746 79-513 Hwy 111 La Quinta, CA The following sections provided, unless stated otherwise, will be from the California Code of Regulations, Title 19 Chapter 11.5 and/or 2007 California Fire Code. The above referenced plans have been reviewed and are acceptable by the Riverside County Fire. Department with the following conditions: 1) The unit shall be located not less than 50 ft from any fuel transfer and not less than 10 ft. from Any buildings or buildable property. 2) Vapor Processing Unit shall be protected against tampering. trespassing and vehicular traffic and the area must be clear of combustibles at least 10 ft. 3) The following signs shall be posted at the dispenser and letters shall not be less than 3 inches in height and 'h inch stroke. a) "NO SMOKING OR OPEN FLAMES WITHIN 50 FEET" 4) The emergency shutdown device shall be readily visible, located no more than 75 ft. but no closer than 10 ft. from fuel dispensing. The installing company shall be responsible to contact the Fire Department to schedule a final inspection. Requests for inspections are to made at least 24 hours in advance and may be arranged by calling (760) 863-8886. Should there be need for further information and/or clarification, please contact the undersigned at (760) 863-8886.-