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.-