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08-0190 (RC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 08-00000190 Property Address: 47647 CALEO BAY STE 120 APN: 643-200-004- - Application description: REMODEL - COMMERCIAL Property Zoning: COMMUNITY COMMERCIAL Application valuation: 175000 T`ht u&& BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: LA QUINTA MEDICAL PARTNERSHIP 5500 TRABUCO RD #100 IRVINE, CA 92620 Contractor: Applicant: Architect or Engineer: ORR BUILDERS 39301 BADGER, SUITE PALM DESERT, CA 9221 (760)360-6632 Lic. No.: 693077 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 n License No.: 693077 Oate(0_&&EContractor.O/ �� OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the fallowing 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).: (_) 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 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 IIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/02/08 D L! t1 D 0MAY 3 0 2000 CITY OF LA QUINTA FINANCE DEPT 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. 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 STATE FUND Policy Number 756-0000335-07 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 �� /y �ppp 3700 of the Labor Code, I shall forthwith comply with those provisions. Dale(G[ Applicant: a/Ge,h/Ztho:/ 4- r-7- WARNING: 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 1$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 c nstruction, and hereby authorize representatives of this cou�fV tysto enter upon the above-mentio propery spection purposes. Date Z e Signature (Applic Application Number . . . 08-00000190 ------ Structure Information 2,710SF TI/V-B/B-OCC/39-OL/SPRINKLED ----- Other struct info . . . . . CODE EDITION 2007CBSC FIRE SPRINKLERS FULLY MIXED-USE OCCUPANCY B OCCUPANT LOAD 39.00 -------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE -------------------------- 2710.00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee 902.00 Plan Check Fee 586.30 Issue Date . . . . Valuation . . . . 175000 Expiration Date 11/29/08 Qty Unit Charge Per Extension BASE FEE 639.50 75.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 10.0,001-500,000 262.50 Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 69.20 Plan Check Fee 17.30 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/29/08 Qty Unit Charge Per Extension BASE FEE 15.00 2710.00 .0200 ---------------------------------------------------------------------------- ELEC GARAGE OR NON-RESIDENTIAL 54.20 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 101:50 Plan Check Fee 25.38 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/29/08 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 4.5000 EA MECH VENT INST/ DUCT ALT 4.50 3.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 49.50 3.00 6.5000 EA MECH AH <=10K CFM 19.50 2.00 6.5000 ---------------------------------------------------------------------------- EA MECH VENT FAN 13.00 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 115.50 Plan Check Fee 28.88 LQPE"11T Application Number . . . . . 08-00000190 Permit. . . . . PLUMBING Issue Date . . . .. Valuation . . . . 0 Expiration Date 11/29/08 Qty Unit Charge Per Extension BASE FEE 15.00 15.00 6.0000 EA PLB FIXTURE 90.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 ---------------------------------------------------------------------------- Special Notes and Comments 2,710SF TENANT IMPROVEMENT/V-B/B-OCC/39- OCCUPANT LOAD/FULLY SPRINKLED. [INTERNAL MEDICINE SPECIALISTS) THIS.PERMIT DOES NOT INCLUDE BUILDING SIGNAGE. 2007 CALIFORNIA BUILDING STANDARDS. June 2, 2008 9:02:15 AM AORTEGA ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ACCESSIBILITY PLAN REVIEW 58.63 ENERGY REVIEW FEE 58.63 STRONG MOTION (SMI) - COM 36.75 Fee summary Charged Paid Credited --------------------------- Due ---------=---------- Permit Fee Total 1188.20 .00 ---------- .00 1188.20 Plan Check Total 657.86 .00 .00 657.86 Other Fee Total 154.01 .00 .00 154.01 Grand Total 2000.07 .00 .00 2000.07 LQPEPA11T Bin # y�{ OYl City of La Quinta Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet ' Permit # Project Address: y7 G y%L�j ,��¢ , vL Owner's Name A. P. Number: S'v� 21jy Address: 11L7 1Aj0/V RO- Legal Description: City, ST, Zip: //4/2>/a Contractor: Gl" PA Telephone: 760 . 77 5-. 8O/ J Address: 3 JP' .3,t?/ 134-0 S A-4 . $ r S1*. 300j . Project Description: City, ST, Zip: A44_,&f % w.5 ,e 47 ZZ // 2 7Ia </- Telephone: 7 tiiO 2.5-0 N % /WZ ��0/ Ce State Lie. # : i;. q 30 7 7. City Lic. #: re?trL44 -`S' Arch., Engr., Designer: 1104 -1 - Address: 70 Z Z 5' City, ST, Zip: 144-A)CtIV 14e 2/MZ4LO'(/J 1727 70 Telephone: 7 (o o .77-F S72- Construction Type: T/ Occupancy:. / State Lic. #: G /2 l % ti Project type (circle one): New. Add'n Alter Repair Demo Name of Contact Person: Tff 1-f . h4v GW f e_ Sq. Ft.: Z- 71G # Stories:# Units: / Telephone # of Contact Person: ' 7i;o 32J 3-2- Estimated Value of Project: / 7S� d� APPLICANT: DO NOT WRITE BELOW THIS LINE . # Submittal Req'd Reed TRACKING. PERMIT FEES Plan -Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections IlfIllL4$ Plan Check Deposit Truss Cities. Called Contact Person Out Plan Check Balance Energy.Calcs. Plans picked uli . . M1 Construction Floodplain plan Plans resubmitted Mechanical Grading, plan' 2" Review, ready.for orrectio issue 08 Electrical SubcontactorList Ca1ledContactK'erson 0a Plumbing A W Grant Deed Plans.pickedup ` S.M.I. MO.A. Approval Plans resubmitted `ij Grading .4 A] 1N HOUSE:- 7nd Review, ready for correct' nsrssu Developer impact Fee, � �y Planning Approval Called Contact Person P.P. �� y Pub. Wks. ApprDate of permit issue School Fees Total Permit Fees i 9 -a- � Certificate of Occupancy44Qd INcaroanTsn � a I �a GBuilding & Safety/ Department � OF �9 � ,7 } This Certificate is issued pursuant to the requirements of Appendix Chapter 1 Section 110.1 of the California Building Code, certifying.that, at the time of issuance, this structure was in g compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS. 47-647 CALEO BAY #120 F i j ti pi = Use classification: COMMERICAL (RUIZ FAMILY PHYSICIANS) Building Permit No.: 08-190 z; a Occupancy Group: B Type of Construction: V Land Use Zone: CC 5 ur I Code Edition: 2007 Occupant Load: 39 Sprinkler Installed: YES Required: YES >; C Owner of Building: LA QUINTA MEDICAL PARTNERSHIP Address:' 5500 TRABUCO RD #100 City, ST, ZIP: IRVINE, CA 92620 By: STEVE TRAXEL Date: OCTOBER 2, 2008 i Building Official" ?Y POST IN A CONSPICUOUS PLACE' L