10-1020 (RC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 10-00001020
Property Address: 47647 CALEO BAY STE 220
APN: 643-200-004- - -
Application description: REMODEL - COMMERCIAL
Property Zoning: COMMUNITY COMMERCIAL
Application valuation: 150000
T4bt 4. aCP Q"
Applicant: Architect or Engineer
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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: A B C8 C27 Lic nse No.: 181805
Date: L�o��nvactor.
Yempt
R -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 a 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 ($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, 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 1, 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.).
( I 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:
LQPERMIT
Owner:
ACCRETIVE LA QUINTA PARTNERS
1 PARK PLAZA SUITE 340
IRVINE, CA 92614
Contractor:
DIFFENBAUGH INC, J D
6865 AIRPORT DRIVE
RIVERSIDE, CA 92504
(951)351-6865
Lic. No.: 181805
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/25/10
OrCT 2'J 20010
R
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 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.
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 TRAVELERS INS Policy Number VTC2JUB17L77210
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
WO
the Labor Code, I shall forthwith com ith those provisions.
Date:�/4k(tplicant:
WARNING: FAILURE TO SECURE WORKERS' P ATION COVERAGE IS UNLAWFUL, AND SHALL
NAL
SUBJECT AN EMPLOYER TO CRIMINAL PEIES 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 160 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 count to enlier up/oon t a above-mentioned property for inspection purposes.
Date: �'� Sign-ature (Applicant or Agent):
Application Number . . . . . 10-00001020
------ Structure Information 950 SF SUITE 220 T.I.
-----
Construction Type . .
. . . TYPE V, UNPROTECTED
Occupancy Type . .
. . . BUSINESS <50
Other struct info . .
. . . CODE EDITION
2007/08 ENERGY
FIRE SPRINKLERS
YES
OCCUPANT LOAD
12.00
----------------------------------------------------------------------------
2ND FLOOR SQUARE FOOTAGE
950.00
Permit . . . .BUILDING
PERMIT
Additional desc . .
Permit Fee . . . .
814.50 Plan Check Fee
529.43
Issue Date . . . .
Valuation . .
. . 150000
Expiration Date
4/23/11
Qty Unit Charge
Per
Extension
BASE FEE
639.50
50.00 3.5000
----------------------------------------------------------------------------
THOU BLDG 100,001-500,000
175.00
Permit . . .
ELECT - ADD/ALT/REM
Additional desc . .
Permit Fee . . . .
85.90 Plan Check Fee
21.48
Issue Date . . . .
Valuation . .
. . 0
Expiration Date
4/23/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
20.00 .7500
PER ELEC DEVICE/FIXTURE 1ST.20
15.00
2.00 18.5000
EA ELEC SVC <=600V/<=200A
37.00
42.00 .4500
----------------------------------------------------------------------------
EA ELEC DEVICE/FIXTURE >20
18.90
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . . . .
43.50 Plan Check Fee
10.88
Issue Date . . . .
Valuation . .
. . 0
Expiration Date
4/23/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 4.5000
EA MECH VENT INST/ DUCT ALT
9.00
3.00 6.5000
----------------------------------------------------------------------------
EA MECH VENT FAN
19.50
Permit . . . PLUMBING
Additional desc . .
LQPERMIT
Application Number . . . . 10-00001020
Permit . . . . . .
PLUMBING
Permit Fee . . . .
64.50 Plan Check Fee
16.13
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
4/23/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
4.00 6.0000
EA PLB FIXTURE
24.00
3.00 7.5000
EA PLB WATER HEATER/VENT
22.50
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
---------------------------------------------------------------------------=
Special Notes and Comments
950 SF INTEROPR MEDICAL OFFICE T.I. 2ND
FLOOR SUITE 220. "B"
OCCUPANCY TYPE V -B
CONSTR. OCCUPANT LOAD
= 12. 2007 CODES
2008 ENERGY.
----------------------------------------------------------------------------
Other Fees . . . .
. . . . ACCESSIBILITY PLAN REVIEW
52.94
ART IN PUBLIC PLACES -COM
730.00
BLDG STDS ADMIN (SB1473)
6.00
ENERGY REVIEW FEE
52.94
STRONG MOTION (SMI) - COM
31.50
Fee summary Charged
Paid Credited
Due
---------------------------
Permit Fee Total
------------------------------
1008.40 .00 .00
1008.40
Plan Check Total
577.92 .00. .00
577.92
Other Fee Total
873.38 .00 .00
873.38
Grand Total
2459.70 .00 -.00
2459.70
LQPERMIT
Bin #
Qty of La Qu►nta
-Building 8i Safety Division ,
P.O. Box 1504,78-495 Calle Tampico Irf
La Quinta, CA 92253 - (760) 777-7012 G
Building Permit Application and Tracking Sheet
Permit # ��
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Project Address:>
Owner's Name: ��% 7✓�
A. P. Number:
Address: 2 tr
Legal Description:
City, ST, Zip: Tr V t Zip
Contractor:. V r
Address: 7s : S 3
telephone:
Project Description: r
City, ST, Zip: • et l m C� / �'� /
.
e- ra '
Telephone: �i�
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StateLic.#:
City Lie. #: qYVV5
Arch., Engr., Designer:
Address: -10Z Z I I
City, ST, Zip: a nc Z<"(
Tele hone n?�.�:,.;;<.,n..:.<.•�v' �>�
C ( 3 Z ' S Z zi �!>'ee. + .e. ��n:�:2:<;N;��?... .
�vY' {.ic$ �'3 vy> .•$'ct. f:
State Lic. #: (2 — 'j x;:,:y,r. .;: <>:':<:';��;_
ConstructionT e: Occup -1.
an
YP P cY.
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: b yj
Sq. Ft.: Cj- SC)
I # Stories: L
# Units: Z�
Telephone # of Contact Person: -j Z
Estimated Value of Project: I S 0 •0 DO.
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Ree'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted 30wo
Item
Amount
Structural Cales.
Reviewed, ready for corrections toh
Plan Check Deposit
Truss Calcs.
Called Contact Person D
Plan Check Balance - •
Tide 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted / 3
Mechanical •
Grading plan
2'd Review, ready for correctios/Issue
Electrical
Subcontactor List
Called Contact Person
Plumbing •
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
0
9190I%W . "150
/a-'7 - 16
A
ohn R. Hawkins
'ire Chief
'roudly serving the
mincorporated
reas of Riverside
.ounty and the
;ities of-
tanning
f
tanning
leaumont
4.
;alimesa
.anyon Lake
.oachella
)esert Hot Springs
ndian Wells
ndio
ake Elsinore
4.
.a Quinta
:-
Moreno Valley
'aim Desert
'ems
:•
rancho Mirage
'.ubidoux CSD
4.
-an Jacinto
:-
'emecula
;oard of Supervisors
;ob Buster,
District I
)hn Tavaglione,
District 2
:ff Stone,
District 3
)hn Benoit,
District 4
larion Ashley,
District 5
IUVERNIDh CUUNTY
FIRE DEPARTMENT
In cooperation with the
California Department of Forestry and Fire Protection
77-933 Las Montanas Rd STE 201 • Palm Desert, CA 92211 • (760) 863-8886 • Fax (760) 863-7072
September 8, 2010
RE: TENANT IMPROVEMENT PLAN CHECK
LAQ-1 0 -TI -031 Comprehensive Cancer Center 47-647 Caleo Bay #260 La Quinta, CA
You have been issued a release for a tenant improvement on an existing building. THIS IS NOT AN
OCCUPANCY PERMIT.
It is prohibited to use/process or store any materials in this occupancy that would classify it as an "H"
occupancy per Sec. 307 of the 20007 CBC.
THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO INSPECTION:
Install door hardware and exit signs as per Chapter 10 of the 2007 CBC.
A minimum 2A1 OBC Fire Extinguisher, (State Fire Marshal Approved) must be mounted in a visible
location within 75' walking distance from any point in your building or suite. Fire extinguishers can
be installed by a licensed extinguisher company with a State Fire Marshal service tag attached to the
extinguisher, or purchased from a retail store with a sales receipt attached. A licensed fire extinguisher
company must service extinguisher yearly.
All breakers must be labeled and a clearance of 36 inches must be maintained around the panel at all
times.
A durable sign stating "This door to remain unlocked during business hours" shall be placed on or
adjacent to the front exit door. The sign shall be in letters not less than one inch high on a contrasting
background.
An approved audible interior notification alarm device shall be provided in approved locations. A
C-1 O licensed contractor must submit plans, designed in accordance with NFPA 72 to the Fire
Department for review and approval prior to installation.
Provide key(s) 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. Key(s) shall be
provided at time of final inspection.
As may be necessary to maintain proper fire sprinkler protection due to constructions changes, fire
sprinkler system plans for the tenant improvement area are required to be submitted to the Fire
Department for review.
Approved suite address shall be placed in such a position to be plainly visible and legible from the
street. Said numbers shall contrast with their background.
Applcant/installer shall be responsible to contact the Fire Department to schedule inspections. A re-
inspection fee will be required if more than one (1) inspection is. necessary. Requests for inspections
are to be made at least 72 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,
Jason Stubble
Fire Safety Specialist