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11-0671 (RC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 11-00000671 Property Address: 47647 CALEO BAY STE 230 APN: 643-200-004- - Application description: � REMODEL - COMMERCIAL Property Zoning: COMMUNITY COMMERCIAL Application valuation: 15000 T,iht 4 4 Q" Applicant: I/�C/�� 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. LicenseClass: B, C9, 10, 20 Ll a No.: 581636' eC Date: i7 Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I 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 oushe 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.). (_ 1 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 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/03/11 Owner: ACCRETIVE LA QUINTA PARTNERS 1 PARK PLAZA #340 IRVINE, CA 92614 n I?D1 2oli } Contractor: A" t3 SIPOVAC CONSTRUCTION, I}NC 72651 THEODORA LANE )(( COTYQFLAirUiNTA PALM DESERT, CA 92260 �)'Ep% (760)567-2347 Lic. No.: 581636 ----------------------------------------------- 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 0028487-2010 _ 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, //.j��J///,,aan�d�agree that, if I should become subject to the workers' compensation provisions of Section 'r�y'7'--0 of the Labor Code, I shall forthwith com ly with those Provisions. Date.;!?/4.71&1 Applicant: /2 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. 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 coy //�/p�enter upon the above-mentioned pro rty for ' pection purposes. , Date: 3 �� Signature (Applicant or Agent): 0 Application Number . . . . . 11-00000671 Structure Information Construction Type . . . . . TYPE V, UNPROTECTED Occupancy Type . . . . . BUSINESS <50 Other struct info . . . . . CODE EDITION 2010 ---------------------------------------------------------------------------- FIRE SPRINKLERS YES Permit BUILDING PERMIT Additional desc . Permit Fee . . . . 162.00 Plan Check Fee 105.30 Issue Date . . . . Valuation . . . . 15000 Expiration Date 1/30/12 Qty Unit Charge Per Extension BASE FEE 45.00 13.00 9.0000.TH0U ---------------------------------------------------------------------------- BLDG 2,001-25,000 117.00 Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 21.75 Plan Check Fee 5.44 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/30/12 Qty, Unit Charge Per. Extension BASE FEE 15.00 9.00 .7500 ------------------------------- PER ELEC DEVICE/FIXTURE 1ST 20 ------------------=---------- 6.75 ---------------- Permit MECHANICAL Additional desc Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . Valuation . . . . 0 Expiration Date 1/30/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 .9.0000 ---------------------------------------------------------------------------- EA MECH B/C <=3HP/100K BTU 9.00 Permit PLUMBING Additional desc . Permit Fee . . . . 27.00 Plan Check Fee 6,75 Issue Date Valuation . . . . 0' Expiration Date 1/30/12 Qty Unit Charge Per Extension LQPERMIT Application Number . . . . . 11-00000671 Permit . . . . . .. PLUMBING Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 3.0000 EA PLB FIXTURE.DRAIN/VENT REP/ALT 3.00 ---=------------------------------------------------------------------------ Special Notes and Comments CONVERSION OF EXISTING OFFICE (138 SF) INTO LABORATORY IN MEDICAL OFFICE. ROOFTOP HVAC INSTALLED PER ENGINEERED STRUCT. DESIGN.2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ACCESSIBILITY PLAN REVIEW 10.53 BLDG STDS ADMIN (SB1473) 1.00 ENERGY REVIEW FEE 10.53 STRONG MOTION ('SMI) - COM 3.15 Fee summary Charged. Paid Credited ------------------------------ Due --------------------------- Permit Fee Total 243.75 .00 .00 243.75 Plan Check Total 125.74 .00 .00 . 125.74 Other Fee Total. 25.21 .00 .00 25.21 Grand Total 394.70 .00 .00 394.70 i LQPERMIT Bin # City of La QUfnta Building & Safety Dh*ion P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # I _ 4 ` Project Address: 47 _ ly 7 12le O /Sot- Owner's Name: A. P. Number: &"LI3 — 2od — "I' Address: Legal Description: City, ST, Zip: Contractor:Telephone: S a3•, o:c:�,., �yW , 1'..'.."}-'. •,„.,..,;�"':m:• `'}�. Project Description: Address: City, ST, Zip. c - Telephone: � is�1 %Z3 State Lic. # : $ 3 City Lic. Arch., Engr., Designer: " �4 VIOL Address: City, ST, Zip: Telephone: ; P � , ��� State Lic. #: Name of Contact Person: 150'S S p, Construction Type: Occupancy: Project type ( / circle one1' New Add'n tcc Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: LO —— 2 7 Estimated Value of Project: / S APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd R"'d TRACKING PERMIT FEES Plan Sets 01 Plao Check submitted /.SAI �i Item Amount Structural Cates. Reviewed, ready fo correctio Plan Check Deposit Truss Cates. Called Contact Person (1 Plan Check Balance. Title 24 Cates. Plans picked up is Construction Flood plain plan Plans resubmitted Mechanical Grading plan V Review, ready for correction ttu ) I Electrical Subcoutactor 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 correctionshmue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue A A t4 School Fees Total Permit Fees 6 / 2d �,�xjrrn f-1 d -Z44 4/62 7 11;z &/-W P.O. Box 1504 BUILDING & SAFETY DEPARTMENT 78-495 CALLE TAMPICO (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 To:.Greg Butler, Building & Safety Manager To CDD: & "020' l From: Les Johnson, Director -Planning' Due Date: Permit #: Status: Building Flans Approval (This is an approval to issue a Building Permit) The Planning Department has reviewed the Building Plans for the following project: Description: e 73 Address or General Location: '`i 7- 6 Applicant Contact: 00.4 760 - 367 - `2 3'1/ 77 The Planning Department finds that: ❑ ...these Building Plans do not require Planning Department approval. fi ...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 Johns Director -Planning received JUN 2 0 2011 City of La Quinto Planning De.m went Rivmsax COUNW RRE DEPARTMEW IN COOPERATION WITH THE CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION John R. Hawkins - Fire Chief 210 West San Jacinto Avenue — Perris, CA 92570 (951) 940-6900 — www.rvcfire.org PROUDLY SERVING THE UNINCORPORATED AREAS July 27, 2011 OF RIVERSIDE COUNTY AND THE CITIES OF: RE: TENANT IMPROVEMENT PLAN CHECK -Non Structural LAQ-11 -TI-024 Dr. Zadeh Pathology Lab Room BANNING 47-647 Caleo Bay #230 La Quinta, CA BEAUMONT CALIMESA You have been issued a release for a tenant improvement on an existing building. THIS IS NOT AN OCCUPANCY PERMIT. CANYON LAKE COACHELLA 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 2010 CBC. DESERT HOT SPRINGS EASI'VALE INDIAN WELLS THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO. INSPECTION: INDIO Install door hardware and exit signs as per Chapter 10 of the 2010 CBC. JURUPA VALLEY A minimum 2A10BC Fire Extinguisher, (State Fire Marshal Approved) must be mounted in a LAKE ELSINORE visible location within 75' walking distance from any point in your building or suite. Fire LA QUINTA extinguishers can be installed by a licensed extinguisher company with a State Fire Marshal MENIFEE service tag attached to the extinguisher, or purchasedfrom a retail store with a sales receipt attached. A licensed fire extinguisher company must service extinguisher yearly. MORENO VALLEY PALM DESERT All breakers must be labeled and a clearance of 36 inches must be maintained around the panel PERRIS at'all times. RANCHO MIRAGE A,durable. sign stating "This door to remain.unlocked during business hours" shall be placed on RuBiooux CSD or adjacent to the front exit door. The sign shall be in letters not less than one inch high on a contrasting background. SAN JACINTO TEMECULA 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) WILDOMAR shall be provided at time of final inspection. Applicant/installer shall be responsible to contact the Fire Department to schedule inspections. BOARD OF A re -inspection fee will be required if more than one (1) inspection is necessary. Requests for SUPERVISORS: inspections are to be made at least 72 hours in advance and.may be arranged by calling (760) BOB BUSTER 863-8886. DISTRICT 1 JOHN TAVAGLIONE All questions regarding the meaning of these conditions should be referred to the Fire DISTRICT 2 Department Planning. & Engineering Staff at (760) 863-8886. JEFF STONE DISTRICT 3 IOHN BENOIT DISTRICT 4 Sincerely, MARION ASHLEY DISTRICT 5 By: Jas in Stubble Fire Safety Specialist