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