13-0633 (RC)P.O. BOX 1504 4
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 13-0'0000633 Owner:
Property Address: 47875 CALEO BAY STE 102 CALEO BAY
APN: 643-200-001-3 -31248 - 47875 CALEO BAY
Application description: REMODEL - COMMERCIAL LA QUINTA, CA 92253 D
Property Zoning: COMMUNITY COMMERCIAL
Application valuation: 75000
Contractor:
Applicant: Architect or Engineer: ALL COUNTY CONSTRUCTIt�N
PO BOX
S0`� FULLERTONON, L
CA 92834
\�\ (562)244-8638
Lic. No.: 669244
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: 13 License No.: 669244
Datey�2 Contractol4
v
O�Kptlu.'L DER DECLARATION
I hereby affirm under penalty of perjury that I amm 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, 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 ISec. 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 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 contractors) 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: 8/21/13
1
Z I�
OF LA QUINTA
CITY _ ....� nopT.
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.
ave 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 9053224
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
... of the Labor Code, shall forth i comply with those provisions.
Dates � Applican' t: [/
WARNING: FAILURE TO SEC, WO E ' COMP TION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO C".,. L 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 applicatidn 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 herr y authorize representatives
of thiscou y to ter upon the above-mentioned property f i pec ' r br
Dat X3 IV Signature (Applicant or Agent
Application Number . . . . . 13-00000633
------ Structure Information 790 SQ FT T I -----
Other struct info . . . . . CODE EDITION 2010
FIRE SPRINKLERS yes
MIXED-USE OCCUPANCY B
OCCUPANT LOAD 8.00
1ST FLOOR SQUARE FOOTAGE 790.00
----------------------------------------------------------------------------
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee . . . . 527.'00 Plan Check Fee 342.55
Issue Date . . . . Valuation 75000
Expiration Date . . 2/17/14.
Qty Unit Charge Per Extension
BASE FEE 414.50
25.00 4.5000 THOU BLDG 50,001-100,000 112.50
----------------------------------------------------------------------------
Permit . . . ELECT - ADD/ALT/REM
Additional desc .
Permit Fee 30.80 Plan Check Fee 7.70
Issue Date . . . . Valuation . . . . 0
Expiration Date 2/17/14
Qty Unit Charge Per Extension
BASE FEE 15.00
790.00' .0200 ELEC GARAGE OR NON-RESIDENTIAL 15.80
----------------------------------------------------------------------------
Permit . . . PLUMBING
Additional desc . .
Permit Fee . . 67.50 Plan Check Fee 16.88,
Issue Date . . . . Valuation . . . . 0
Expiration Date 2/17/14
Qty Unit Charge Per Extension
BASE FEE 15.00
7.00' 6.0000 EA PLB FIXTURE 42.00
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
790 Sg Ft Dental Office, Occupancy B, 8
Occupancy, 2010 codes
June 4, 2013 1:51:06 PM jjohnson.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . PLAN REVIEW, ACCESSIBILTY 42.25
LQPERMIT -
Application Number
. . . . .
13-00000633
-----------------------
Other Fees . . .
------------
. . . . . .
--------------------------
BLDG STDS ADMIN (SB1473)
---------------
3.00
ENERGY REVIEW
FEE
42.25
Fee summary
-----------------
Charged
----------
Paid
--------------------
Credited
----------
Due
Permit'Fee Total
625.30
.00
.00
625.30
'Plan Check -Total
367.13
.00
.00
367.13
Other Fee Total
87.50
.00
.00
87.50
Grand Total
1079.93
.00
.00
1'079.93
LQPERMIT
i
HT
... ... ......... ..........
MAY .0 8 2013
CITY 0FLAQUINTA
COMMUNITY DEVELOPMENT
4
Building & Safety Department
78-495 Calle Tampico
PO Box 1504
La Quinta, CA 92253
(760) 777-7012 voice — (760) 777-7011 fax
To: Greg Butler, Building Official
From: Les Johnson, CDD Director
To PD: May 6, 2013
Due date: ASAP
Permit # - 13-633 Status: 1st review
Building Plans Approval
(This is an approval to issue a Building Permit)
The Planning Division has reviewed the Building Plans for the following project:
Description: Tenant Improvement, Dentist Office
Address or general location: 47875 Caleo Bay
Applicant Contact: Dr. Steve Phan, DDS
The Planning Division finds that:
❑ /...these Building Plans do not require Planning Division approval.
f ...these BuildingPlans area roved b the Planning Division.
pp Y 9
❑ ...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 Division for review.
Les A nson�Community Development Director F Date
Note: PLEASE RETURN PLANS WITH GREENSHEET TO THE BUILDING
DIVISION.
OCT -24-2013 THU 07:16 AM RIVERSIDE COUNTY FIRE FAX NO, 17608637072 P. 02
Riverside County Fire Department Fire Protection Planning Section
R1vers190 0 lce: 2300 Minkel St, Sle, 150, Nvemide, CA M01 Ph. (951) 866-0777 Fsx (9511 955-46 66
Palm DeaNrt ofte: 77.933 Las Mantafias Rd., # 201 Palm Desert, CA 92 21 1-4 1 31 Ph- (760) 863.8886 Fax (7GM 863-7072
Fire Department Clearance/Release
Date: 10/23/2013
To: LA QUINTA B&S J
Fax:-
Tract/Parcell Map #: DR PHAN DENTAL
Permit/Lot #: LAQ-I3-TI-019
Job Site Address: 47875 CALEO BAY #A102
City, State, Zip LA QUINTA
❑ Final For Recordation
❑ Release For Building Permit(s)
❑ Shell Final Only (No Tenant)
® Final for Sprinkler System
c
❑ Release For Residential Sprinkler Installation
❑ Building Plan Check Fees Paid, Water Requirement Met- It water applicable
❑ Building Plan Check Fees Not Paid
❑ Residential Sprinkler Plan Check Fees Paid
Residential Sprinkler Plan Check Fees Not Paid
Other Fees
❑ Fees Not Required
If you should have any questions, please contact the appropriate Riverside County Fire Protection Planning office for
further assistance.
KOHL HETR)CK
Print Namo of Plan Reviewer/Inspector Approved Release
Sent By: Print Name
Form c - Revised 3101/2012