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04-4727 (RC)4 • BUILDING & SAFETY DEPARTMENT Box 1504 (760) ,777-7012 95 CALLE TAMPICO FAX (760) 777-7011 QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 JUN 14 2004 BUILDING PERMIT CITY OF LA QUINTA FINANCE DEPT.- pplication Number 04-00'0.04727_ Date 6/07/04 Property Address 79440 CORPORATE CENTER DR STE 118 APN: 649-020-067--000000- Application description . . . REMODEL - COMMERCIAL Property.Zoning . . . . . . . COMMERCIAL PARK Application valuation . . . . 200000 Owner Contractor ------------ PAUL JAMES R GALAXY 4MEDICAL BUILDERS INC 79440 CORPORATE CTR 102 984 MONUMENT STREET LA QUINTA CA 92253 PACIFIC PALISADES CA 90272 (310) 230-7953 WCC: STATE FUND WC: 208422003 -10/01/04 CSLB: 779295 05/31/06 CCC: B -------------------------- Structure Information ------------------------- Construction Type . . . . TYPE V - NON RATED Occupancy Type . . . . . BUSINESS <50 Other struct info . . . . . CODE EDITION 2001 FIRE SPRINKLERS YES MIXED-USE OCCUPANCY B OCCUPANT LOAD 54.00 FIRST FLOOR SQ FTG 4168.00 ------------------------------------------------------------ - ----- Permit . . . BUILDING PE'RMY' Additional desc Permit Fee . . . . 989.50 Plan Check Fee 643.18 Issue Date Valuations r. ,%_j,20�0000 Qty Unit Charge Per Extension BASE FEE 639.50 100.00 3.5000 THOU BLDG 100,001-500,000 350.00 ---------------------------------------------=---------------------------- Permit ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 98.36 Plan Check Fee 24.59 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 4168.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 83.36 ----------------------------------------------=----------------------------- r P.O. Box 1504• �� VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 01 - �- r% a % Date: 6 -7 - O t Applicant: CO -r Applicant's Mailing Address: Architect or Engineer: /V F- f /t-, 0'1 /V Architect or Engineer's Ad es �� / 2,F 5 O eve Los 5 Co' -5—"oD Co Lic. No.. BUILDING PERMIT DECLARATIONS 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 Lie ffery� is in full force and effect. '721Z95 -License Class ,C3 License No. Date 6-/'1`-0q Contractor a A44 -k l .14e&eA L zRu 14 bekS OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U 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 or 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reason Date WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of pedury 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 issMd. workers' compensation insurance carrier and polic number are: Carrier .5%^TF, L.,U1� Policy Number _ 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 3700 of the Labor Code, I shall forthwith comply with those provisions. Date 4 *194'D4 Applicant (MAIC A/6M4 ii/LD��s 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. 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 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, indemnity 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 1 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 county to enter upon the above-mentioned property for inspection purposes. Date Signature (Applicant or Agent): _� Fee summary Charged Permit Fee Total 1253.86 Plan Check Total 709.28 Other Fee Total 42.00 Grand Total 2005.14 Paid Credited Due.. ---------- ---------- ---------- .00 .00 1253.86 .00 .00 709.28 .00 .00 42.00 .00 .00 2005.14 Page 2 Application Number . . . 04-00004727 Date . 6/07/04' Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 74.50 Plan Check Fee 18.63 Issue Date . . . . Valuation . . . . 0_ Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 11.0000 EA MECH FURNACE >100K 22.00 3.00 6.5000 EA MECH VENT FAN 19.50 -------------------------------------------------------7-------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 91.50 Plan Check Fee 22.88 Issue Date . . . . Valuation . . . . 0 Qty. Unit Charge Per Extension BASE FEE 15.00 11.00 6.0000 EA PLB FIXTURE 66.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STRONG MOTION (SMI) - COM 42.00 Fee summary Charged Permit Fee Total 1253.86 Plan Check Total 709.28 Other Fee Total 42.00 Grand Total 2005.14 Paid Credited Due.. ---------- ---------- ---------- .00 .00 1253.86 .00 .00 709.28 .00 .00 42.00 .00 .00 2005.14 k `Bin q Permit # vW3 0 X Project Address: q A14 0 A. P. Number. Legal Description: X Contractor. City of La Quinta Building a Safety Division P.O. Box 1504, 78-495 Calle Tampico U Quinta, CA 92253 - (760) 777-7012 Building P ' Application and Tracking Sheet O s Name: .%.L Address:--no'40 l OCAO 6-11 U .L City. ST, Zip: x Address: of b p� J ar�(V ` Project Description: )C City, ST, Zip: ?AXI% F`�S &0tw>l w t IM Telephone: St v Z! • == �= State Lic. # : City Lic. #: 1..��s Arch., Engr., Designer. &.&J -TW l f ! e -A A&ress: 613o City, ST, Zip: \. I& OL0 0G 4 A Telephone: r) State Lic. #-\C. Name of Contact Person: J. k�"'' :r#y K J. %Md,r4 Construction Type: Occupancy: Project" (circle one): New Add'n Alter Repair Demo Sq. FL: #Stories: # Units: X Telephone # of Contact Person: I rEstimated Value of Project: �. APPLICANT: DO NOT WRITE BELOW THIS Llw--A-,Z*2 00 1000 V # Submittal Req'd Ree'd TRACKING PERMIT FE Plan Sets 2 Plan Check submitted Item Amount —Structural Cales. 2 Reviewed, ready for corrections /s Plan Check Deposit Truss Cala. Called Contact Person /S Plan Check Balaoee Energy Cales °;�e Plans picked up Construction Flood plain plan Plans resubmitted U;1,,J tV !S Mechanical Grading plan 2'' Review, ready for correctionslss �p/� Electrical Subcontactor List Called Contact Person - 4 Plumbing Grant Decd Plans picked up SAA. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''' Review, ready for correctionslusue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue /yp School Fees Ad N—--som�'in- T--:f.riiiW zw-.7, :-, X 7 :1a —'�-=`=1 /Vo7-f: l3�CRvSE £�l/lo+vEaurly (Z.Gfvse'� %o l4rCCC/�/__t-,',�/�it,�v:f/�a-..T"�P P!G rAvc T V / t✓L' 6..v •• (ddb 2� mr S 4aa at -e bac -l< Approuabl--- Wlexce- 617 T\ v Z�7 e4l) t Qjp J, o(wo fS- Co `. a , �a.. •...'. 1as.�i ,.....4 �� yt 'L'.. I `.', ``L .'l4�•:�. .e •Yi Z4 Coil Certificate of OccupancyOp COPY G OF Buildin & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 79-440 Corporate Center Drive Suite 118 Use classification: Commercial "Imaging Center & Clinic" TI Building Permit No.: 04-4727 V Occupancy Group: B Type of Construction: VN Sprinkled Land Use Zone: CR Owner of Building: J. Paul Address: 79-440 Corporate Ctr Dr. City, ST, ZIP: La Quinta, CA 92253 By: Daniel P. Crawford Jr. Date: 10/21/04 Building Official POST IN A CONSPICUOUS PLACE Earth Systems Southtasst Building Permit No.: Project game: Project Address: SB/R.S CO. GOV. 79-8118 Country Club Drive Bermuda Dunes, CA 82201 (760) 345-1588 • (800) 924.7016 OF CONCRETE TITLE 21/24 OTHER DSA Application No.: Date of Inspection: 6" 9'5� 7 C11Ui.U. iii //8 Job No.: Architect: 777--� Structural Engineer:%lFiP_S NoctT,r'rt>�y P`/�l�i�� General Contractor: Sub Contractor: TYPE OF INSPECTION: Reinforcing Placement Other Description of Work Inspected: -'1=^e --�J �y.�� c.��7tns� B1 �°'`�/L¢�—�a�..• �.o J zz/ s- - . / mel® e". hi 0- -�,�:l..l.d -4 _ AYS-, Z - .r , 2 T Tie, Unresolved Items: --- — Descriptive Location of Samples: Slump: Water Added: Air Content, %: Cone Temp: Air Temp: Time in Mixer: Specified Strength: Unit Wt.: _ Sample Time: Supplier: Mix Design: Admixture: Truck #: # of Samples: Field I.D. Marking: i Hereby certify that I have inspected all of the above reported work, unless otherwise noted, and to the best of my ability I have found this work to comply with the approved pians, specifications S applicable building 147s. Final report issued at project completion. inspector's Name/N,."-?_� _ Inspector's Signature_ -- All !nspections based on a minimum of 4 hours; over 4 hours will be an 8 hour minimum. In addition any inspection extending past 12 pm will be an 8 hour minimum. Contractor's Representative 9D -M GG?:t0l99! Copy t ESC Lob Copy 2 Project Superintendent Copy 3 Governing Agency CERTIFICATE OF COMPLIANCE . Part 1 of 2 MECH-1 PROJECT NAME MEDEVLOP INC. Imaging Center & Clinc DATE 3/22/04 PROJECTADDRESS 79-440 Corporate Drive La Quinta . BuildingPemnit# Checked byre Use PRINCIPAL DESIGNER -MECHANICAL K&S Air Conditioning g TELEPHONE 714-685-0077—^� DOCUMENTATION AUTHOR Bob Gadde TELEPHONE 714&85-0077pncy ENERAL INFORMATION DATE OF PLANS BUILDING CONDITIONED FLOOR AREA CLIMATE ZONE 10 Sq.Ft BUILDING TYPE ® NONRESIDENTIAL ❑ HIGH RISE RESIDENTIAL ❑ HOTELIMOTEL GUEST ROOM PHASE OF CONSTRUCTION ❑ NEW CONSTRUCTION - ❑ ADDITION ® ALTERATION- ❑ EIOSM+ADDMON METHOD OF MECHANICAL © PRESCRIPTIVE ❑ PERFORMANCE COMPLIANCE PROOF OF ENVELOPE COMPLIANCE ❑ PREVIOUS ENVELOPE PERMIT ❑ ENVELOPE COMPLIANCE ATTACHED STATEMENT OF COMPLIANCE edcation n to comply with Title 24, This Certificate of Compliance fists the building features and performance s=n�tobui Parts 1 and 6 of the California Code of Regulations. This certificate applies i mechanical requirements. The documentation preparer hereby certifies that the documation is accurate cc p DOCUMENTATION AUTHOR SIG TU DATE K&S Air Conditioning 3/22/04 The Principal Mechanical Designer hereby certifies that the proposed building'gn in this set of construction documents is consistent with the other compliance forms and worksheets, with s , and with any other calculations submitted with this permit application. The proposed building has been designed to meet the mechanical requirements contained in Sections 110 through115,120 through 124,140 through 142,144 and 145. Please check one: ❑ I hereby affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code to sign this document as the person responsible for its preparation; and that 1 am a civil engineer, mechanical engineer or architect I affirm that I am eligible under the exemption to Division 3 of the Business and Professions Code by Section 55372 of the Business and Professions Code to sign this document as the person responsible for its preparation; and that I am a licensed contractor preparing documents for work that I have contracted to perform. ❑ I affirm that I am eligible under the exemption to Division 3 of the 8 and Professions Code by Section of the Code to sign this the person responsible for its preparation; and for the following reason: PRINCIPAL MECHANICAL DESIGNER -NAME Bob Gadde NA LIC. NO TDATE 483431 3/22/04 MECHANICAL MANDATORY MEASURES Indicate location on plans of Note Block for Mandatory Measures M-1 INSTRUCTIONS TO APPLICANT For detailed instructions on the use of this and all Energy Eifidency Standards compliance forms, please refer to the Nonresidential Manual published by the California Energy Commission. MECH-1: Required on plans for all submittals. Parts 2 may be incorporated in schedules on plans. MECH-2: Required for all submittals, but form does not have to be completed if location of mechanical equipment schedule is indicated on the forth per Section 4.3.3. MECH-3: Required for all submittals unless required outdoor ventilation rates and airflows are shown on plans per Section 4.3.4. MECH-4: Required for Prescriptive mechanical compliance. EnnyPro By EnerTAd User Number. Job Number Paw. OECHANICAL VENTILATION MECH-3 PROJECTNAMEMEDEVLOP INC. Imaging Center & Clinc (DATE 3/22/04 ` MECHANICAL VENTILATION R ®© 0 0 0 0 0 0 o a ZONE/SYSTEM RTU 1 RTU 2 RTU 3 RTU 4 FCU -1 OCCUPANCY BASIS NO. CFM MIN. OF PER CFM PEOPLE PERSON (ExF) READ DESIGN MILITM :1 :/ - - 11 !®® OCCUPANCY BASIS NO. CFM MIN. OF PER CFM PEOPLE PERSON (ExF) READ DESIGN IE Minimum Ventilation Rate per Section 121, Table 1-F. Based on Expected Number of Occupants or at least 50% of Chapter 10 1997 UBC Occupant Density. 1 Must be greater than or equal to H, or use Transfer Air. Design Outdoor Air includes ventilation from Supply Air System & Room Exhaust Fans. K Must be greater than or equal to (H minus 1), and, for VAV, greater than or equal to (H -J). MILITM :1 :/ - - IE Minimum Ventilation Rate per Section 121, Table 1-F. Based on Expected Number of Occupants or at least 50% of Chapter 10 1997 UBC Occupant Density. 1 Must be greater than or equal to H, or use Transfer Air. Design Outdoor Air includes ventilation from Supply Air System & Room Exhaust Fans. K Must be greater than or equal to (H minus 1), and, for VAV, greater than or equal to (H -J).