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06-3832 (RC)NA P.O. BOX 1504. 4'4QamM,..VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760)-777-7011_ LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT - Date: 2/26/07 Application Number: 06x00003832 Owner: Property Address: .78110 CALLE TAMPICO CIRCLE K STORES INC APN: 770-020-005- -000000- WEST COAST BUSINESS UNIT h Application description: REMODEL - COMMERCIAL 495 EAST RINCON SUITE0 Property Zoning: VILLAGE COMMERCIAL CORONA, CA 92879, Application valuation: .35000 •�Contractor: 1r_I^ 200 f0 Appicant: Architect or Engineer: TLM PETRO LABOR FORCE ItFEB 9165 BAYSINGER STREET GMOF:a.&UINTA DOWNEY, CA 90241 �IAl�►tdC OEPT. (310)639-2227 ~ Lic. No.: 761755 ----------------------------------------- LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: - co Section 7000) of Division- 3 of the Business and Professionals Code, and my License is in full force and effect. - _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License lass: A B C10 HAUZ License No.: 761755 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. • i�- " . Contractor:` Lr,�-1 _ _ 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 OWN R -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1541150=2007 following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, . permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Lab r Code, I shall forthwith comply with those pro ' ns. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by .r L ,/ any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: '1late �=,Ue—,'fF� Applicant�71 (J�l Vln' 1"lu^' (_ I 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and ?� , �-_pp --��� the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. _ 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.). APPLICANT ACKNOWLEDGEMENT (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, 1 _ I I am exempt under Sec. , B.&P.C. for this reason 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. - Date:. - Owner: 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 CONSTRUCTION LENDING AGENCY permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all work for which this permit is issued (Sec.. 3097, Civ. C.). city and county ordinances and state laws relating to buildin construction, an hereby authorize representatives ' ' of this unty to enter upon the above-mentioned pro y inspection pure as. Lender's Name: f "SignatL - urep ntor AgentL' �• Lender's Address: '3y 4�'VV V - LQ!%RMIT Application Number . . . . 06-00003832 ----- Structure Information- 2,613SF TENANT IMPROVEMENT/0L-50/OCC-M ------ Other ----Other struct info. CODE EDITION - 2001/2005 FIRE SPRINKLERS NO MIXED-USE OCCUPANCY' M OCCUPANT LOAD 50.00 1ST FLOOR SQUARE FOOTAGE 2613..00 Permit BUILDING PERMIT Additional desc . Permit Fee317.00 Plan Check Fee 206.05 Issue Date . . Valuation 35000 Expiration Date'. 8/21/07 Qty Unit Charge Per Extension BASE FEE 252.00 10.00 6.5000 THOU BLDG 25,001-50,000 65.00 Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee 85.76 Plan Check .Fee 21.44 Issue Date Valuation 0 Expiration Date 8/21%07 Qty Unit Charge Per Extension BASE FEE 15..00 t, 2613.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 52.26 1:-00 18.5000 EA ELEC SVC <=600V/<=200A 18.50 Permit MECHANICAL Additional desc . Permit Fee, 32.50 Plan Check. Fee 8.13 Issue Date Valuation. 0. Expiration Date 8/21/07 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 4'.5000 EA MECH.VENT .INST/ DUCT ALT 4.50 2.00 6.5000 EA MECH OTHER MECH EQUIPMENT 13.00 Permit . . PLUMBING Additional desc . Permit.Fee 82.50 Plan Check Fee 20.63 Issue Date Valuation . . 0 LQPERMIT Application -Number 06-00003832 Permit . . . PLUMBING .Expiration Date 8/21/07 Qty Unit Charge Per Extension BASE.FEE .15.00 6.00 , 6.0000 EA PLB FIXTURE 36.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3..0000 EA PLB WATER INST/ALT/REP 3.00. t 7,00 3-.0000 EA PLB FIXTURE DRAIN/VENT REP/ALT 21.00 ----_------ Special-Notes and Comments ------------- " 2,613SF TENANT IMPROVEMENT/OCCUPANT LOAD-50/OCCUPANCY-M/[CIRCLE K1. 2001 BUILDING, PLUMB, MECH, 2004 ELECTRICAL, 2005 ENERGY. February 22, 2007 3:54:01 PM AORTEGA --------------------------------------------------------- Other Fees . . . . . . ACCESSIBILITY PLAN REVIEW 20.61 ENERGY REVIEW FEE 20.61 Fee summary Charged Paid Credited Due Permit Fee Total 517.76 .00 .00 517.76 Plan Check Total 256..25 .00 .00 256.25 d Other Fee Total. 41.22 .00 .00 .41.22. Grand' Total 815123 .0,0 :00 815.23 LQPERMIT- - - - Bin #•. Qty.of Quinta Building &r Safety Division Permit #P.O. Box 1504, 78-495 Calle Tampico ;B 3')— La Quinta, CA 92253 - (760) 777-7012 p6' Building Permit Application and Tracking Sheet c i7zc� E Project Address: /< s` c R� CgL�jP/Cb 7 Owner's Name: A. P. Number: %�0 — DZO _ Address: (:::'OA�3U�S/�1� /Y/T CYYV / ,�v �S V,7/'4. 11V PDR'¢�A'�CG Legal Description: 'r69 876E MsFP 46000. g Oq _,f 7 City, ST, Zip: C6AZW4., C4, iZ87% Contractor.Telephone: /� Z, 70 - S-/¢7 Address: Project Description: - & /K%WV(o C,C C9VV*Y/•GNCLC City, ST, Zip: s /—D /NSM41- /I! .COb1£�?L V4(1C7 AM/7bi✓, Telephone: .;, .,;,,,,�:�, ,,:.:.:,.:w,:.�;,<.:::: rr,'r .C�E%Y)DY� /-�/JC�ICE � ! Mme✓ //!/S State Lic. # : City Lir. #.: C00/Vrr;;C'-C TD /W7 ` �4,5�4 s TifNDiF/d.D�, Arch., Engr., Designer C % L f'QQi�T Dom? /!�. Rr-- //j0R WWe- &/W Address: 1CO&Z N. City, ST,Zip: FL CVW , C.4 912026 Telephone: �(</9)�' - 6773 °..e ; :: w':N,^.v$ ; a °'' ; Construction Type: y cc an /STA/L Project type (circle one): New Add'n Alter Repair Demo State Lic.#: Z% Name of Contact Person: /SUs' Sq. Ft: 2 �/� # Stories: ovv,�:F #Units: Telephone # of Contact Person. — Esdmated Value of Project: ?i,6 CIPM& •(2I4'7Z?--*PP CANJ: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets 3 Plan Check submitted io Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Ca les. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up I Oto Construction Flood plain plan Plaus resubmitted Z Mechanical Grading plan 21d Review, ready for correctio ssu 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 correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue Z 7,q School Fees �� ( ✓ Total Permit Fees Tian AvIcn. P5,ftftW%M 10 2-11+10-7 C90. A PPRovEY lt&k �1 �� John R. Hawkins . Fire Chief . Proudly serving the Unincorporated Areas of Riverside County and the, Cities of . Banning .. Beaumont Calimesa Canyon Lake Coachella Desert Hot Springs .; Indian Wells Indio Lake Elsinore La Quinta ❖ Moreno Valley Palm Desert Perris 4 Rancho Mirage San Jacinto Temecula Board of Supervisors Bob Buster, District 1. John Tavaglione, District 2 Jim Venable, District 3 Roy Wilson, District 4. Marion Ashley, District 5 RIVERSIDE COUNTY FIRE DEPARTMF- In cooperation with the California Department of Forestry and Fire Protection 210 West San Jacinto Avenue *,Perris, California 92M • (909) 940-6900 • Fax (909) 940-6910 November 2, 20056 Jesus Arenas Contel Project Dvelopement 1662 N Magnolia Avenue EI Cajon, CA 92020 _ RE: TENANT IMPROVEMENT PLAN CHECK LAO -06 -TI -094 / Circle K #457 at 78110 Calle Tampico, 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 2000 UBC. THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO INSPECTION Install door hardware and exit signs as per Chapter 10 of the.2000 UBC: •. Install Knox Lock Boxes, Models 4400, 3200 or 1300, mounted per recommended standard of the Knox Company. Plans must be submitted to the Fire Department for approval of mounting location/position and operating standards. Special forms are available from this office for the ordering of the Key Lock Boxes. This form must be authorized and signed by this office for the correctly coded system to be purchased. If the building/facility is protected with a fire alarm system or burglar alarm system, the lock boxes will require "tamper" monitoring. A minimum 2A10BC 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, ith 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. ELECTRICAL PANEL BOX: All breakers must be labeled and a clearance of 36 inches must be maintained around the panel at all times. OTHER REQUIREMENTS: Approved building address shall be placed in such a position a to be plainly visible and legible from the street. Said numbers shall contrast with their background. . . , 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. Applicant/installer shall be responsible to contact the Fire D4e�partment to schedule inspections. A re-insp8 ���9`�'& I `ay 111, 2nd Fl.,-In�ii io, CA 2 of a`fi'8� Tl1 o (760) 863-8886 Fak � s $ otion is necessary. COACHELLA VAJ" WATER DISTRICT 8S-995 A.vem 52 ASSiESSOR'S Pix. NUMAEIE Co&cheUa, Ca"Orlda 922,36 /{-IW: .lCW= a4Q,4A47 770 --- DZp 00--r- (760)395-2651 A"UCA21ON FOR WASTEWATER SEPARATOR APPROVAL AMICAND Sabmet nos tum vft a copy of a $CAL>m yla pbp (1"a 2('to 140,40 SCALE) drawn m District bpae"dcatioo9, q aomefimdabte wbra sbe agplicatioa is spbmayod, C3ccic must Ise mads pAyAble w dse Cwobpll9 Vaii�y oWam niawicc wpproval of res �, �B �e re teq� not m rwad emo (1) ymr qem ftc arpayr=, SPP s+1aA t+cman .•syd fpr a pond Plan Cbeck No. C�omaacmS CwtttttFgypot lR.•..s• !c .+.P7Ly4L�S r{TG. r 6r6 aviTc afy SLtre; � Telvho se coil, /7w ab oRo+�1 G4 92979 lob Progapr Aebitess c/ACw. AF OQ& **41!-7 44 Q w / -7p TAP QpRO° RvOlAr &V*47y .3+ol�0¢{3' c �N it4�¢ se 6 77or /Pi m Me e&(, sm-42 %&Am& -%L cvN1STRDf.TlON: -- ..��•�••�•+',nurinrrc�Cic f6IAM type eKCoate�; . W4WroodAwffiy. Ramodd(IMMMngFendli?spibliebspentZ HomeotOpoauoa �B wish b'Ii4re18 a Heueay O -- � 8iaomai o Ser s Ba+rwi$Faod Seavioe � BpeNoofood Setviea-� wacersafbmer� �� raisidsavice (�satla� � sesv�e (�abto� x �Rc� k ��- C1WNEblI$F3RFSEMTA7IVE TlOar� I �'tLes7 Levosand � tmara app4aaiop nen � no RU t+�d is based an o;yr tladarniaot ia6osmapen pn farm aDd tLaz iaoc:: ;�amtioa a an is tasrsecs. I updMmW ttms dye mao= of fee alaearaea �qot O*kw oa ' (60} days ofepprovAl or daniel mad t6� m ' ' lora cant a�tLc eubaaiana pups. i also ted A� wiA be ProP4 icdv�d eioed bora mid Am hze bem apPloved mad �mY aeablisLmau a�71 ba eoaduoy�d, os appm al �+ceod ro OPCR% mw s4 Sisoamto 7�,,� p iQo. OESy3SCtli6 T� of s J USE ONL�%?',':� �:. • a��..' .c�i�� } ' �°F Thi' f'' . ? .` , r Q ❑ New FLU Umb Gme lowxwwr ❑ Ysicrias 0�D w Sww COD e GAL ��� Ll Dcniod is coadiaonal,lpytoval• �Soe i Fees -d.� Coak Ne. —' Dm 401R,-" o� c',e# /11ly ri-al Received 10-13-2006 11:15am From -619 561 2445 To-CVWD PD SATELLITE Page 002 RIVERSIDE COUNTY COMMUNITY HEALTH AGENCY DEPARTMENT OF: E=NVIRONMENTAL HEALTH FOOD ESTABLISHMENT PLAN APPROVAL NOTICE Plan Check # PSP06-9-20b Date 1-10-07 Project Name Circle K Stores #457 Plans Submitted by Jesus Arenas Owner Circle K Stores, Inc. Address Address 78110 Calle Tampico, La Quinta Phone 619-448-6773 499 E. Rincon, Ste. 150, Corona Phone 951-270-5147 The plans are now approved subject to the conditions listed below and the attached compliance sheet. 1. Provide approved back flow prevention device/s for all direct water feed lines, i.e. coffee brewers, cappuccino machines, etc. 2. All food and utensil sinks must be plumbed to floor sinks through approved air gaps. The mop sink must be of the floor basin style. Behind all three sinks in the splash zone the finish must be water proof to a height of 8' (e.g. FRP/tile) 3. The soda line must have an RP style anti backflow device mounted upstream of the carbonator. From the RP onward all piping or tubing must non reactive such as PVC. 4. This plan does not include sewage or water service approval. Prior to the final inspection provide a grease interceptor sizing form or waiver from your local water agency. CONSTRUCTION INSPECTIONS: Contact the Plan Checker for a Preliminary Inspection when construction is approximately 80% complete., with plumbing, rough ventilation, and rough equipment installed. Request for inspection should be made at least five (5) working days in advance. A FINAL INSPECTION MUST be made upon completion of ALL work including finished details. APPROVAL to operate shall not be granted, or remodeled areas approved to operate, until the facility has passed the FINAL INSPECTION, and "APPLICATION TO OPERATE" has been completed and PERMIT FEES have been paid. Request for inspection should be made at least five (5) working days in advance. PLANS CHECKED BY Jerry Dubin REHS Phone 951-766-2824 I acknowledge the corrections noted herein and a� indicated on the plans and agree to incorporate them during Signature Company Name DEH -SAN -178 (Rev 2/06) Date ©% 7 Corona Hemet Indio Murrieta Palm Springs Riverside 2275 S. Main St Suite 204 800 S. Sanderson 47-950 Arabia St -A- 38740 Sky Canyon Dr 2500 N. Palm Canyon Dr 4065 County Cir (951) 273-9140 (951) 766-2824 (760) 863-8287 (951) 461-0284 (760) 320-1048 (951) 358-5172 Fax (951) 520-8319 Fax (951) 766-7874 Fax (760) 863-8303 Fax (951) 461-0245 Fax (760) 320-1470 Fax (951) 358-5017 Department Web Site — www.rivcoeh.org TAMPICO ;A 92253 REQ. PLUMBING FIXTURES ;.F, OLF OCCUP.. 553 1 200 6.76 iLE A -29—A 2001 SEN THE DESIGN NT LOAD IS LESS ), A FACILITY USABLE ER SEX MAY BE NOT A PUBLIC BATHROOM AND WE MAX OF 4 EMPLOYEES OR LES IFT. DEPARTMEN I : ULVAK! Mt!v! ur ruouK, nCJ-,Li n 2500 N. PALM CANYON DRIVE STE. A-3 PALM SRINGS, CA 92262 WATER COACHELLA VALLEY WATER DISTRICT AGENCY: HWY 111 ® AVENUE 52 COACHELLA, CA 92236 TEL. (760) 398 2651 SEWER COACHELLA VALLEY WATER DISTRICT AGENCY: HWY 111 ® AVENUE 52 COACHELLA, CA 92236 TEL. (760) 398 2651 PERMITS: BUILDING: HEALTH : PERMIT # INSPECTOR PH# (760) 777-7012 COUNTY OF RIVERSIDE COMMUNITY HEALTH AGENCY \ 'DEPARTMENT OF ENVIRONMENTAL HEALTH <; proposed construction/equipment ;;. a!lation is approved. attached correction sheep Approved 02--By�) This approval does not authorize the violation of any law, ordinance, or other regulation. THIS APPROVA� GRANTED BY THE COUNTY OF RIVERSIDE DEPARTMENT OF ENVIRONMENTAL HEALTH IS VALID FOR ONE (t) YEAR FROM DATE OF APPROVAL NU TIF•Y THE: PL.i%<;`�'f ai��.Ci�€ R IRS V`�& IMG OF ANY CHANGES OR ALTERATIONS TO PLANS AS ORIGINALLY APPROVED. scheduled five (5) working days in advance. (760) 320-1043 D 1,✓e % 57�� 0 N I 6'-3" 84Ti0CY., i i 8 11 g. CONTACT THE PLAN_CHFCKER FOR A PRELIMINARY _ — INSPECTION WHEN CONSTRUCTION IS APPROXIMATELY _ 80% COMPLETE. (BEFORE EQUIPMENT IS INSTALLED.) FOR PRELIMINARY AND FINAL. INSPECTIONS NOTIFY DEPARTMENT OF ENVIRONMENTAL HEALTH. N' Zoo.-3Zv �(bti� "Approval of these plans by the County of Riverside Departrner �t of E.-Mronm ntal Health, does not relieve the Engineer or Architect of the responsibility for the Engineering or Architactural design." -NOTICE- A PERMIT MUST BE OBTAINED FROM THE COUNTY OF RIVERSIDE DEPARTMENT OF ENVIRONMENTAL HEALTH PRIOR TO OCCUPANCY OR USE THIS APPROVAL ODES NOT INCLUDE THE SLJE URFACE SEPTIC SYSTEM, GREASE INTERCEPTOR, OR GrHER vVASTE DISPOSAL SYSTEM. OBTAIN CLEARANCE FROM APPROPRIATE AGENCY FOR YOUR WASTE DISPOSAL SYSTEM. ALL ELECTRICAL, PLUMBING, MECHANICAL; AND STRUCTURAL FEMA; t-..`kND INSTALLATIONS SHALL BE DONE UNDER PERMIT DEPT OF BUILDING AND SAFETY NORTH NO SCALE IING/PLUMBING/MECHANICAL^ 0C I