09-0566 (RC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 09-00000566
Property Address: 78065 AVENIDA LA FONDA
APN: 770-122-009-14 -000000-
Application description: REMODEL - COMMERCIAL
Property Zoning: VILLAGE COMMERCIAL
Application valuation: 7000
C&hf aF 4 Q"
Applicant: Architect or Engineer:
G�ly�lr.�►r
�v
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License CI s: License No.: 867583
Date 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 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 (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.). '
(_) 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.).
( ) 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:
LQPERI%IIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/18/09
Owner:
FORTUN PROP
5800 125TH LN NE
KIRKLAND, WA 98033
Contractor: D
MORRIS CONSTRUCTIO IDp
51200 CALLE PALOMAO 2009
LA QUINTA, CA 9225
(760) 272-9292 CITY OF LA QUINTA
Li.c . NO.: .867583 Fi.�la4rc ncor
-----------------------------------------------
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 EXEMPT Policy Number EXEMPT
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,
d agree that, if I should become subject to the workers' compensation provisions of Section
�{/��_/r 7 of e Labor Code)YII spa o ith comply with those provisions.
✓Dates/ Applicant:
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 1$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 unt ordinances and state laws relating to building 4cons&trction,�hereby uthorize representatives
of c my o ter up n the above-mentiohed properf�)
D Signature (Applicant or Agent):
Application Number . . . ... 09-00000566
------ Structure Information INT. TI TO EXIST. 1375 SF BLDG -----
Other struct info . .
. . . CODE EDITION
2007
FIRE SPRINKLERS
NO
MIXED-USE OCCUPANCY
B/S
OCCUPANT LOAD
14.00
----------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
1375.00
Permit . . . . . .
BUILDING PERMIT
_ Additional desc
INT. T.I. TO EXISTING BLDG
Permit Fee
90.00 Plan Check Fee
58.50
Issue Date . . . .
Valuation . .
. . 7000
Expiration Date
12/15/09
Qty Unit Charge
Per
Extension
BASE FEE
45.00
5.00 9.0000
----------------------------------------------
THOU BLDG 2,001-25,000
------------------------------
45.00
Permit . . .
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . .
31.80 Plan Check Fee
7.95
Issue Date . . . .
Valuation . .
. . 0
Expiration Date
12/15/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
20.00 .7500
PER ELEC DEVICE/FIXTURE 1ST 20
15.00
4.00 .4500
----------------------------------------------------------------------------
EA ELEC DEVICE/FIXTURE >20
1.80
Permit . . .
MECHANICAL
Additional desc . .
Permit Fee'
30.50 Plan Check Fee
7.63
Issue Date . . .
Valuation
0
Expiration Date
12/15/09
Qty Unit Charge
Per -
Extension
BASE FEE
15.00
2.00 4.5000
EA MECH VENT INST/ DUCT ALT
9.00
1.00 6.5000
----------------------------------------------------------------------------
EA MECH VENT FAN
6.50
Permit . . .
PLUMBING
Additional desc
Permit Fee . . . .
27.00 Plan Check Fee
6.75
Issue Date . . . .
Valuation . .
. . 0
LQPERiAlT
Application Number . . . . . 09-00000566
Permit . . . . . . PLUMBING
Expiration Date . . 12/15/09
Qty Unit Charge Per
Extension
BASE FEE
15.00
2.00 6.0000 EA PLB FIXTURE
12.00
-------------------------------------------------------------------=--------
Special Notes and Comments
INTERIOR REMODEL TO EXISTING 1375 SF
OFFICE / STORAGE BUILDING. 2007 CODES.
'
----------------------------------------------------------------------------
Other Fees . . . . . . . . . ACCESSIBILITY
PLAN REVIEW
5.85
BLDG STDS ADMIN
(SB1473)
1.00
ENERGY REVIEW
FEE
5.85
STRONG MOTION
(SMI) - COM
1.47
Fee summary Charged Paid
------------------------------
Credited
----------
Due
-----------------
Permit Fee Total 179.30 .00
.00
179.30
Plan Check Total 80.83 .00
.00
80.83
Other Fee Total 14.17 .00
.00
14.17
Grand Total 274.30 .00
.00
274.30
LQPERMIT
A CITY- OF LA QUINTA*' SUB -CONTRACTOR LIST n
JAS ADDRESS tfy2�� PERMIT NUMBER �- -'OWNER BUILDER_ U f�S�lt` v A&
This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work
on this job. Any -changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance
of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
Trade ! Classificatwn
Contractor :. ...
::::..::...:::. Stat�::Contractot.s License... :::..;:;
W.orkers.Com erlsatlon:lnsuranee7F7
City Bus Mess
License::.
Company Name
Classification
(e.g. A. B,. C-8)
License Number
(xxxxxx)
Exp. Date
(xx/xx/xx)
Carrier Name
(e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
(xxxx)
Exp, Date
Ixx/xx/xx)
EARTHWORK (C-12) .:
CONCRETE
FRAMING .(C-5)
STRUCT. `STEEL WC 51)
MASONRY (C-29)
PLUMBING (C-36)'
`
WTH; PLASTER (0r:35)
DRYWALL (C-9)..
C'
C91 J3
HVAC (C-20)`.
'
4 ��
ELECTRICAL. (C=10). .',
ff
ne l624 C
Clb
-�j�(� �7
T—TU� T
�b
1-'
WST)ZIpZ.1S 2
�I IO
h
2
ROUFING'
.SHEET -METAL
FLOORING
GLAZING (C-17)"`
INSULATION'. W4) :
SEWAGE DISP (C-421'
PAINTING (C=33)
j
CERAMIC TILE (C-54)
CABINETS (C-6)
FENCING (C713)
LANDSCAPING IC=27).11
POOL (C-53)
Pin #
'City of La Quinta
Building &r Safety Division`(�
P.O. Box 1504, 78-495 Calle Tampico - .1 )-
La Quinta, CA 92253 - (760) 777-7012 u
Building Permit Application and Tracking Sheet
Permit #
(o(p
Q ' S
Project Address: 70 , D (oAj A tfir- LP �04
Owner's Name:
A. P. Number: '.
Address: :51d1 2®��
City, ST, Zip: {J
Legal Description:
/n'��
Contractor: S
Telephone:
•'?>:%>�rii4vi}jiCtipy�iivC,i;.t��•,:
•k••;,.„
Address: CACI8 � A.
Project Description:
City, ST, Zip: V urm
Telephone.
•`•`:.�:::...,,...r:.:::>.::..::.:..:.... ••.>
ti•:.
.
State Lic. # : City Lie. C
Arch., Engr., Designer: j � ) S"'C
0
Address:
City, ST, Zip: CA C.�L-A-1-7rlk
Telephone: 2Z :>;::,.;:.h»?,rx :>:: :::::»>:>tirw
State Lie. #:
Name of Contact Person:
Construction Type: Occupancy:
Project a circle one New Add'n Alt Repair Demo
Sq. Ft.: 3 # Stories: / # Units:
Telephone # of Contact Person: Estimated Value of Project: %QQrD
APPLICANT: DO NOT WRITE. BELOW THIS LINE
#
Submittal
Req'd
Recd
TR,AiiCIQIVG'-- - — - -
_
PERMIT FEES
Plan Sets
3
Plan Check submitted'I 11,
Item
Amount
Structural Calcs.
Reviewed, ready for correctioJUN 0 3 � ��
009
Plan Check Deposit
Truss Cates.
Called Contact Persona u
I
'Plan Check Balance
Title 24 Calcs.
a
Plans picked up �i
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"" Review, ready for corrections/issueFA q
Electrical
Subcontactor List
Called Contact Person 6 �.
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'rd Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I,P,P,
Pub. Wks. Appr
Date of permit issue 0
School Fees
\
Total Permit Fees
, �0
(vll 7 �=i'k
oel(_Z� . & - /o
'. *T_/d4f. 4 4aMb(rw
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
To: Greg Butler, Buiilding & Safety Manager
From: Les Johnson,' Director -Planning
Permit #:
BUILDING & SAFETY DEPARTMENT
(760)777-7012
FAX (760) 777-7011
To CDD: &-3-D%
Due Date: �0 -10 - d 9
Status:
Bul'Idin,g Plans, Approval
(This is an approval to issue a Building Permit)
The Planning Department has reviewed the Building Plans for the following
project:
Description:
Address or General Location: -73-o6,5 42e e. y,
Applicant Contact: .���- / 8 & !o
The Planning Department finds that:
❑ ...these Building Plans do not require Planning Department approval.
31 ..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
n, Director -Planning
S -o 9
Date
Riverside County Fire Department Fire Protection Planning Section
f'
=�o
Riverside Office: 2300 Market St., Ste. 150, Riverside, CA 92501 Ph. (951) 955.4777 Fax (951) 955.4886
MUmeta Office: '39493 Los Alamos Rd.. Ste A, Murrieta, CA 92563 Ph. (951) 600.6160 Fax (951) 600-6164
Palm Desert Office: 77-933 Las Montanas Rd., # 201 Palm Desert, CA 92211.4131 Ph. (760) 863-8886 (760) 863-7072
Fire Department Clearance/Release
p�
Date: -1 r
To: LQ(A-1(4 > al Lell
Fax:
Tract/Parcel Map #:
Permit/Lot #: �� '��-�— 0
Job Site Address: D -C r d 4e
Final For Recordation
Release For Building Permit(s)
Shell Final Only (No Tenant)
Final For Occupancy
Building Plan Check Fees Paid
Building 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.
Auth ng Signature For Release
Print Name
Form C — Revised 5/12/2009
John R. Hawkins
Fire Chief
Proudly serving the
unincorporated
areas of Riverside
County and the
Cities of.
Banning
.;.
Beaumont
Calimesa
.;.
Canyon Lake
41 -
Coachella
Desert Hot Springs
4.
Indian Wells
4.
Indio
-P.-
Lake Elsinore
La Quinta
4.
Moreno Valley
Palm Desert
Perris
4.
Rancho Mirage
4.
Rubidoux CSD
San Jacinto
Temecula
Board of Supervisors
Bob Buster,
District I
John Tavaglione,
District 2
Jeff Stone,
District 3
Roy Wilson,
District 4
Marion Ashley,
District 5
RIVERSIDE COUNTY
FIRE DEPARTMENT
In cooperation with the
California Department of Forestry and Fire Protection
77-933 Las Montanas Rd. #201 • Palm Desert, CA 92211 . (760) 863-8886 • Fax (760) 863-7072
June 17, 2009
RE: TENANT IMPROVEMENT PLAN CHECK
LAQ-09-TI-017 Desert Sage Annex 78-065 Avenida La Fonda La Quinta, CA
92253
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 20007 UBC.
THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO INSPECTION:
Install door hardware and exit signs as per Chapter 10 of the 2007 UBC.
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) shall be provided at time of final inspection.
If this facility has existing supervised automatic fire sprinklers and if interior walls are
installed / moved and sprinklers are relocated / added, plans are required and shall
be submitted for approval. , 1
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 with 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.
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 to be plainly visible and
legible from the street. Said numbers shall contrast with their background.
Approved suite address shall be placed in such a position 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 Department to schedule
inspections. A re -inspection fee will be required if more than one (1) inspection is
necessary. Requests for inspections are to be made at least 72 hours in advance
and may be arranged by calling (.760) 863-8886.
All questions regarding the meaning of these conditions should be referred to the Fire
Department Planning & Engineering Staff at (760) 863-8886.
SiVcerelly,By:Jabble
Fire Safety Specialist