0208-343 (RC)LICENSED CONTRACTOR 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 # Lic. Class Exp. Date
716404 A.13 C20 Q1 1,6 I 74 I/Z(
,/Date. ('' �'_ Signature of Contractor��,U_!>4tir
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I.am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code). -
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct .the:_project..,(Sec.,.7044,, _Business & Professionals
Code).
() I am exempt under Section B&P.C. for this reason
Date Signature of Owner
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.
('C' 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 & policy no. are:
Carrier .2TATEE MIM Policy No. 154S950
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) 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: h.5 f'-1. J, Applicant—
Warning:
pplicant Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the"'conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
&.hold harmless the City of La Quinta, its officers, agents and employees.
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 State laws relating to the building
constructionAand hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent),f (t.�.t jY i il' L Date
BUILDING PERMIT PERMIT#'
DATE !j VALUATION LOT.M�L� TRACT
PM 2.5665
JOB SITE APN
ADDRESS�c49i. 111,10`�^^MI —03 .
OWNER I CONTRACTOR / DESIGNER /
;Bs d'f:<3 # 1:' t�T1",L3. C + �I iiauS"►LI 'I:t €tid llL"�T �.?I�tx�'i1�
LA PA[Mh ',CAI 14MVEMA 92340
CM)Z44.6215 UQST111.
USE OF PERMIT
fI+I`I'IYI"t.2f'?R T19,11 4Cjft' W, - WEIN STRUC' UAL fi :'LLIC;ATIoN 01'stp. IIownwr,
COr:rN'i'ERS .AND CASA ,
VALUATION' AMIN LS-/.
Y'fi fi.IYA'Iw`TCiB M'r OF +f:'O Si"HUM1014
CON S" I H,UCI'ION FiM 101-000.418-' 000 752.00
MSCI AIXIId AIa"O' s 1€ 1.0(0.421=000 S19.301
11LACTRIC:.A11 PRE 1.01-00.0-420-000
PI:WARJ-14a nor, . l f t �(1�J •�F i t>00t? 3 �,i
S'e*C(ND MO`I`loa i OEZ • Cf..3iJ M I CX) -00f17244 -000,
1 OCT 0 4'?, 102
0F. , � o T_jt710�6,
' CITY OF (,A AUINTA�
LEM PRE -TSA Ml:? S
• i
RECEIPT DATE / T BY?%,`.\e _ ;-_ DATE FINALED INSPECTOR
S0,0t9
815 -
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit Fv
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS: --
� 776L—
in \
Quin City of La to
Building 8L Safety Division
Permit # ?jc.�j
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building
Permit Application and Tracking Sheet
Project Address: ner's Name:
A. P. Number: p 7 0SO
O 3 F.Address:
Legal Description: P/-, ZS •, City.P
ST. Zi e
LS
C
Contractor: G r
�cvr ��~" 4
Telephone:
Address: ,K R a /3ax
Project Description:
-3;72-3
-
City. ST. Zip: �'' / {r 5
ce L 2 3 ya
e 4
i
T hon : '
eleP e CJ -2 �2
f
State Lic. #: loS/O
Cite Lic. #:
r C'G
Arch.. Engr.. Designer:
Address: -:w
Tii sY /
? e7 57 Z"
Cite, ST, Zip:
Telephone: -
/ _
Construction Ty an N••
Pe. Oc cuPc
Stat eLic .#•
..... .... ..........
ProJ' ect type (circle on New
)N Add'n Alter Repair i
p Dlm�
Name of Contact Person:
,Z,
Sq. Ft.:.,,k , #Stories: #Units:
Telephone # of Contact Person: -?It-
Estimated Value of Project: -X-.24 mop
9/lam
/ APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
,
Z,
Plan Sets
a
11!, 0
Plan Check submitted �
/[ {{/ffPlan
Amount
Structural Calcs.
Reviewed, read% for corrections
eck Deposit
Truss Calcs.
Called Contact Person'/'," $l 30
Plan Check Balance 0
Title 24 Calcs.
Plans picked up
Construction •
Flood plain plan
Plans resubmitted
chanical •
Grading plan
µ2nd Review,-readv for correctio issue
;;Electrical
Subcontactor List
Called Contact Person
Plumbing ✓'' •
O
Grant Deed
Plans picked up
H.O.A. App royal
Plans resubmitted
Grading
IN HOUSE:-
''d Review, ready for corrections/issue.
Developer Impact Fee
Planning Approval
PP
`
Called Contact Person �
�,
`%,I,P.P.
Pub. Wks. Apprwh
Date of permit uw�8_
�lfe8t5
u
School Fees
Total Permit Fees
1/10XJEA F/WS s cil3M ;Tri y
a , ,� ri✓ y 2 ve sr fr*^� S =73-
f�sa U — f ' ?'I� Y- ;.r
._ - kar- d10 "si ego -w --atrar
Tom Tisdale
Fire Chief
Proudly serving the
unincorporated
areas of Riverside
County and the
Cities of:
Banning
❖
Beaumont
Calimesa
4.
Canyon Lake
,•
Coachella
.;•
Desert Hot Springs
Indian Wells
Indio
.;.
Lake Elsinore
4.
La Quinta
4.
Moreno Valley
40
Palm Desert
.
Penis _...
Rancho Mirage
San Jacinto
•S
Temecula
Board of Supervisors
Bob Buster,
District 1
John Tavaglione, .
District 2
t
Jim Venable,
District 3
Roy Wilson,
District 4
.Toni Mullen;
District 5
RIVERSIDE COUNTY FIRE DEPARTMENT
In cooperation with the
California Department of Forestry and Fire Protection
210 WestSan Jacinto Avenue • Perds, Ca i omia 92570 • 909) 6900 • Fax 0
September 25, 2002
Tait & Associates, Inc.
701 North Parkcenter Drive
Santa Ana, CA 92705
Re: Non -Structural T/I Building Plan Review
LAQ-02-BP-193 / ARCO AM/PM
Fire Department personnel have reviewed and approved the plans you submitted for the above
referenced project.
Please contact the Fire Department Planning & Engineering staff for final inspection prior to
occupancy.
Requests for inspections are to.be made at least 24 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.
Sincerely,
FRANK KAWASAKI
Chief Fire Department Planner
By
Walter Brandes
Fire Safety Specialist
H."PEMPOATALLAQU1NTAXPROJECTS\TN—UdPMAJO-02-aP-193.doc
...:EMERGENCY SERVICES DIVISION • PLANNING SECTION • INDIO OFFICE
'82-675 Highway 111, 2nd FI., Indio, CA 92201 • (760) 863-8886 • Fax (760) 863-7072
10-11-2002 01:20pm F -cm- ;' ?30 1.10;A02 F-434
14it Associates, Inc..
E:ngineeiirg • Architt,:(Aure - Environrrn'n(a!
3
October 10, 2002
Re: ARCO AM/PNi facility 45856.
46-150 Washington Street
La Quinta, CA
To whom it may con mn-.
TlDs:rnen:t.c- is In re-spo i.-ise to a cow.-orn. r[CI F:(1 with r•.,l;at'C to a tT;a:7led :I; fl aatll:)rl (:: ;l: c: Ill
during t:he rc;novat1on pf flue above referenced facility. (n the �::<p �secl ;:ctn;titir:nt .r st:ucl
witldn the exterior,.bea'rin ; wall is cut, hcai ed..oui an(i'srtpl)ort:ax'.l,hy,a (].A .2 -x6 lteul:iva,
sparimm, the typical lii"stud bay. The ` ic;lder' is sizppi'1r:(-x1 on (thc:r iii le by 2 p;rrte;rl
height. cripple studs. The sili,ation was crc; ted bccau:,(, of the tol:aing .rl the WaTo- E-uppiy
fi)r the:.flush v Avc of (h.e water i.'.loset.
tfporr review of the pri?totypei drawings fortlus.desig;n of.f\RC0 building we find that the
wall in question is dcsignaaed as a shear wall_ 1-loweve-, the entire cxt:et or of the
stnicture is specified to receive plywood sbcat.hing in a similar nail pattern, so there is
significant redundancy. 7.110 wall in question is also not it significant bearing wall, as the
roof truss loading occurs parallel to this wall, the walls only supporting themselves, and
provide sorrne lateral st:abil:ity. As such the: 2x6 studs witic V." exu!rior plywood sheat ,ing
over the un -braced height ol:,l0 feet shotil(l be capable o:` a design spac;in;; of 24 `oc
('Table 23-W-11 &. D-1). Finally, it appears that thc ftarning mod)' ficalio:n was
acc:o>uplished in. a neat and professional im.u.iner that w61ild tend to Indicate that it Was
done as part: of'th.e init al flaming and not later rnudified to accommodate the ptumb.111g.
This means that it was inspected and .apino eci in its .initial developim-nt.
Wsed. I.l.p,)n tho above criteria it is ou.r f1r,.:t1ng crnd tet;61rmerida-bon 11a.t Uu::coaditi.art i::
not. critical to the stni(,turza :;nte city of th(, strt.tcmrc ;Inti f crefor-, it i!: ar.r:c:�)ta1�.l v)
remain M-1.9.
Respectfully,
TIMI,ssociar lnr... 1/l,t',,\�`
-p N0. C-17342
'1'i.tn thy. B_irias, Al i'\.
�s\10
Senior Arc tect q5 �
'Engineering Solutions td Enhance. Project Value'
701. North Parkc:enter Djvo • Saiita, Ana, California 92705
,_
,,dn Dirgo San Frz.r.c,ex:n - `.,ac:rz;rnenlu PiiOCrtia 1`fr?n0 I -d:; VE?i?8; - i)E:rYdf:r' 1:01E;E,'
" w�aysi.t�it.corn
COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY
DEPARTMENT OF ENVIRONMENTAL HEALTH
ENVIRONMENTAL HEALTH SERVICES
SUPPLEMENTAL REPORT TO SAN. FORM #
DATE
SUBJECT -A,,A']PAA
PERMIT NO.
A
L A /Da OJ7 c.--)
ADDRESS
INSPECTOR \" I,J6^ IA
REMARKS:.
A AJ ^.7 el Xz) 7,,,, nn,r4.n-
-Am* c,IQ
-7
1,Mj, Alnn 0(o, r, 2
p
--K 0 L-A -ca- nA,,v
7,/
)r. A)
4' Al
jell
)6rrwdd, Tj�-e -*p". 4d&-, L
�,p
6 A
DEH -SAN -118 (Rev Z196).
Distribution: WHITE—Office; CANARY—Owner; PINK—Office
M�x
Dist.# COUNTY OF RIVERSIDE HEALTH SERVICES'AGENCY
DEPARTMENT OF ENVIRONMENTAL HEALTH
t PLAN CORRECTION
Plan Clieck # RO2-0029 Date 9/16/02
,DBA Arco AM/PM, Address 46-150 Washington St. La Quinta CA
Plans Submitted by Robert Adams Phone (714)560-8610
Owner BP West Coast Address 701 N. Park Center Dr., Santa Anna Phone 92705
The plans are now approved subject to the conditions listed below and the attached compliance sheet.
1. Provide four additional feet of storage shelving. The rolling carts listed do not typically qualify as
storage shelving. You may use 2' metro style shelving as a replacement.
2. The trash enclosure interior. must be finished with a two part epoxy compound
3. All construction must be performed in accordance with the construction guidelines issued to you at the
time you received this plan correction. An error of omission does not constitute tacit approval, contact this
department if you have questions.
i
CONSTRUCTION INSPECTIONS: -Contact the Plan Checker for a Preliminary -inspection when construction
is approximately 80% complete, Wil ;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 T�Q;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 David E. Day,,,,, Phone (760) 778-2235
I acknowledge the corrections noted herein and as indicated on the plans and agree to incorporate
them during construction:
Signature
Company
o Date
i
I
>r
;;CL ELECTRICAL, PLUMBING; MECHANICAL, AND STRUCTURAL
REPAIRS AND INSTALLATIONS' SHALL BE.DONE UNDER PERMIT Y
1
rROM
DEPT OF BUILDING AND SAFETY `
q *va._�. sunnir.; a Yro� d�t9
a rE t
5;;jlii ` P
u r;t`xires Ta.1
"Approval of these plans by tr County of Riverside '
Department of Ehviranr+i�-ni :h, does not relieve the
Engineer & Architect of the idc ;,iL ility for the Engineering
or Architectural design." ,
i•sr In ,i .,� (k0L an�d �ir:r�� • CL
r s fis:S `ia ii;i):}j �siT3�s. `
FOR PFiEI_Ir.an!..?�= ""N! ' INSPECTIONS '
NOT F.Y DEPr,R' 4,E:,' -I" 0:," ENVIRONMENTAL
'HEALTH
NOTIF`I THE PLAN CHECKER IN WRITING t
OF ANY CHANGES OR P,LTERATIONS TO
PLANS AS ORIGINALLY APP
ROD'ment)
(ie: flooring, walls, ceilings or eq P ,
CONTACT THE PLAN CHECKER FOR A PRELIMINARY
TELY
INSPECTION WHEN CONSTRliCPMENT IS INSTALLED.)
, 3 . "
80%.COMPLETE..(BEFORE EQUI
• THIS APPROVAL GRANTED BY THE.-
COUNTY
HE:COUNTY OF R!VERSIDE ,
DEPARTMENT OF ENVIRONMENTAL HEALTH f
IS VALID FOR ONE (1) YEAR FROINA, DATE OF APPROVAL
. -NOTICE-
A PERMIT MUST BE OBTAINED FROM THE
COUNTY OF RIVERSIDE DEPARTMENT OF ENVIRONMENTAL HEALT I
PRIOR TO OCCUPANCY OR USE ;
COUNTY OF RIVERSIDE y
HEALTH SERVICES AGENCY `
DEPARTMENT OF ENVIRONMENTAL" HEALTH
Th. oropcsed construction/equipment
in:sta'ii_tion is upproved:
Sec ani�chzd correction sh
Aee
cve(. , By
p�•" d 9. l r l `Z
This approval does not author zi ,
violation of any, ordinance, or , F
-,
gton
St �. r, :4• :
• 4
f.o r ra.�