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07-2053 (CSCS)'Jk P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 07-0.0.0-02-0= 5 H Property Address: 79765 HIGHWAY 111 r APN: 600-020-034- - - �D/��OLA.-M/ 9ev'- Application description: NEW COMML - ^oii= a"ieci ied^nee,eei4ie,eT Property Zoning: COMMERCIAL PARK Application valuation: 509012 Applicant: Architect or Engineer: -------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION 1 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. Lic se Class: B License No.: 524136 Date�I -09 cracto 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).: 1 _ 1 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—) 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: 2/01/08 Owner: KOMAR INV 23 CORPORATE PLZ STE 247 NEWPORT BEACH, CA 92660 D Q p Contractor: WICKS CONSTRUCTION INC FEB 0 12008 11614 STERLING AVENUE RIVERSIDE, CA 92503 CITYOF FINgIyC�QuINTq I (951)351-8303 E DEPT. Lic. No.: 524136 ----------------------------------------------- WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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 STATE FUND Policy Number 1709977-2007 _ 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 C I shall fo with omply with those provisions. D� � "(� plicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CO RAGE "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. 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 county ordinances and state laws relating to building construction, and hereby authorize representatives of this co ty to enter upon t e above-mentioned pro inspecti purpo es. te:, _0 Si ature (Applicant or Age Application Number . . . . . 07-00002053 Structure Information 6576 SF RESTAURANT BLDG Other struct info . . . . . CODE EDITION .01BMP04E05EN FIRE SPRINKLERS MIXED-USE OCCUPANCY A -3/B OCCUPANT LOAD 285.00 PATIO SQ FTG 1361.00 _ 1ST FLOOR SQUARE FOOTAGE- 6576.00 ----------------- ---------------------------------------------------------- 2ND FLOOR SQUARE FOOTAGE • .00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 2069.50 Plan Check Fee 1345.18 Issue Date. Valuation . . . 509012 Expiration Date 7/30/08 Qty Unit Charge Per Extension BASE FEE 2039.50 10.00 ---------------------------------------------------------------------------- 3.0000 THOU BLDG 500,001-1,000,000 30.00 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 342.00 Plan Check Fee 85.50 Issue Date . . . - Valuation . . . . 0 Expiration Date 7/30/08 Qty Unit Charge Per Extension BASE FEE i 15.00 4.00 11.0000 EA MECH FURNACE >100K 44.00 1.00 9.0000 EA MECH SUSP/WALL HEATER 9.00 =4.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 66.00 5.00 6.5000 EA MECH VENT FAN 32.50 4.00 6.5000 EA MECH EXHAUST HOOD 26.00 23.00 ---------------------------------------------------------------------------- 6.5000 EA MECH OTHER MECH EQUIPMENT 149.50 Permit . . . ELEC-NEW COMMERCIAL Additional desc . Permit'Fee �. 173:74 Plan Check Fee 43.44 Issue Date Valuation 0 Expiration Date 7/30/08 Qty Unit Charge Per Extension BASE FEE 15.00 7937.00 -----------------------'----------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 158.74 �QPERMIT . Application Number . . . . . 07-00002053 Permit . . . . . . PLUMBING Additional desc . . Permit Fee . . . . 399.00 Plan Check Fee 99.75 Issue Date . . . . Valuation 0 Expiration Date 7/30/08 Qty Unit Charge Per Extension BASE FEE 15.00 42.00 6.0000 EA PLB FIXTURE 252.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 7.00 6.0000 EA PLB ROOF DRAIN 42.00 2.00 7.5000 EA PLB WATER HEATER/VENT 15.00 1.00 12.0000 EA PLB INTERCEPTOR 12.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 1.00 7.5000 EA PLB OTHER BACKFLOW <=2 INCH 7.50 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 14.00 .7500 EA PLB GAS PIPE >=5 10.50 1.00 15.0000 ---------------------------------------------------------------------------- EA PLB GAS METER 15.00 Permit . . . GRADING PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 7/30/08 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments 6,576 SF RESTAURANT BLDG. FOR "MIMI'S CAFE" A-3 OCC.TYPE VN CONSTRUCTION W/ SPRINKLER CREDIT FOR ALLOWABLE AREA INCREASE.285 TOTAL OCCUPANT LOAD. 2001 CBC,CMC,CPC, 2004 CEC, 2005 ENERGY CODES**PERMIT DOES NOT INCLUDE TEMPORARY POWER, BLOCK WALLS, TRASH ENCLOSURE AND SITE LIGHTING.**2006 D.I.F. -----------------------------=---------------------------------------------- Other Fees . . . . . . ACCESSIBILITY PLAN REVIEW 134.52 ART IN PUBLIC PLACES -COM 2525.06 DIF CIVIC CENTER - COMM 2117.47 ENERGY REVIEW FEE 134.52 DIF FIRE PROTECTION -COMM 295.92 STRONG MOTION (SMI) - COM 106.89 s DIF STREET MAINT FAC -COMM 697.05 I npfzvmfT d• 1a ^ Application Number . . . . . 07-00002053 ---------.------------------------------------------------------------------- Other Fees . . . . . . . . . DIF TRANSPORTATION - COMM 19984.47 Fee summary Charged Paid Credited Due Permit Fee Total ---------- 2999.24 ---------- .00 ---------- ---------- .00 2999.24 Plan Check Total 1573.87 1000.00 .00 573.87 Other.Fee Total 25995.90 00 .00 25995.90 Grand Total 30569.01 1000.00 .00 29569.01 LQPERAUT 1 J IL %r: - cc�173 -City of La Quinta Building 81: Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: �� — ?6 5 �� ( Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: w 1 C k 5 &^Cz kr'1(_ t t OA TeleP hone Address: L ��l�I i A Ave Project Description: 4;0n o� Nom✓ ) ,- �; )c+ILJ,- Sc i P n 2 i d , City, ST, Zip: 9, 'VefSde C Telephone: 6 � 51 3 State Lic. # : ut" 6 City Lic. #:....... Arch., Engr., .Designer: Lee �` Address: I69yZ. =VOA Itche'PWA Vie • City, ST, Zip: �i'f�,1 e� ('l't (l 200 Construction struc ' on T YP Occupancy: Telephone: h one: Z U y a State to Lic. #• C i S 8 ' Project type (circle one): New Add'n Alter Repair Demo � Name of Contact Person: Mart k L S4. Ft.: 2,? # Stor' # Units: Estimated Value of Project: L,-. 3 3 C) 0 Telephone # of Contact Person: • 2&9, I og )(I J APPLICANT: DO NOT WRITE BELOW THIS LINE ' # Submittal Rcq'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submittedItem I Amount Structural Calcs. Reviewed, ready f 1r corrections Plan Check Deposit Plan Check Balance Truss Cales. Called Contact Person 4111 Title 24 Calcs. Plans picked up /� Construction Mechanical Electrical Plumbing S.M:I. Grading Flood plain plan Plans resubmitted Grading plan 2°d Review, read for corrections/is e 2-3 Subcontactor List Called Contact P on Grant Deed Plans picked up H.O.A. Approval Plans resubmitted 3 IN HOUSE:- ''d Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees e mit Fees `N lye` 27 L ri T ' 5 P6_60 Ry0cSta� 1 c'oNTowci 4I,o P0L:i(0 " Foy ' . 602 -b CT -co ✓ s 8CofxV— w A ll N,) 3 V (SSU CVn - IYA P.O. BOX 1504 Building ,`"ung ��/ C %��_/ t i 78-495 CALLE TAMPICO Address /"t 65 , ` 7 1 LA QUINTA, CALIFORNIA 92253 W"llui K 9G C4 e, � Mailing Address r� 1242 OI Ave, 43, Cit Z' ZTel.' e �� f It Contractor 'G State Lic. City I & Classif. I Lic. # Arcn., tngr Desi., L Thr` Designer Adcjress g6q?, Uun KwDN &ve,:wo qqq- Z61 - 610o Cityrro"I'4 , C��Ziqao� State n s� Lic. # (� LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that he 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 Profes- sions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or im- provement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale). O I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKER'S COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become subject to the Workers' Compensation Provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter the above-mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip WHITE = BUILDING DEPARTMENT D�3 0 APPLICATION ONLY BUILDING: TYPE CONST V -b f5 OCC. GRP. A.P. Legal Description Project Description ,,C � _56f$ I S,t)t aoolti re!tor^t w:* OutGxr d;n,N4 a%eco. Sq. Ft. No. No. DIN. — 4 ( Stories Units INew.>' Add ❑ Alter ❑ Repair ❑ Demolition ❑ I Estimated Valuation � 1 � �y� L !( /VIJv � PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center L Rear Set � fromXReroSide Stre a' Side Set from Property FINAL DATE ILL INAV154F Issued by:— Validated by: 1 Validation: YELLOW = APPLICANT PINK = FINANCE AMOUNT /O , D 2007 Comments CC check for $2,761.50 plus $0.42 change to equal amt due At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 5 00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile ho mes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $0.42 X 6,576 - S.F. or $2,761.92 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By CC/Bank of America - Geet Chand Check No. CERTIFICATE OF COMPLIANCE Name on the check Telephone Desert Sands Unified School District o��'S,�21FZsc�o Funding Commercial 47950 Dune Palms Road Q BERMUDADUNES O Date 11 /29/07Gn La Qu i nta, CA 92253 RANCHO MIRAGE CJ INDIAN WELLS No. 29797 (760) 771-8515 PALM �`P, LA QUINT "y rjf - QINDIo y� O Owner Mimi's Cafe APN # 600-020-034 Address 17852 E. 17th Street South Building, Suite 108 Jurisdiction La Quinta City Tustin Zip 92780 Permit # Signature Tract # �.r;?;�»,T'i Study Area Type Commercial No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 79765 Highway 111 6576 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments CC check for $2,761.50 plus $0.42 change to equal amt due At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 5 00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile ho mes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $0.42 X 6,576 - S.F. or $2,761.92 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By CC/Bank of America - Geet Chand Check No. 419010043 Name on the check Telephone Funding Commercial By Dr. Sharon P. McGehee Superintendent rjf - Fee collected /exemp b Sh V-rey Payment Recd Zt41$o.00 1 $2,761.92 r/Ui = Oye3d6r , Signature �.r;?;�»,T'i NOTICE: Pursuant to Government Code Section 66020(d)(1), t is wil serve to notify you that the 90 -day approval period in which you may protest the fees o r other payment identified above will begin to run from the date tn wtYch the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public ent thorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting I P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 �F�4�rw To: Greg Butler, Building & Safety. Manager From: Les Johnson; Director -Planning Permit #: 07-2053 BUILDING & SAFETY DEPARTMENT (760) 777-7012 FAX (760) 777-7011 To CDD: October 09, 2007 Due Date:_ October 19, 2007 Status: 2nd Review Building Plans Approval (This is an approval to issue a Building Permit) The Planning Department has reviewed the Building Plans for the following project: Description: Shell Buildinq (Mimis Cafe) Address or General Location: 79-765 Highway 111 Applicant Contact: Leesak (949)261-1100 The Planning Department finds that: ❑ ...these Building Plans do not require Planning Department approval. .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. Johnsq , Director -Planning Date CITY OF LA QUINTA - PUBLIC WORKS DEPARTMENT GREEN SHEET PUBLIC WORKS CLEARANCE FOR RELEASE OF BUILDING PERMIT Form updated & effective 11/17/2006 Green Sheet a rovals are forwarded to the Building & Safety Department directly by Public Works. Please DO NOT submit the Green Sheet (Public Works Clearance) Packet to the Public Works Department until ALL requirements listed below are complete. Incomplete applications or applications which cannot be processed will be returned to applicant. Date: -1/29/0-S Developer: KOMOr Inves4mer4s LLC- _v - Tract No.: Tract Name: Lot No.(s): 339 (o Address(s): 'j9 -�65 N►AhwQu {11 LA CcZuin}q A 82253 The following are the requirements for Public Works Clearance to authorize issuance of a building permit from the Building & Safety Department: ❖ CUSTOM HOMES: PROVIDE ITEMS #2 #3 #4 AND #5 BELOW •:• TRACT HOMES: PROVIDE ITEMS #1 #2 #3 #4 AS APPLICABLE .AND #6 BELOW COMMERCIAL BUILDINGS/OTHER- PROVIDE ITEMS #1 #2 #3 AND #5 BELOW • WALLS: PROVIDE ITEMS #7 BELOW �3 SIGNS: PROVIDE ITEMS #8 BELOW Attach Pad Elevation Certificates in compliance with the approved design elevation p g n for building pad (maximum allowable deviation of +/- 0.1 foot). Pad Elevation Certificates must be current (within 6 months of current date). If a precise grading pian creates the pad for approval, please withhold green sheet submittal until a Pad Elevation Certificate can be provided. Attach geotechnical certification of grading plan compliance. Attach recorded final map showing proposed building locations are legal lots. 4. Attach a completed < 1 acre. per lot or infill project Fugitive Dust Control project information form, . PM10 plan & agreement or provide alternative & valid City approved PM10 plan set reference number or hard copy plan. PM10 plans for commercial & residential developments (beyond 1 lot) Oare submitted separately with grading plans & are subject to additional requirements. Attach an approved precise grading plan for the building location(s). AO flood zone developments will require an approved floodplain development plan. 6. Attach an approved rough grading plan for the building location(s). 7. Attach wall plan & related approved grading plan. 8. Attach sign layout/plan & related precise grading/landscape plan. I have reviewed and confirmed the requirements listed above as presented and find the improvements to be sufficiently complete for construction of the proposed buildings/structures/walls/signs on the subject lot(s). Pursuant to my findings, the above project may be released for building permit issuance. Recommended by: Dated: Public Works Distribution: (_) Green Sheet to Building & Safety counter (_) Green. Sheet to Community Development Declined for approval for reason(s) as follow(s), please correct and resubmit: City of La Quinta - PM 10 Project Information (< 1 acre per Lot or Infill Proiect) Paqe 1 of 3 Form updated & effective 8/25/2005 Project Information Project Contractor: Project Phase N f A 1/J (GkS ConS}f��.�ipn Project Phase Project Name: (Check One): Construction Project Tract Number: ❑ Demolition Lot Number(s): 33y6o Anticipated Start Date: 01- 30-08 Anticipated Completion: 011-01-08 Project Street Address: �9- 7�5 H�9hway 1 1 1 LQ auin+A CA 922573 Total acres in active construction (< 1 acre per Lot): Project Contact Information Please Note: Dust control is required 24 hours a day, 7 days a week, regardless of construction status. Person listed below is responsible for dust control during business and non- business hours. Name: bGvid WgnC Title: Su ef Company Name: Wicks Cors4-fix4 ion Mailing Address: 61 5+cflinq Avenue City: Rwevsid e State: CA Zip Code: qoso 3 Primary Telephone Number: (95i� 351- 8303 Fax: Q51 351— qq•t r� 24 Hour Access/Emergency Phone: ($Oo7652- 2o21 Cell Phone: (951),q64 - 590 PM10 Certificate Number: 07-12.- 508'7 ❖ Expanded PM 10 plans for commercial and residential developments > 1 acre are required by the City of La Quinta. PM 10 1. < 1 acre Der Lot or Infill Project Fugitive Dust Control Plan Page 2 of 3 Plan updated & effective 8/25/2005 This plan shall take into account applicable SCAQMD Rule 403 regulations. Training may be obtained by contacting SCAQMD (Sharon Zamora - Phone: (909) 396-2183). This plan shall consist of the following action items: WATERING: Continuous watering is required to prevent dust and must occur a minimum of 4 times daily. Water shall be applied to dry soils to stop: • Visible dust emissions over 20% opacity • Visible dust emissions that travel over 100 feet. • Water source % nch water meter at front (south) side of pad. 4- EDUCATION: Responsible Dust Control Individual and key personnel shall attend SCAQMD PM10 class and obtain PM 10 certificate number prior to construction activity. •:• WEATHER MONITORING: Wind predictions shall be monitored. SIGNAGE: Use Coachella Valley Fugitive Dust Control Plan Handbook Construction Site Signage Guidelines. TRAFFIC: Construction traffic shall not be allowed on the pad, unless absolutely necessary. If vehicles operate on pad; pad shall be kept firm and moist through hose watering or sprinklers. Fugitive Dust shall be prevented by fencing off site to prevent unauthorized traffic on pad. (15 mph maximum traffic speed). PARKING: Parking is not allowed on the pad. All vehicles must park on street (at designated areas only). • TRACK O.UT: Provide 24 hour .street cleaning and track out system as approved by City Public Works Inspector. (No dirt on public or private roads). Track out shall be cleaned up within one hour of incident. DIRT PILES: Dirt piles shall be limited to 50 cubic yards and built per California Building Code grading requirements. Piles shall be kept moist or covered with tarp material. Larger dirt piles will require stockpile or grading permit. ❖ FENCING: Provide PM 10 fencing at perimeter of public roads and where applicable. Wood slat fencing can be installed at rear of property and return 20 feet on either side if HOA restrictions apply. Block walls can replace PM10 fencing during the construction phase. ❖ EQUIPMENT: Extra hoses and sprinklers shall be maintained on site. ee EXCAVATION MEASURES: All areas to be excavated or graded shall be pre -watered. Water shall be applied during excavation or grading operations also. •:• DUMP TRUCKS: Open top dump trucks to be' wet down,' moist and tarped prior to leaving site. ❖ INACTIVE SITE: Within 10 days of ceasing of activities, re -vegetate or permanently stabilize as required. City of La Quinta - Site Specific Construction Phase PIM 10 Agreement Page 3 of 3 Agreement updated & effective 8/25/2005 The signature of the property owner (or authorized representative)' ❖ Shall act as his/her acknowledgement of dust control requirements and their enforceability, pursuant to AQMD Rules 403 and 403.1; Shall constitute and agreement to comply with all project conditions as identified in the approved dust control plan; The property owner (or authorized representative): •:• Acknowledges that dust control is required 24 hours a day, 7 days a week, throughout the period of project performance, regardless of project size or status; Shall ensure that each and every contractor/subcontractor and all other persons. associated with the project shall be in continuous compliance with all requirements of the approved dust control plan; 46 Shall take all necessary precautions to minimize dust, even if additional measures beyond those listed in the dust control plan are necessary; ❖ -Shall authorize representative of the City/County to enter upon the above mentioned property for inspection and/or abatement purposes; and Shall hold harmless the City/County and its representatives from liability for any actions related to this dust control plan or any City/County initiated abatement activities. Signature of Property 0w er or Authorized Representative Printed Name Title Company /� Date C� CC John R. Hawkins Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of: Banning Beaumont Calimesa 4. Canyon Lake ' Coachella 4 - Desert Hot Springs Indian Wells Indio Lake Elsinore La Quinta Moreno Valley Palm Desert Perris Rancho Mirage 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. STE 201 Palm Desert, CA 92211-4131 (760) 863-8886 Fax (760) 863-7072 Date La Quinta Building Department r _ RE_ I Vv1 I S (d FQ The Riverside County Fire Department is granting the fire clearance for the following location 7 --76S HI� I Please call if you should have questions. 760-863-8886. Thank You K Respectfully, 7 n Stubble Fi Safety Specialist Nov 28 07 01:30p . John R. Hawkins Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of Benning Beaumont Calimesa Canyon Lake 4 Coachella Desert Elot Springs 4. Indian Wells Indio Lake Elsinore Le Quinta Morcno Valley Palm Desert Perris Rancho Mirage Son Jacinto 4.6 Temecula Board of Supervisors Bob Buster, District 1 John Tavaglione, District 2 Jeff Stone. Disuict 3 Roy Wilson, District4 Marion Astley, District 5 b ` p.5 RIVERSIDE COUNTY FIRE DEPARTMENT In cooperation with the California Department arForestry and Fire Protection 77-933 Las Montanas Rd., Suite 201 • Palm Desert, California 92211 . (760) 863-8886 • Fax (760) 863-7072 November 27, 2007 Komar Properties 23 Corporate Plaza #247 Newport Beach, Ca. 92660 (949) 718-4844 Re: Water System Plan Review 1 On Site Water Plans PM339601 Komar Desert Center The above referenced water plans have been reviewed and are acceptable by the Riverside County Fre Department The County Fire Department must witness the following tests. 1. A hydrostatic test of 200 -psi pressure for two (2) hours or at 50 psi In excess of the maximum static pressure when it Is'in excess of 150 psi shall be witnessed by a fire inspector prior to covering piping Joints. 2. System bush inspection. 3. A final inspection is required. Blue retro -reflective pavement markers shall be mounted on private streets, public streets and driveways to indicate location of fire hydrants. The required water system including fire hydrants shall be installed and accepted by the appropriate water agency prior to any combustible building material being placed on an individual loticonstrvction site: All questions regarding the meaning of these conditions should be referred to the Fire Department Planning & Engineering staff at (951) 955-4777. si/n.'idi Colleen Estr a Fire Safety Specialist 2300 Market Street, Suite 150 • Riverside, California • (951) 955-4777 • Fax (951) 955-4886 39493 Los Alamos Road. Suite A • Murrieta, California 92563 • (951) 600-6160 • Fax (951) 600-6164 John R. Hawkins Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of Banning Beaumont Calimesa Canyon Luke Coachella Desert Hot Springs: lndian. Wells f Indio ee Lake Elsinore Ile La Quirita Moreno Valley Palm Desert Perris Rancho Mirage 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 ti RIVERSIDE COUNTY FIRE DEPARTMENT In cooperation with the. California Department of Forestry and. Fire Protection 77-433. Las Montanas •Rd., Suite 201 • Palm Desert, California 92211 !, (760)-80-8886 a Fax (760) 863-7072 October 29, 2007 Moni Dosanjh 1'342 Bell Ave., Suite 3K Tustin, CA 92.780 Re: Non -Structural -Building Plan Review LAQ-07-BP-060; Mini's Cafe:; 79-765 Hwy. 111, La Duinta. Fire Department personne(h ve reviewed and approved the plans you submitted for the above referenced project. 'Please be advised the following conditions apply as a part,of the conditions for the. issuance of a building permit. 1) Fire Department approval is based upon the 2001 CBG requirements.(or Group A-3. occupancies. It is prohibited to use -,.process or store any materials in the occupancy that would classify it as a Group H occupancy per Sec. 307 of -the 2001 CBC. 2) Repair work and/or maintenance using open flame equipment, welding or the use of Class I, 11, or 111-A liquid&are prohibited. 3)_ The Fire Department is required to set a minimum fire flow. for the remodel or construction of all commercial 'buildings using the procedure established in the 2001 CFC. Afire flow of 1500 gpm for a 2 -hour duration at •20 psi residual operating pressure must be available before any combustible material is placed on the job site. 4) The required fire flow shall be available •from a Super hydrant(s) (6" x 4" x 21/2' x 21/2') located.not.less than 25' or more than 165' from any portion of the building(sy.as. measured lalong approved vehicular travelways. 2300 Market Street, Suite 150 • Riverside, California • (951) 955-4777 o Fax (951) 95511886 39493 Los Alamos Road, Suite A • Muriieta, California 92563 0 (951•) 600-6160 a Fax (951) 600-6164 5) Prior to the issuance of a building permit, applicant/developer shall furnish one blueline copy of the water system plans to the Fire Department for review. Plans shall conform to the fire hydrant types, location and spacing, and the system shall meet the fire flow requirements. Plans must be 'signed by a registered Civil Engineer and/or the local water company with the following certification: "f certify that the. design of the watersystem is in accordance with the requirements prescribed by the Riverside County Fire Department". The following conditions must be met prior to occupancy': fi) Install a complete fire sprinkler system per NEPA 13. The post, indicator valve and fire department connection shall be located to the' front within 25' to 50' of a hydrant; and. a minimum of 25' from the building. System plans must be. submitted to the Fire Department for review, along with .a planlinspectiori fee. The approved plans, with Fire Department Job card must'be at the job site for all inspections. (Fire sprinklerd§er.loca#cn:should. be placed within the building in relation to the,approved;localion of the FDC%Pl1/) 7) Whenever sprinkler overhead mains of 4" size orlarger are provided, the Riverside County Fire. Department requires documentation from a structural engineer that the roof structural members will be capable of supporting the weight of.the water filled mains and attached lines. Provide. appropriate detailed documentation, with a wet stamp and signature, by the .project structural engineer. . 8) Install an alarm monitoring •system for fire 'sprinkler system(s) with 1:00 or more heads. Valve monitoring, water -flow alarm and trouble signals shall be automatically transmitted to an approved central station, remote station;orproprietary monitoring.station in accordance with 2001 CBC, Sec. 904.3,1. An approved audible sprinkler flowalarm shall be provided bn'the exterior in, an approved location and also in the interiorin'a normally occupied location. A C-10 licensed contractor must.submit plans, designed in accordance with NFPA 72,'1999 Edition, to the Fire Department for review and approval prior to installation. Buildings/facilities 9) Install Knox Key Lock box, Model 3200, mounted per recommended standard of the Knox Company. If the building/facility is Protected with a fire alarm .system or burglar alarm system, the lock boxes will require "tam.. per' monitoring.. Special forms are available from this office for the, ordering of.the Key Switch. This -form must be -authorized and signed by.this office for the correctly coded system to be purchased. Other requirements: '10) Install panic hardware and exit signs as per Chapter 10 of the 2001 CBC., 11). Prior to final inspection of any building, the applicantshall prepare and submit to the Fire Department.for approval, a site plan designating required fire lanes with appropriate lane painting.and/or signs. 12) Certain designaied.areas will be required to.be maintained as fire lanes: 13) Install portable fire extinguishers per Title 19, but not less than 2A10BC in rating. Contact a certified extinguisher company for proper placement. and spacing of equipment. 14) Install a Hood/Duct automatic fire extinguishing. system. System plans must be submitted, along with a plan check/inspecton fee, to the Fire Department for review. 2300 Market Street, Suite 150 • Riverside, California • (951) 955-4777 • Fax (951) 9554886 39493 Los Alamos Road, Suite A • Murrieta, Califomia 92563 • (95 1) 6.00-6160 • Fax (951) 600-6164 15) Shelving,-counters,.etc:, must be in place, .however, no merchandise may be placed in -the building prior to inspection. 16) All fire sprinkler systems, fixed fire suppression: systems and alarm plans must. be submitted separately for approval prior to construction. 'Contractors should contact the Planning & Engineering office (or. submittal requirements. 17) ;Approved building address shall be placed in such a position as to be plainly visible andlegible from the street and rear access if applicable:. Building address numbers shall be a'rninirrum of 12" for building(s) up. to 25' in height, and 24" in height for building(s) exceeding 25' in height. In multi -tenant buildings, businesses shall post'the business name and suite number on back doors as well as the ftont. Suite numbers or letters must be a minimum of 6" in height. All addressing must be legible :and of a contrasting color with the backgrou"nd.and:adequately illuminated.to be visible from the str ' t,atall hours. 10 Electrical room'door shall be posted "ELECTRICAL, ROOM" on the outside of door. 99). Room; capacity shall be posted in a, conspicuous place on --an approved, sign nearthe m;aih ,exit from the room. ;20) Aidurable.sign.stating "This door to remain unfocked'duhng business hours" shall be, placed on or adjacentao the front exit doors. The sign.shalf,be in fetters not less than one Jnph high.on a:contrasting background.- Please:eontaetthe. Fire Department Planning ,& Engineeringstaff for final.inspecfion prior;io:occupancy: Applicantfin"staller shall be responsible to confact the,Eire D606-etment to schedtile:.inspections. Requests for• -inspections are to be made at I`east 72 hours in advance and may be arranged,by calling (760) 863-8886. All questions. regarding th'e meaning of these:condi.tions should be referred to the'Fire:Departrnent; Planning & Engineering staff at (760) 863=8886. ' Norman Davidson Fire Safety;$0ecialist, 2300 Market Street, Suite, 150 • Riverside, California • (951)955-4777 • Fax (95.1) 955-4886 39493 Los Alamos Road, Suite A o Murridfa, California 92563 9 (951) 600-6160 a Fax (951) 600-6164 *1'�2 Lid . STATE9.ECALIF_QRNlA— INES.S. IRAN.Sf'QRTAT.LQN.ANQ HO.U.S[N.G.AG-�ARNQLD S-C.L-IWARZENEaG.ER.-Govemoc DEPARTMENT OF ALCOHOLIC BEVERAGE CONTROL 1: 3927 LENNANE DRIVE, sm. I oo SACRAMENTO. CA 95834 (916) 419-2530` April 24, 2008 S WH Corporation License: 47-458722 17852 E 17th St. South Bldg., Ste 108 Date Issued: April 23, 2008 Tustin, CA 92780-2142 Expected Completion Date: October 23, 2008 Premises: 79765 Highway 111 La Quinta, CA 92253 This letter will serve to confirm that the license described above has been issued under the provisions of Rule 64(b) and Section 24044 of the Alcoholic Beverage Control Act. Please call at the office where you filed your application approximately 15 days before you consider that you will be ready to exercise the privileges of the license. If for any reason the premises do not qualify by the expected completion date shown in this .letter, you must apply for an extension of time at the office where the application was filed. Insofar as this agency is concerned, the escrow established under the provisions of the Alcoholic Beverage Control Act may be closed upon receipt of this notice. You will be responsible for the renewal of this license whether or not the privileges thereof are exercised prior to its expiration date. Failure to do so will result in automatic revocation. If you have any questions or further information is needed, please contact the licensing Staff on (916) 419-2530. Sincerely, Judy Gabrielli Licensing Officer JG: sf cc: Rancho Mirage District Administrator cc: Heritage Bank of Commerce Corporation Escrow Services Escrow Holder ABC -236A (5/94) COUNTY OF RIVERSIDE COMMUNITY HEALTH AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH SERVICES SUPPLEMENTAL REPORT TO SAN. FORM # DATE SUBJECT . nn 1 C �— PERMIT NO.(%q ADDRESS REMARKS: INSPECTOR 000 e� • c I . j 4p 1- i r ti x,01Tl< U J o DEHSAN-„a (Rev 8/02) Distribution: WHITE—Office; CANARY—Owner; PINK—Office I %I V 1-4%.J6 VE— vVVan t T wnat.tvt as t 1 t wr'11-8 a t AV"I V%✓ a DEPARTMENT OF ENVIRONMENTAL HEALTH FOOD ESTABLISHMENT PLAN APPROVAL NOTICE Plan Check # PSr07-0803 Date 1117/7 Project Name Mimi's Cafe Plans Submitted by Moni Dosan Address 79765 Hwy 111, La Quinta Phone 714-258-1808 Owner Mimi's Cafe Address 17852 E. 17`h St #201 Tustin Ca 92780 Phone The plans are now approved subject to the conditions listed below and the attached 1) Provide a certified air balance report, including make up air for all exhaust hoods. AV", 2) This plan does not include sewage or water service approval. Prior to the final inspec ' e a gre sizing form from your local water agency. 3) Provide a quick drain for the bar 3 -compartment sink. �G 4) The soda line must have an RP style anti backflow device mounted upstream of th tor.F piping or tubing must non reactive such as PVC. 5) Provide a splash guard 18"high between the fryer and range. 6) Provide a double check valve for Espresso Maker #98. Plans indicate dual check valve. 7212 onward all 7) The 3 -compartment bar utensil sink must have approved drain boards on each side minimum 18"x18". Plans show sink with a 12' and 24° drain board. See redline correction on plan sheet K1.1 8) Provide 58' of linear shelving as approved by D. Albeitz on 8/3/7. Plans indicate 52'. You must install an additional six more feet of linear shelving. 9) Provide approved splash guards at all, sinks where needed, verify onsite 10) Service area 1 & 2 must have smooth cleanable walls. I.e. FRP, ceramic tile, etc. Plans indicate brick veneer, which is not approved. 11) Provide shatter proof guards for listed fixtures above any open foods ,drinks, bars, etc. 12) Food finisher #57, remove from facility or provide approved exhaust hood. 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 760-320-1048 I acknowledge the corrections noted herein and as indicated on the plans and agree to incorporate them during construction: Signature ati Date 2A -0 7 Company Name F4ndn-e," Df✓2iorm'e_n ,- RIVERSIDE 'COUNTY COMMUNITY HEALTH AGENCY OF—PAR`Y°MEN`l1" OF EN\I URONm N` AL, HEALTH FOOD ESTABLISHMENT PLAN APPROVAL NOTICE Request for inspection should be made at least five (5) working days. in advance. . PLANS CHECKED BY Jerry Dubin REHS Phone 760-320-1048. I acknowledge the corrections. noted herein -and as indicated on the. plans and agree to incorporate them during construction'. Signature Date Company Name - DEFI-SAN-178 (Rev 2/06) Corona Hemet Indio Murrieta Palm Springs Riverside 2275 S. Main SG Suite 204 800 S. Sanderson 47-950 Arabia Sr "A" 38740 Sky Canyon Dr 2500 N. Palm Canyon Dr. 4065 County Cir (951) 373.9140 (951) 766-2824 (760) B63 -83B7 (951) 461-0284 (760) 320-1048 (951) 358-5173 Fax (951) 520.8319 FaX (952).766-7874 I ax (760)-863-8303 Fax (951) 461.0245 Fax (760) 320-1.470 Fax (951) 358.5017 Department Web Site _ www.rivcoeh.org Ce11-2007 09:20am From -CM PD SATELLITE j CITY Oc g0 j962�A'Z^ T-322 P-002/002 f-066 I BUILDING $ SAFETY DEPT `COACHELLA VALLEY WATER DIS RIOT ASSESSOR'S PARCE[. Ni1]YjgER ,11-995 Avenue 52 FOR CONSTRUCTION Coachella, California 92236 p7� (760) 398-2651 DA 0 p , APPLICATION FOR WAST1r WATER; ETMCEPTOR/S_E APPLICANT: Submit this form with a copy of a SCALED plot plan (1"- 20' to 1"= A0' SCALE) drawn to District specifications. A noarefundable filing fee is required when the applicadom is submitted Check must be made payable to the Coachella Valley Water District, Approval of this applicatlon shall remain vaNd fora period motto exceed one (1) year from date of payme dt_ Plan CheckNo. Agent, Contractor, Contc[ aPersonAdd City SmAte Zip Teltyhome 14002 t�r5q i _ 1.3,Z ll Ave- �j ` TU` iR art �� 0 �i ' ZS$1 i7� Owner, 'Address � City. Surto Zip Telephone M � r�; i5 � I � ,s Z �. i � .�,l s� 4109 JL61 \ c A' q2 -7 '71`I -50t 122 Jobl'ropettyAddress " kW l4. G�CrtyuGV��"1+^ �p� Legal Deseciptic. VDA MtM.i'S Cay PLEASE `COMPLETE TSPS SECTION FOR REVIEW OF FOOD ESTABLISHMENTS NOTE; PLANS WRI NOT RE ACCRIM0 UNLESS THIS APPLICATION is CUiHPI.ETE AND THE PLAN CHECK FEE IS PAID . GENERAL CONSTRu _TYANe Type of Construction: l- ll New Food Rdiity� Itumodel of Existing Food Estnnduneet: - Mum of.Opaation Sig Cairitcity Internal l Z� F-v;n al Extamal Scaling with Mistem or Heaters 1Bar with Food Service � Har Noaiood SaYice Water Soften[ Service: MultisiYvice(retrsable) SIR*i ervicc(tiisQosabk) OWNER/ftEPRSSENTAME DECLARATION: I`cw* tbst I have read the entire appH=dm and stele that all information is eoneet I understsmd that the amount of the paid is based an my declaration of iufotmation on this fo®and that incorrect imbtmadnn is,grou>ids fordmtal of the submitted plans. I also undeormnd that plana will be discarded if not picked up witbia-vixty (64) dip ofappoval or denial and tbnt no inspecttou of nor mtahliahmcd will be eonducted, orval proper intbrmation spino grouted to opaatc, until all ed and pLms have hem approved and rstwnod, Signature /'", 0 7 I2.10 7 y...FORDISTRICT V�7>rJ.Vi\Lx y.,Y. y:-. {T'... t•'- Na of Systems Type of Systcm(s) No. lSweitimg Units S�d/0r1 ( , ]Mew ('mesa interceptor Waived J gReplacczacutC3 Now ❑ E9dstmg Faturt Unite ❑rG�li.GGl� . V AdMoa C, a,O QiPl 0 Connect to Soar[ ❑ t�a All�1172G+? fit>:i�11i�' tS: © Dcnicd ❑ Conditional Approval - •See Remaria L°=a Fee S cheek Nn. o! ' �x'•�'�ao�B3 Date % Q�7 laidal Ll V' ! ► E It rtnin. not 'i I m Interceptors/separators: (i.e., grease, oil, sand, and lint) Interceptors/Separators shall.be provided when, in the opinion of the General Manager, they are necessary for the proper handling of liquid wastes containing grease in.excessive amounts, or any flammable wastes, sand or other harmful ingredients; except that such Interceptor/Separators shall not be required for Dwelling Units. All Interceptors/Separators shall be of a type and capacity approved by the General Manager, and shall be located as to be readily accessible for cleaning and inspection. Interceptors/Separators shall be maintained in continuously efficient operation.at all times by the User and at the User's expense., Requirements 1) Size and location of Interceptor/Separator to be approved prior to installation: 2') Interceptor/S.eparator to have: a) Sample Box., b) Sanitary Tee on discharge side of sample box. C) Running Trap d) Two 'Way Clean-bu't' prior to sewer :connection. e).vent line. after Sample Box, vent to be routed to building internal plumbing.. f) Manholes required. -at inlet, outlet baffle tubes, and over each battery opening. g) To ,provide cleaning access all,aieas of an interceptor; a minimum of 'one, manhole.; one (1.) per ten (10) feet of interceptor length. Manhole, covers ishall be gastight, in construction having a minimum opening. demension ,of twenty, (2.0) inches: 3) Inspection of Interceptor/S;eparator: a) Interior examination requi.red.by District Source. Control Inspectors prior to filling Interceptor/separator with water. b) All external inlet.and outlet plumbing to be inspected'by Source Control Inspectors prior to backfilling: C) All manholes and sample boxes must be installed a minimum of one (1) inch above finish grade/pavement with a concrete collar •a minimum of.eighteen (18) inches around the manhole and sample.box frames, with a minimum depth of eighteen (18) inches. D) Examinaton.by inspectors required prior to pouring concrete collars to verify depth. . I r . SEE NOTE NO. 3 A INU INLET A' L "vent. 2 -way cleanout outlet sanitary tee, running trap. K;- FITTING' SMEM ..sr��a TANK' HEIGHT :G-5000 G=6000 39'-0" 39'-6" 10'-0 11'-0" 4' -fl" 5:-2.771 VARIABLE TO GRADE M 6" INCREMENTS 3 1/4" SITp CAL. 7 4 3/4" TYPICAL. END ec'SIDE WALLS 2"X6 OUTLET W009 SLEEFERS N vl w EXCE ALL DIMENSIONS IN INCHES MODEL A 8 1 C D E F G HMODEL PC G-4000 50 48 65 , 74 74 24 3/4 4'1/2• 1/2 .LENGTH PC G-5000 59 57 74 74 74 291/4 4 1/2' E41 1/2 1ND1H i PC: G-6000 621/2 60 1/2 77 1/2 85 85 1 30 3/41 5 53'112 BELOW INLET TANK' HEIGHT :G-5000 G=6000 39'-0" 39'-6" 10'-0 11'-0" 4' -fl" 5:-2.771 VARIABLE TO GRADE M 6" INCREMENTS 3 1/4" SITp CAL. 7 4 3/4" TYPICAL. END ec'SIDE WALLS 2"X6 OUTLET W009 SLEEFERS N vl w .i LA QUMTA 07-2063 ,L4T. 23, 2007 SPECIAL INSPECTION PROGRAM ADDRESS OR LEGAL DESCRIPTION: N,�t>tir�a Ii t PLAN CHECK NUMBER: b7^ Z0&, OWNER'S NAME; S L-1 4 Cp D ( rto I, as the owner, or agent of the owner (contractors mayro employ the special Inspector), certify that 1, or the architactlengineer of record, will be responsible for employing the special Inspector(s) as required by Uniform Building Code (UBC) Section 1701.1 for the construction project located at the site tlsted(above. UBC Section loe.3.s. Signed 1, as the engineer/architect of record, certify that I have prepared the following special Inspection program as required by UBC Section 106.3.5 for the construction project located at the site listed above. Slgned 1. List of work requiring special Inspection: ® Soils Compliance Prlorto Foundation InspectIon ❑ Field Welding ® Structural Concrete Over 2500 PSI High Strength Solling ®Prestressed Concrete ExpansionfFpoxy Anchors Structural Masonry Sprayed -On Fireproofing ❑ Designer Specified Other 2. Name(s) of Indivtdua►(s) or firm(s).responsible for the speclal,inspectlons listed above: A. C. 3. Dulles of the special Inspectors for the wo* fisted above: A. B. C. spot] V>. ,. • MImt5 GFS I rA rioNALD i. CYSf'�Ailii iA\ y;- C-1153 : r\" UL 200�r� r�r Corporate: Ar7m 2992 E. La Palma Ave. Ste. Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 www.mtglinc.com/ Dispatch: 800.491.2990 MTGL Project#: 21.4/.(VA-O 1 San Diego/Imperial County' 7313 Carroll Rd. Ste. G San Diego, CA 92121 Tel: 858.537.3999 Fax: 858.537.3990 Dispatch: 888.844.5060 ®AOLY 1U,1MDECTION Inland Empire: .., 14467 Meridian Pkwy., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951.653.4666 Dispatch: 800.491.2990 OSA/CITY File #: Permit# (J —`-I:;,I REPORT DSA/OSHPDAPPL# Report # PG P j / DF DSA / LEA #: Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliard conditions must be distributed Immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection, PROJECT NAMEW I Mi / CA rr & DATE , ARCHITECT STT TIMEff TIMEOEPAR7ED cz ENGINEER TRAVEL TIME LUNCH TIME CONTRALTO r G e CONTRACTOR INSPECTION AD ES=7 GS Hw ' I f C� ADDRESS OF J s m mg - mg - TYPE OF INSPECTION El CH PLANT MASONRY ❑ ENGINEERED FILL ❑ PT CONCRETE /❑ HIGH STRENGTH BOLTING ❑ FOUNDATION ❑ SHOTCRETE ❑ WELDING ❑ BACK FILL ❑ CONCRETE ❑ SHOP WELD ❑ FIREPROOFING U ANCHOR/DOWEL ❑ NDE FIELD ❑ NDE SHOP f) CEILING WIRE ❑ ❑ ❑ DSA/OSHPD/PROJECT: AVAILABLE: SOIL REPORT Y U Nn APPROVED DOCUMENTS: APPROVED PLANS Y N ❑ SPECS: Y❑ NO APPROVED SHOP DRAWING Y❑ N ❑ MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT NO. OR MATERIAL TEST REPORTS): CONTRACTORS EQUIPMENT/ MANPOWER USED: v AREA GRID LINES, PIECES INSPECTED: tCA v &coo CA oo STRUCTURAL NOTES, DErAn, OA RFIS USED: �• >\ J� REMARKS, INCLUGr GNEONGB; o `� REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WAS X WAS NOT❑ Inspected in accor/adce with the requirements of the DSA/OSHPD/PROJECT approved documents. MATERIAL SAMPLING WA WAS NOT ❑ WA ❑ Performed in accordance with SA/OSHPD/PROJECT approved documents. cc Project Architect. - Structural Engineer DSA Regional Office School District 6TO/ZTOPI Contractor Building Department Owner THE WORK INSPECTED MEIDID NOT MEET ❑ THE requirements of the DSA/ SH D/PROJECT approved documents. Samples taken: Weather: SUt C Temp: ` SI nature of Special Inspector' � c � OL �AJ ons S Print Name Certification # d0 Verified by: XH3 09:60 £TOZ/SO/OT a www.mtglinc.com %i//1r/ S C'19/ -`f= Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 Dispatch: 800.491.2990 MTGL Project #: Permit # Report#I PG _J_ OF I San Diego/Imperial County 7313 Carroll Rd. Ste. G San Diego, CA 92121 Tel: 858.537.3999 Fax: 858.537.3990 Dispatch: 888.844.5060 DAILY INSPECTION REPORT �r Inland Empire: 14467 Meridian Pkwy., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951.653.4666 Dispatch: 800.491.2990 DSA/CITY File #: DSA/OSHPD APPL DSA / LEA #: Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. PROJECT NAME 1 DATE ARCHITECT a TIME ARRIVED TIME DEPAR ENGINE R TRAVEL TIME LUNCH q S CONTRACTOR r SUBCONTRACTOR INSPECTION ADDRESS _ : _ AD&ESS OF PROJECT y- ,• TYPE OF INSPECTION ❑ BATCH PLANT 29 MASONRY ❑ FIREPROOFING ❑ CEILING WIRE ❑ ENGINEERED FILL ❑ PT CONCRETE ❑ HIGH STRENGTH BOLTING ❑ ANCHOR/DOWEL ❑ ❑ FOUNDATION ❑ SHOTCRETE ❑ WELDING ❑ NDE FIELD ❑ ❑ BACK FILL ❑ CONCRETE ❑ SHOP WELD ❑ NDE SHOP ❑ DSA/OSHPD/PROJECT: AVAILABLE: SOIL REPORT YB N ❑ SPECS: YZ9 N ❑ APPROVED DOCUMENTS: • APPROVED PLANS Yid N ❑ APPROVED SHOP DRAWING Y © N ❑ MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT No. OR MATERIAL TEST REPORTS): f + • 0 ' - u % � I CONTRACTORS EQUIPMENT / MANPOWER USED: ' t V y� yy V; AREA, GRID LINES, PIECES INSP CTED: 7 ewj 0 -y- F r STRUCTURAL NOTES, DETAIL, OR RFIS USED: REMARKS, INCLUDING MEETING %R ti l! .v p . _ v REWORK AS PERCENT OF ALL WORK TODAY: —RE-RGE JECT COMPLETE: THE WORK WAS ® WAS NOT ❑ Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents. MATERIAL SAMPLING WASfj9 WASNOT❑ N/A❑ Performed in accordance with DSA/OSHPD/PROJECT approved documents. cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED MET ❑ DID NOT MEET ❑ THE requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken: 3 'a/LeOiJr Weather: !� mp: j a Signature of Spe Inspector Print Name Certification #�o.�i ; 3® 9�— k 4 Verified by MTG L i' —`l Corporate: 2992 E. La Palma Ave., Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 San Diego/Imperial County: 7313 Carroll Road, Suite G San Diego, CA 92121 Tel: 858.537.3999 Fax: 858.537.3990 Inland Empl , . 14320 Elsworth Street, Ste. C101 Moreno Valley, CA 92553 Tel: 951.653.4999 Fax: 951.653.4666 FIELD REPORT Los AngelesNentura County: 13010 San Fernando Rd., Unit 1 Sylmar, CA 91342 Tel: 818.833.8100 Fax: 818.833.0085 TYPE OF WORK INSPECTOR ❑ TECHNICIAN AVAILABLE: SOIL REPORT (Y) (N) SPECS (Y) (N) APPROVED PLANS (Y) (N) APPROVED SHOP DRAWING (Y) (N) ARCHITECT FOR WEEK ENDING — —0 ro 1 PROJECT. No. 2 i 4 f. 11 ENGINEERi j t EU Ua / REPORT N0. PG OF CONTRACTOR roV o ! L C VlS PLAN FILE NO. PERMIT N i SUB -CONTRACTOR PROJECT NAME A INSPECTION ADDRESS ?vw- )4,_�. tai ADDRESS OF PROJECT -701 -)4.— HLA _trr �- REPORTING REQUIREMENTS: ICBO FIELD INSPECTION MANUAL/MTGL SOIL MANUAL — REVIEW PREVIOUS REPORTS AND LISTS IF THERE IS NON -CONFORMING WORK AT THE END OF THE WORK DAY, OR MISSING MTRS, AND RFIS, ETC., FILL OUT AND ATTACH A DEFICIENCY REPORT WHEN A DEFICIENCY, YOURS OR A PREVIOUS INSPECTOR'S, IS CORRECTED, SO NOTE ON THE ORIGINAL DEFICIENCY REPORT AND SUBMIT A COPY WITH YOUR WEEK'S REPORTS. / 11 0 ( ;r Q OLL�E1 toe S CO'r ✓If v' V lr LM W1 1 S e CY w t o 4- L fAEkTA119M NP9WD: tit I �1-SLA j< ' (� l j q K 5 14,2 do d �j U T�* e f La �Ly,t4g�lT A l 0,Cli- I i c 1 • r REWORK AS PERCENT OF ALL WORKTOOAY4 PERCENT PROJECT COMPLETION: WEATHER: TEMPERATURE: SAMPLES TAKEN: TESTS REQUIRED: SITE TIME START:.- , - Q SITE TIME FINISH: LUNCH PERIOD: ,GCS TRAVEL TIME: VERIFIED BY: I DO CERTIFY THAT I HAVE PERSONALLY OBSERVED ALL OF THE WORK LISTED ABOVE AND THAT THIS WORK COMPLIES WITH THE SOIL INVESTIGATION RECO ENDATIONS, AND / OR THE'APPROVED PLANS, SPECIFICATIONS AND APPLICABLE SECTION OF THE BUILDING CODE, UNLESS OTHERWISE NOTED IN THE DEFICIENCY REPORT 4,4e,5"�_ c I ",)* 6`1 7 106 tl(631V4`t Signature Date of Report ICBO Certification Number Print Name City / County Certification Number Rev: 7/97 Corporate 2992 E La Palma Ave. Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 Dispatch: 800.491.2990 MTGL PROJECT#: 2146A01 „ Permit # 07-2053 Report # 1 Page 1 of 1 San Diego/imperial County 7313 Carroll Rd., Ste. G San Diego, CA 92121 Tel: 858.537.3999 Fax: 858.537.3990 Dispatch: 888.844.5060 DAILY INSPECTION REPORT Inland Empire 14467 Meridian Pkwy., Bldg 2A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951.653.4666 Dispatch: 800.491.2990 DSA/CITY File # DSA/OSHPD Appl. #. DSA/LEA # Special Inspection Reports must be distributed to the parties listed below within 14 days of the Inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection on a daily basis. Each report shall be completed and signed by the special inspector conducting the i.. - Mi - PROJECT NAME: MIMI'S CAFE 1 Date: 3/04/2008 ARCHITECT: LEE & SAKAHARA TIME ARRIVED: 7:00 TIME DEPARTED: 10:00 ENGINEER: SHIMAJI & LASCOLA TRAVEL TIME LUNCH TIME CONTRACTOR: WICKS SUB CONTRACTOR: SOUTH COAST INSPECTION ADDRESS: DDRESS;OF PROJECT: 79-765.S.HWY 1,1.1 y LA QUINTA TYPE OF INSPECTION ❑ ENGINEERED FILL ❑ FOUNDATION ❑ BACK FILL ❑ BATCH PLANT ❑ PT CONCRETE ❑ SHOTCRETE ® CONCRETE ❑ MASONRY ❑ HIGH STRENGTH BOLTING ❑ WELDING ❑ SHOP WELD ❑-FIREPROOFING ❑ ANCHOR/DOWEL ❑ NDE FIELD ❑ NDE SHOP ❑ CEILING WIRE ❑ ❑ ❑ DSA/OSHPD PROJECT APPROVED DOCUMENTS AVAILABLE APPROVED I PLANS Y ❑ N ❑ I SOIL REPORT Y ❑ N ❑ SPECS: Y ❑ N ❑ APPROVED SHOP DRAWING Y ❑ N ❑ MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT NO. OR MATERIAL TEST REPORTS): 40 cubic yards of 3000 -psi concrete from Robertson's ready mix, design # 32241 CONTRACTORS EQUIPMENT/MANPOWER USED: 42 meter boom pump, mechanical vibrator, 10 men AREA, GRID LINES, PIECES INSPECTED: concrete placement for grade beams only @ lines A & A.1 from 4 to 8, line D, from 6 to 10.2, line E, from 1 to 5 STRUCTURAL NOTES, DETAIL OR RFIS USED: S1& S2 REMARKS, INCLUDING MEETINGS: monitored placement & consolidation by mechanical vibrator of approximately 40 cubic yards of 3000 -psi concrete for grade beams only. Note: City inspector verified reinforcement, holdowns & anchor bolts, no reinforcement inspection from MTGL Sam le -1 set of 4 concrete from load # 2, ticket # 5692892, slum 4", concrete tem 62, location GB line H - 1 to 5 REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: 1 Ht WORK 1NA5 U 1NAb NU I LJ Inspected in accordance with the requirements of the DSA/OSPHD Project approved documents. MATERIAL SAMPLING WAS ❑ WAS NOT ❑ N/A ❑ Performed in accordance with DSA/OSPHD Project approved documents. cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District IHlz WORK INSPEG tt0 Mt I LJ UIU NU 1 MLL I L_I The requirements of the DSA/OSPHD Project approved documents. Samples taken: 1 set of 4 Weather. clear Temp: 60's Signature of Special Inspector Print Name: DONALD SMITH Certificatio 1037223, 8 1,88 Verified Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 7313 Carroll Road, Suite G, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 Report of. COMPRESSIVE STRENGTH -CONCRETE ASTM C39 CITY OF LA QUINTA-BLDG & SAFETY 78495 CALLE TAMPICO LA QUINTA, CA 92253 Client: -FRANCHER DEVELOPA4ENT SERVICES, INC A Set No.: 8-R1167 File No.: Permit No.: 07-2053 Project No.: 2146AOI Project Name: 1yS "7-777A N TA - 79 -7 V HWY 1'11 LA QUINTA, 7A Age Date (Days) Tested Nominal Size Actual Area (Sq. Inch) Load (lbs.) Strength (psi) Type of Fracture 7 3/11/2008 6X 12 28.27 62,500 2,210 Shear 28 4/1/2008 6X 12 28.27 28 4/1/2008 6X 12 28.27 56H 4/29/2008 6X 12 28.27 Specified Strength: 3,000 PSI Sampled By: DON SMITH ASTM C172 Date Sampled: 3/4/2008 Date Received: 3/5/2008 Location: GRADE BEAM LINE H= 1 TO 5 Concrete Supplier: ROBERTSON'S READY MIX Mix No.: 32241 Ticket No.: 5692892 Water added at Site: 10.00 gal. By CONTRACTOR Cement Type: IIN Mix Time: 40 min. Remarks: Distribution: FRANCHER DEVELOPMENT SERVICES, INC. LEE & SAKAHARA ARCHITECTS SHIMAJI & LASCOLA WICKS CONSTRUCTION INC. CITY OF LA QUINTA-BLDG & SAFETY **LAB COPY** Concrete Temp: 62 OF ASTM C1064 Ambient Temp: 58 OF ASTM C1064 Slump: 4.00 in. ASTM C143 Tested at: Riverside Respectfully Submitted, MTGL, Inc. e ';� Sam Sayawat P.E. Engineer Corporate: 2992 E. La Palma Ave. Ste. A San Diego/Imperial County 7313 Carroll Rd. Ste. G Inland Empire: Anaheim, CA 92806 Tel: 714.632.2999 San Diego, CA 92121 14467 Meridian Pkwy., Bldg. 2-A Riverside, CA 92518 Fax: 714.632.2974 Tel: 858.537.3999 Fax: 858.537.3990 Tel: 951.653.4999 Wwvv.mtglinc.com Dispatch: 800.491.2990 Dispatch: 888.844.5060 Fax: 951.653.4666 MTGL Project #: V ❑ Dispatch: 800.491.2990 , Permit DAILY INSPECTION DSA/CITY File #: # , ,r � - p'ff T-Tkikaz— REPORT DSA/OSHPD APPL #: Report # PG DF AREA, GRID LINES, PIECES INSPECTED: Special Inspection Reports must be distributed to the parties listed below Separate reports shall be prepared for each type of special inspection, DSA / LEA #: within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. uu"Inmulum 11 i+ r?_ _ =y SUB CONTRACTOR I'f, 6u o, � Si6L6,^ /_ Y�CC���l�r - INSPECTIO�1KADDRY^�b_l IE ADDRESS OF PROJECT / l 5� TYPE OF INSPECTION ❑ BATCH PLANT ❑ MASONRY ❑ ENGINEERED FILL ❑ PT CONCRETE❑HIGH STRENGTH BOLTING ❑ FOUNDATION ilil'BACK 0 FIREPROOFING ❑ANCHOR DOWEL ❑ CEILING WIRE ❑ SHOTCRETE ❑ WELDING FILL ❑CONCRETE ❑ SHOP WELD ❑ NDE FIELD ❑ NDE SHOP ❑ ❑ DSA/OSHPD/PROJECT: AVAILABLE: SOIL REPORT Y N APPROVED DOCUMENTS: APPROVED PLANS Y ❑ N ❑ SPECS: Y ❑ N ❑ ❑ MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT NO.OR MATERIAL TEST REPORTS): APPROVED SHOP DRAWING Y ❑ N ❑ CONTRACTORS EQUIPMENT /MANPOWER USED: ,r � - p'ff T-Tkikaz— \ AREA, GRID LINES, PIECES INSPECTED: 5 STRUCTURAL NOTES, DETAIL, OR RFIS USED: 1EMARKS, INCLUDING MEETINGS: s �Z� c�s-rc n KTc, sZ6Pb�et U 5 .. i I - ­ I vrJ rV`itJ✓(i��� 1Ci�L l/'7v `�,Acy^_��(U Or* o) lis) e! 6 Q�Y•l��- (.�� �Tlr1W /t1�- Jl� ��Nv�fF(11%�MCtr_ C/1 l49 -- V1 /I tAA C*>, J I /^- :.-77, iEWORK AS PERCENT OF ALL WORK TODAY: E WORK WAS' WAS NOT❑ ;pected in accordance with the requirements of the DSA/OSHPD/PROJECT )roved documents. JERIAL SAMPLING WAS ❑ WAS NOT ❑ N/A ❑ formed in accordance with DSA/OSHPD/PROJECT approved documents. Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District � S7 CDc�I IF-/ ' PERCENT PROJECT COMPLETE: THE WORK INSPECTED MET❑ DID NOT MEET❑ THE requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken:_ SGIL �A�'�ii Weather: MU,, Temp: r Signature ofSpacialinspector Tr' „:Ail Print Name Certification #: Verified by: r Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 7313 Carroll Road, Suite G, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 I Report of. COMPRESSIVE STRENGTH -CONCRETE ASTM C39, CITY OF LA QUINTA-BLDG & SAFETY 78495 CALLE TAMPICO LA QUINTA, CA 92253 Client: FRANCHER DEVELOPMENT SERVICES, INC. A Set No.: 8-R1167 File No.: Date Tested Permit No.: 07-2053 Project No.: 2J46A0.1 Project Name: CAF A INA MIMI'S E @ LQUT 3/11/2008 79-76�HWY 111 28.27 LA QUINTA, CA S Age (Days) Date Tested Nominal Size Actual Area (Sq. Inch) Load (lbs.) Strength (psi) Type of Fracture 7 3/11/2008 6X 12 28.27 62,500 2,210 Shear 28 4/1/2008 6X 12 28.27 104,000 3,680 Shear 28 4/1/2008 6X 12 1 28.27 1 105,000 1 3,710 1 Shear Specified Strength: 3,000 PSI Sampled By: DON SMITH Location: GRADE BEAM LINE H= 1 TO 5 Concrete Supplier: ROBERTSON'S READY MIX Mix No.: 32241 Ticket No.: 5692892 Water added at Site: 10.00 gal. By CONTRACTOR Cement Type: IIN Mix Time: 40 min. Remarks: Distribution: FRANCHER DEVELOPMENT SERVICES, INC. LEE & SAKAHARA ARCHITECTS . SHIMAJI & LASCOLA WICKS CONSTRUCTION INC. CITY OF LA QUINTA-BLDG & SAFETY **LAB COPY** ASTM C172 Date Sampled: 3/4/2008 Date Received: 3/5/2008 Concrete Temp: 62 OF ASTM C1064 Ambient Temp: 58 OF ASTM C1064 Slump: 4.00 in. ASTM C143 Tested at: Riverside Respectfully Submitted, MTGL, Inc. Sam Sayawat P.E. Engineer 3700 PSI 28 -day compression test complies with the specified strength. A Corporate: O 2992 E. La Palma Ave., Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 San Diego/Imperial County: 7313 Carroll Road, Suite G San Diego, CA 92121 Tel: 858.537.3999 Fax: 858.537.3990 Inland Empij 14320 Elsworth Street, Ste. C101 Moreno Valley, CA 92553 Tel: 951.653.4999 Fax: 951.653.4666 FIELD REPORT Los AngelesNentura County: 13010 San Fernando Rd., Unit 1 Sylmar, CA 91342 Tel: 818.833.8100 Fax: 818.833.0085 TYPE OF WORK INSPECTOR O TECHNICIAN AVAILABLE: SOIL REPORT (Y) (N) SPECS (Y) (N) APPROVED PLANS (Y) (N) APPROVED SHOP DRAWING (Y) (N) ARCHITECT S a �� h FOR WEEK ENDING 3--j e --0$ PROJECT. i -I NO A- Q i ENGINEER 1 j a If Qs co REPORT N0. PG OF CONTRACTOR PLAN FILE NO. PER-MITrSpO.n 1�/ ii SUB -CONTRACTOR s5 o -0 PROJECT NAME : IM ak INSPECTIONcyADDRESS ( ) ll ADDRESS OF PROJECT 1q _,7t n ' y_ REPORTING REQUIREMENTS: ICBO FIELD INSPECTION MANUALJMTGL SOIL MANUAL - REVIEW PREVIOUS REPORTS AND LISTS IF THERE IS NON -CONFORMING WORK AT THE END OF THE WORK DAY, OR MISSING MTRS, AND RFIS, ETC., FILL OUT AND ATTACH A DEFICIENCY REPORT WHEN A DEFICIENCY, YOURS OR A PREVIOUS INSPECTOR'S, IS CORRECTED, SO NOTE ON THE ORIGINAL DEFICIENCY REPORT AND - SUBMIT A COPY WITH YOUR WEEK'S REPORTS.- - - - M +e. 6-g. L_ 1f e�/ f o �' i �c iii'g k411 cA 7X6x 0"" A+1 'Aredd C I�IErkF-rMaNPowER•Hst EQ1,lr�: r►, i]OSo�t Se,>�''�Q'L �hc,�wl.�Q�(z�a,IVACS1t%_ /�o tiJ lV L + /Fi�l�� kola 5 l vl Am w exe- iWLtAQ c L -m i2 dor -LIJ C. P oc V 1141; ( ICl rl EA, GRID LINECE9 OBSERVED: O ' c:- �C (d•)% `Y.cx.lJ.Cb.2l�li�1��! Fs e WEATHER: �QG° I "i? h -y („ ° TEMPERATURE: 6 (� ' / SAMPLES TAKEN: TESTS REQUIRED: SITE TIME START: Q Z F L SITE TIME FINISH: —' TRAVEL TIME: VERIFIED : I DO CERTIFY THAT I HAVE PERSONALLY OBSERVED ALL OF THE WORK LISTED ABOVE AND THAT THIS WORK COMPLIES WITH THE SOIL INVESTIGATION RECOMMENDATIONS, AND / OR THE APPROVED PLANS, SPECIFICATIONS AND APPLICABLE SECTION OF THE BUILDING CODE, UNLESS OTHERWISE NOTED IN THE DEFICIENCY RE11P�O�RT Signature Date of Report ICBO Certification Number to Et- t. Print Name City / County Certification Number Rev: 7/97 Earth 6- Sn .�.. uthwest November 15, 2007 7 _t Komar Investments 5581 Daniels Street, Suite A Chino, California 91710 Attention: Mr. Zaven Hanessian Subject: Plan Review 79-8118 Country Club Drive Bermuda Dunes, CA 92203 (760)345-1588 (800) 924-7015 FAX (760) 345-7315 File No.: 07762-02 07-11-786 Project: Proposed Mimi's Cafe 79-765 Highway 111 La Quinta, California References: 1, Earth Systems Southwest, Final Report of Testing and Observations Performed during Grading, Commercial Development near Southwest Corner of Highway 111 and Jefferson Street, La Quinta, California, rile No.: 07762-04, Document No.: 06-08-837, dated August 31, 2006, 2. Shimaji Lascola Structural Engineers, Structural Plans and Details for Mimi's Cafe, La Quinta, California, Sheets S1, S2; Y7019, dated July 3, 2007. S4, S5, S6, S7, and S8, Project No.: As requested, we have reviewed the referenced project structural plans and details as referenced above. This review was performed in conjunction with our referenced geotechnical engineerin recommendations for the proposed Mimi's Cafe to be constructed at the subject site. g Based on our review of the project structural plans, it is our opinion that the plans submitted a in general compliance with the referenced geotechnical engineering recommendations. re Based on our review it is our opinion that the referenced documents are applicable to the Proposed development. We malce no representation as to the accuracy of the dimensions measurements, calculations; or any portion of die design. This report is issued with the understanding that the owner, or the owner's representative, has the responsibility to bring the information and recommendations contained herein to the attention of the architect and engineers for the project so that they are incorporated into the plans and specifications for the project. The Owner,. or the owner's representative, also has the responsibility to take the necessary steps to see that the general contractor and all subcontractors follow such recommendations. It is further understood that the owner or the owner's representative is responsible for submittal of this report to the appropriate governing agencies. November 15, 2007 2 File No.: 07762-02 07-11-786 Earth Systems Southwest (ESSW) has striven to provide our services in accordance with generally accepted geotechnical engineering practices in this locality at this time. No warranty or guarantee is express or implied. This report was prepared for the exclusive use of the Client and the,Client's authorized agents. This report is based on the assumption that an adequate construction monitoring, and testing will be performed during tie nail rogram d signs aent d construcconsultat on phases to check compliance with these recommendations. Maintaining ESSW as the geotechnical consultant from beginning to end of the project will provide continuity of services. The geotechnical engineering firm providing tests and observations shall assume the responsibility of Geotechnical Engineer of Record. Should you have any questions concerning our report please give us a call and we will be pleased to assist you. Respectfully EARTHSY Craig S. Hill CE 3 8234 L'fR/csh/ajf Distribution: 4/Komar Investments URC File 2/BD Pile 9 EARTI-I SYS'I'L?MS SUU114WEST 1 F Earth S 'gid Southwest August 9, 2007 Komar Investments 5581 Daniels Street, Unit A Chino, California 91710 Attention: Mr. Zaven Hanessian 79-811 B Country Club Drive Bermuda Dunes, CA 92203 (760)345-1588 (800) 924-7015 FAX (760) 345-7315 File No.: 07762-04 07-08-735 Subject: Precise Grading of Pads A, B, C, D, E, F, G, H and J Project: Southwest Corner of Highway 111 and Jefferson Street Commercial Development La Quinta, California Reference: 1. Earth Systems Southwest, Design -Level Geotechnical Engineering Report, La Quinta Commercial Park, SWC Highway 111 and Jefferson Street, La Quinta, California, File No.: 07762-02, Document No.: 06-03-821, dated March 22, 2006. 2. Earth Systems Southwest Final Report of Testing and Observations Performed during Grading, Commercial Development near the Southwest Comer of Highway 111 and Jefferson Street, La Quinta, California, File No.: 07762-04, Document No.: 06-08-837, dated August 31, 2006. The purpose of this letter is to provide a written verification to the City of La Quinta that the precise grading of the building pads has been completed. During the precise grading testing was performed to verify compaction of the fills as placed. A formal report of testing and observations will be coming within the next 7 days. If you have any questions please contact us at (760) 345-1588. Respectively submitted, EARTH SYSTEW S' OUTHWEST Reviewed and A o ��$ESS/ONq p,\G S. h, CE 38234 � Phillip D. Clanton Craig S. Hill `tr'� UP. 03/31/09 rn Supervisory Technician CE 38234 oJ�T CAM- - Letter/pdc/rvg CALW Distribution: 4/Komar Investments l /RC File 2/131) File i-sry,e.2 4r4 • .�.ti�i .� '�.� ✓Z� 2 n ,+�...Is...~` ...w.-.._.. W.........-. -.... -n.__.. �... '-......-�.-.t...r.--.....-..-.....-.�.,-..,.,� Cr E, mm is t us i10 E,--' E N G 1 N E E R I N G August 10, 2007 Jesse Jimenez City of La Quinta Department of Public Works 78495 Calle Tampico La Quinta,'CA 92247 Subject: Civil Engineer's Pad Certification, Parcel Map 33960, Parcels 3 & 4 Komar Development Project: Plan Set No.: 07126 Parcel Map Number: 33960, Parcel 3 & 4 SDP No: 2006-874 Owner: Costco Komar Development Work Completed: August 8, 2007 Irvine Son Diev. Illlond Empire Palm Springs Dear Jesse, This is to verify that the locations and elevations of Buildings Pads A, B, C, D, E, F, G, H and J of Parcel Map 33960, Parcels 3 & 4, were field checked by Cornerstone Land Surveying and found to be in substantial conformance with the approved Precise Grading Plan. The results are as follows: Pad # Plan Field Difference A 56.3 56.4 +.1' B 56.8 56.9 +.1' C 56.8 56.7 D 57.3 57.2 E 57.0 56.9 F 57.8 • 57.7 G 57.9 57.8 H 59.6 59.5 J 59.6 59.5 If you have any questions please contact me. Sincerely, FUSCOE ENGINEERING. -M - _ Bob Strong, P.E. m VA 44 Project Manage Ems' Q C28300 ♦r , t�flV _nQ`�� t �• � ���OF�P%fir „ � �, t, 16795 Von Korman, Suite 100, Irvine, California 92606 tel 949.474.1960 n fax 949.474.5315 www.fuscoe.com P:\Proiects\687\Ol\Ens\Admin\Cert Letters\Ped Ceri.doc J . LA QUINTA , 07=2053 L4T.23;.2007 SPECIAL IN5PEGI ION'PROGRgM -ADDRESS OR LEGAL DESGEtIPTIONt PLAN CHECK NUNIBEF2 t?WNER'§ NAMES �:w N .Co�?o (Cla : �: ¢t • t1(11N1'15 1, as the :owner, or agent of.the owner'(contrabtcm may: lot employ the special inspector), certify that 1, orthe aMbItactlengineer of record; Will be jespot sibte f6r. employing thespeclat Inepector(s) as required by Unlfonn Bull'ding Code (U@C) Section iZol.i forthe construction project located at the site'(t�sted abo/v�e. UBC Section 1116;3;5. 'Signed �. J`/✓`. i, as tfie.engineer/architoct of record, certify that i have prepared the.fohowing special Inspection ' program a5 rt3qulredby UEC Section 10ti 3.5 for tfse construction project tocatted at the slte.listed;� shove: 1 N. 1 1: List ofwork:requiringspeciatinspeCtlon: {j ® Sons Compliance Pdorto Foundation'Inspec0❑ Field Welding � on ` ` L 1 NOT , . , i ®Structural Concrete Over 250t? PSI Nigh Siren BolUn � Prestressed Concrete ErrpanstonfEpoxyAnors �� Structural Masonry � 1...�. Q t)estgneCSpectleiJ.d OR:Flreproepng t` �� �� 3 ti 2 Nariit►(s) of (ndirtdual(s) or 8rrn(s) responsible far the special ►nspecUons listed etioya C. 3. Duties. of lhe#ecial (nspeetora fortlie work pi;teii-eboJe: ' A. 1,2,4,_. i' _ sAONof.I=Pc D, mBUIChickInWithftClly:nnd,proactitthatrcmdanllW:f' raPprovet' t tobaglnnlnpwor t Bin # City of La Quinta Building &I Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # 0 IF Project Address: A. P. Number: C�o - 96, 93, SS Owner's Name:NACv snucm Address: ;z3_C0.-P0,M+e_ T3N-zC.% It �07 Legal Description: Contractor: City, ST, Zip: 1Vekjp0r+ Serck, CA 9140 Telephone: Cl VA. Address: Project Description: A&0A',%,, City, ST, Zip: A, (A; Co4e Telephone: State Lic. # -City Lic. eftfArch., Engr., Designer: ACCL6 Address: AVe City, ST, ZiP: C01fA^41rG0_ f CA 00y6 - Tel 323- 71(-20e0 .7T State Lic. #: ........ Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: ftAI 00 5AN Sq. Ft.: _J# Stories: # Units: Telephone # of Contact Person: Estimated Value of Project:. APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACMG PERMIT FEES Plan Sets Plan Check submitted -;z/2 V Item Amount Structural CaIcs. Reviewed, ready for corrections Plan Check Deposit Truss CaIcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for correction sue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M1. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Review, ready for corrections/issue Developer impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees tip A dioidan of In7perialIrrigation District 8 1 -600 Avenue 58 • La Quinta, CA 92253 - www.iid.com 1TDPD-DDC May 15, 2007 Komar Investments, LLC Attn: Clint Knox 23 Corporate Plaza, Ste. 247 Newport Beach, CA 92660 Subject: Available Short Circuit Current Calculation for Komar Desert Center, for Building G, 79-765 Hwy. 111, La Quinta, CA for a Service Voltage 120/208V, 3 Phase, 1200A Panel. Deai Mr. Knox: r The available S4ort Circuit Current at the secondary terminals of the transformer is 32,600 Amps RMS Symmetrical at 208 volts. This is based upon the following information: 1) Transformer size: 500 KVA 2) Transformer impedance: 4 3) Primary voltage: 7,200/12,470Y volts 4) Secondary voltage: 12 08 volts 5) High -side KVA available: 185,000 KVA 6) Transformer connection:. Wye/Wye 7) No motor contribution to fault current. Please contact me should you have any questions, at (760) 398-5820. Thank You, Carlos Partida Project Manager CP/ms SLCFAULT.Ltr.KomarBuildingG s • Certificate of Occupancy 5 oF�9ti Building &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: 79-765 HIGHWAY 111 Use classification: RESTAURANT (MIMI'S CAFE) Building Permit No.: 07-2053 Occupancy Group: A - 3 Type of Construction: V —NON RATED Land Use Zone: CR Owner: SWH CORPORATION Address: 17852 EAST 17T" STREET SOUTH BUILDING STE #108 } City, ST, ZIP: TUSTIN, CA 92780 By: AJ ORTEGA Building Official Date: JULY 29, 2008 POST IN A CONSPICUOUS PLACE