12-1035 (RC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
` Application Number:
12-00001035
Property Address:
79845 HIGHWAY 111 STE
APN:
600-020-034- -
Application description:
REMODEL - COMMERCIAL
Property Zoning:
COMMERCIAL PARK
Application valuation:
72000
4 VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 11/21/12
Owner:
101 P6K PORTFOILO KDP LLC _
79845 HIGHWAY 111
PNOVq LA QUINTA, CA 92253
1011 ,
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
LicenseCl)ass: B C10 Licens 669871
Date: ( S ' ZContract
�r
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—) 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.).
1 _ 1 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.).
1 _ 1 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
Contractor: CITY OF LA QUINTA
TIER ONE FINANCEDEPr
2863 BROKEN ARROW STREE
NORCO, CA 92860
(951)377-6344
Lic. No.: 669871
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of'the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier HARTFORD UNDER Policy Number 7SWECDS3926
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 ode, I shall forthwith comply with those provisions.
Date:�?-'7/Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($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 county to enter upon the above-mentioned property
/I inspection purposes.
or Agentl:
Date: f6tgnature (Applicant : !'
Application Number . . 1. 12-00001035
Structure Information
Construction Type . .
. . . TYPE V, UNPROTECTED
Occupancy Type
BUSINESS <50
Other struct info . .
. . . CODE EDITION
2010
FIRE SPRINKLERS
YES
OCCUPANT LOAD
15.00
'
-----------------------------------------------------------------------=----
1ST FLOOR SQUARE FOOTAGE
1495.00
Permit . . .
BUILDING PERMIT
Additional desc . .
Permit Fee . . . .
513.50 Plan Check Fee
333.78
Issue Date . . . .
Valuation
72000
Expiration Date
5/20/13
Qty Unit Charge
Per
Extension
BASE FEE
414.50
22.00 4.5000
----------------------------------------------------------------------------
THOU BLDG 50,001-100,000
99.00
Permit . . .
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . .
67.80 Plan Check Fee
16.95
Issue Date . . . .
Valuation . .
. . 0
Expiration Date . .
5/20/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
20.00 .7500
PER ELEC DEVICE/FIXTURE 1ST 20
15.00
84.00 .4500
-----------------------------------------------------------------------------
EA ELEC DEVICE/FIXTURE >20
37.80
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . . . .
61.50 Plan Check Fee
15.38
Issue Date . .
Valuation . .
. . 0
Expiration Date
5/20/13
Qty' Unit Charge
Per,
Extension
BASE FEE
15.00
6.00 4'.5000
EA MECH VENT INST/ DUCT ALT'
27.00
3.00 6.5000
EA MECH VENT FAN
19.50
Permit . . .
PLUMBING
Additional desc
'
Permit Fee
76.50 Plan Check Fee
19.13.
LQPERMIT "
LQPERMIT
Application Number . . . . .
12-00001035
Permit . . . . . . PLUMBING
Issue Date . . . .
Valuation
0
Expiration Date 5/20/13
Qty Unit Charge Per
Extension
BASE
FEE
15.00
8.00 6.0000 EA PLB
FIXTURE
48.00
1.00 7.5000 EA PLB
WATER HEATER/VENT
7.50
1.00 3.0000 EA PLB
WATER INST/ALT/REP
3.00
1.00 3.0000 EA PLB
FIXTURE DRAIN/VENT REP/ALT
3.00
----------------------------------------------------------------------------
Special Notes and Comments
11495 -SF INTERIOR T.I. - DENTAL
OFFICE.
TYPE V -B CONSTR. "B" OCCUPANCY.
15
OCCUPANTS. 2010 CODES:
----------------------------------------------------------------------------
Other Fees . . . . . . . . . ACCESSIBILITY PLAN REVIEW
33.38
BLDG STDS ADMIN (SB1473)
2.00
ENERGY REVIEW FEE
33.38
Fee summary Charged
------------- - --- ----------
Paid Credited
---------- ---------- ----------
Due
Permit Fee Total 719.30
.00 .00
719.30
Plan Check Total 385.24
.00 .00
385.24
Other Fee Total 68.76
.00 .00
68.76
Grand Total 1173.30
.00 .00 1173.30
0
!�+jede
Bin. #
oty Of, La Quif1ta
Building a Safety Division
P.O. Box 1504,78-495 Cafie Tampico
La..Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Per wf #
Project Address: / �0 I
Owner's Name:. AS!✓ U� �4
A. P. Number.
Address: ¢s
Legal Descdp6W.
Contractor.:
City, ST, Zip:A
Telephone:
Address: Ll0 d rK
Project Description: n S C
City, ST, Zip:
—711
Telephone: 2
State Lic. # : 4d City Lic #;
Arch., Engr., Designer: 1*
Address:
City, ST, Zip:
Telephone:SLI"
State Lic. #: 11 V0 63
Name of Contact Person: r � -Al
Construction Type:. —� Occupancy:
Project type (circle one): New Add'n Al Repair Demo
Sq. Ft : LW A p #Stories: #Units:
Telephone # of Contact Person:
Estimated Value of Project #Z C
APPLICANT: DO NOT WRITE BELOW THIS UNE
Y
Submittal
Req'd
Recd
TRACIMG
PERMIT FEES
Pim sett
Plan Cheek submitted/;
l o
I Amount
Structural Cates.
Reviewed, ready for correctionst
V4
Plan Check Deposit. .
Truss Calcs.
Called Contact Person n/l
!D `
Plan Check Balance _
Title 24 Cates.
Plans picked up
l�
Constmcdon
Flood plata plan
Plans resubmitted.. '
Mecha�iieal
Grading plan
V Review, ready for correctio a
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.NLL
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE.-
''• Review; ready for correetionvissue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit Issue
-f?kt,
School Fees
Tota, Permit Fees Ill 3D
/0%3 y f ice NS�IP44-4811z. 1D4•
yc�,ru �a..d•t-s�� .
TA-ty, 4gkrav�a
P.O. Box 1504 '
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
To: Greg Butler, Building & Safety Manager
From: Les'Johnson, Director -Planning
Permit #:
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
To CDD:
S 4�--
Due Date:
Status:
Building Pians .A pprov .t
(This is an approval to issue a Building Permit)
The Planning Department has reviewed the Building Plans for the following
project:
Description: Z4� ,
7A
Address or General Location: '%� 841 !�� /D/
Applicant Contact: 3r'lpa, a.4 v- $1038
The Planning Department finds that:
❑ ...these Building Plans do not require Planning Department approval.
'z ...these BuildingPlans
are approved by the Planning Department.
❑ ...these Building Plans require corrections. Please forward a copy of the
attached corrections to the applicant: When the corrections are made
please return them to the Planning Department for review.
Les Johnson, ki ector-Planriing Date
tr
U
IN COOPERATION WITH
NOv 0 S 2012CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION
UJohn R. Hawkins ~ Fire Chief
210 West San Jacinto Avenue - Perris, CA 92570
(951) 940-6900 - www.rvcfire.org
PROUDLY SERVING THE
UNINCORPORATED AREAS
OF RIVERSIDE COUNTY
AND THE CRIES OF:
BANNING
BEAUMONT
CALIMESA
CANYON LAKE
COACHELLA
DESERT HOT SPRINGS
EASTVALE
INDIAN WELLS
INDIO
JURUPA VALLEY
LAKE ELSINORE
LA QUINTA
MENIFEE
MORENO VALLEY
PALM DESERT
PERRIS
RANCHO MIRAGE
RUBIDOUX CSD
SAN JACINTO
TEMECULA ,
WILDOMAR
BOARD OF
SUPERVISORS:
BOB BUSTER
DISTRICT 1
JOHN TAVAGLIONE
DISTRICT 2
JEFF STONE
DISTRICT 3
JOHN BENOIT
DISTRICT 4
MARION ASHLEY
DISTRICT 5
November 7, 2012
RE: TENANT IMPROVEMENT PLAN CHECK -Non Structural
LAQ-I2-TI-057 Blu Oasis Dental 79-845 Hwy 111 #101 La Quinta, CA
You have been issued a release for a tenant improvement on an existing building. THIS IS NOT
AN OCCUPANCY PERMIT.
It is prohibited to use/process or store any materials in this occupancy that would classify it as an
"H" occupancy per Sec. 307 of the 2010 CBC.
THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO INSPECTION:
Install door hardware and exit sign3 as per Chapter 10 of the CBC.
A minimum 2AIOBC Fire Extinglnsher, (State Fire Marshal Approved) must be mounted in a
visible location within 75' walking distance from any point in your building or suite. Fire
extinguishers can be installed by a licensed extinguisher company with a State Fire Marshal
service tag attached to the extinguisher, or purchased from a retail store with a sales receipt
attached. A licensed fire extinguisher company must service extinguisher yearly.
All breakers must be labeled and a clearance of 36 inches must be maintained around the panel
at all times.
Approved suite addresses shall be placed in such a position to be plainly visible and legible from
the street. Said numbers shall contrast with their background.
An approved audible interior notification alarm device shall be provided in approved location. A
C-10 licensed contractor must submit plans, designed in accordance with NFPA 72 to the Fire
Department for review and approval prior to,installation
A durable sign stating "This door to remain unlocked during business hours" shall be placed on
or adjacent to the front exit door. The sign shall be in letters not less than one inch high on a
contrasting background.
Provide key(s) to the tenant space for inclusion in the main building Knox Box. Key(s) shall
have durable and legible tags affixed for identification of the correlating tenant space. Key(s)
shall be provided at time of fmal inspection.
As it may be necessary to maintain proper fire sprinkler protection due to constructions changes,
fire sprinkler system plans for the tenant improvement area may be required to be submitted to
the Fire Department for review. ,
Applicant/installer shall be responsible to contact the Fire Department to schedule inspections.
A re -inspection fee will be required if more than one (1) inspection is necessary. Requests for
inspections are to be made at least 72 hours in advance and may be arranged by calling (760)
863-8886.
All questions regarding the meaning of these conditions should be referred to the Fire
Department Planning & Engineering Staff at (760) 863-8886.
Sincerely,
By:
Jason Stubble
Fire Safety Specialist
Nash Sourial, DDS
r
Blu Oasis Dental
79845 Hwy 111.#101
La Quinta, CA 92253
(3.23) 459-2114
O cto be r.25,,'2012
Dear City of La Quinta,
This letter is to inform,you of,my new contractor Kent Cozart, of:
Tier One Construction
2863 Broken Arrow St.
Norco, CA 92860
(951) 377=6344
He will be submitting my plans and pulling permits for my dental office Blu Oasis Dental.
Sincerely,
Nash Sourial, DDS
M-
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Certificate of Occupancy
Tdit:
4
IF1006WAT4D�
19Q L
7
'
0 Community p p Development Department
3
This Certificate is issued pursuant to the requirements of Chapter 1 Section 111 of the California
k
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
j
construction and/or use.
F
r
k
L
t
BUILDING ADDRESS: 79-845 HIGHWAY 111, STE 101
G
4
Use classification: PROFESSIONAL OFFICE — BLU OASIS DENTAL Building Permit No.: 12-1035
Occupancy Group: B Type of Construction: VB Land Use Zone: CR
i
Code Edition: 2010 Sprinkler Installed: YES Occupant Load: 15
6
Owner of Building: P6K PORTFOLIO KDP, LLC.
Address: 79-845 HIGHWAY 111
City, ST, ZIP: LA QUINTA, CA 92253
�+- By: AJ ORTEGA
Building Official Date: APRIL 10, 2013
k
POST IN A CONSPICUOUS PLACE
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