BCOM2018-000278-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
4
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BUILDING COMMERCIAL/REMODEL
BCOM2018-0002
78364 HIGHWAY 111
604050046
CIRCLE K / INTERIOR REMODEL WITH SITE IMPROVEMENTS
$25,000.00
Applicant:
A & S ENGINEERING
28405 SAND CANYON RD
CANYON COUNTRY, CA 91387
MAR 0 5 2018
CITYOFLAOUINTA
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 Professions Code, and
my License is in full force and effect:
License Class- 6 CJQ, D40 License No.: 776E 6
IraM Corftg off:
OWNER -BUILDER 4LARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair any
structure, prior to its issuance, also requires the applicant for the permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he or she is exempt therefrom and the basis for the
alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:-
I 1
$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.)..
(� I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State
License Law does not apply to an owner of property who builds or improves thereon,
and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors' State License Law.).
(_) I am exempt under Sec. B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/5/2018
Owner:
CIRCLE K STORES INC
P 0 BOX 52085
PHOENIX, AZ.92253
Contractor:
ISLAND PETROLEUM BUILDERS INC
7470 SVL BOX
VICTORVILLE,. CA 92392.
(909)923-9373
Llc. No.: 776846,
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3'00 of the Labor Code, for the performance
0=of e w rk 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: INSURANCE COMPANY OF THE WEST Policy Number: WSD5020021
_ I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner ;o as to become subject to the workers'
compensation laws of California, and agree that, i I should become subject to the
workers' compensation provisions of Sectio:i 370 of the Labor Code, I shall forthwith
comply with t ose provisions.
pa I 0 ApIi
WARNING: FAILURE TO SECURE WORKERS' CO PENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100.D00). 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 Building Official 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 app9cation 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 ;tate that the above information is correct.
I agree to comply with all city and county orcinances and state laws relating to building
construction, and hereby authorize represen_atives of this city to enter upon the above-
mentioned roperty for inspection purposes.
Ma. os I �4Sig'r5atae (Applicant or Agent):
- 4-
— Date: 3/5/2018
Application Number: BCOM2018-0002
Owner:
Property Address: 78364 HIGHWAY 111
CIRCLE K STORES INC
APN: 604050046
P 0 BOX 520&5
Application Description: CIRCLE K / INTERIOR REMODEL WITH SITE IMPROVEMENTS
PHOENIX, AZ 92253
Property Zoning:
Application Valuation: $25,000.00
Applicant:
Contractor:
A & S ENGINEERING
ISLAND PETROLEUM BUILDERS INC
28405 SAND CANYON RD
7470 SVL BOX.
CANYON COUNTRY, CA 91387
VICTORVILLE, CA 92392
(909)923-9373
---------------------------------------------------------------------------=----------------
Llc. No.: 776846
Detail: INTERIOR REMODEL TO CUSTOMER SERVICE COUNTER AND COFFEE COUNTER LOCATIONS
WITH SITE AND RESTROOM ACCESSIBILITY UPGRADES.
THIS PERMIT DOES NOT INCLUDE ADDITIONAL SQUARE FOOTAGE. 2016 CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20
101-0000-42403
0
$26.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20 PC
101-0000-42600
0
$26.01
Total Paid for ELECTRICAL: $52.02
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIRE COMMERCIAL TI PC
101-0000-42420
0
$234.00
Total Paid for F' RE FEES: $234.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PARTITION
101-0000-42400
0
$78.02
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PARTITION PC
101-0000-42600
0
$143.56
Total Paid for PARTITION: $221.58
DESCRIPTION
ACCOUNT (
QTY
AMOUNT
PLAN CHECK DEPOSIT - COMMERCIAL
101-0000-42600
1
$125.00
Total Paid for PLAN CHECK DEPOSIT - COMMERCIAL: $125.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP
101-0000-42401
0
$52.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP PC
101-0000-42600
0
$52.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER SYSTEM INST/ALT/REP
101-0000-42401
0
$13.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER SYSTEM INST/ALT/REP PC
101-0000-42600
0
$13.00
Total Paid for PLUMBING FEES: $130.00
DESCRIPTION
ACCOUNT QTY
AMOUNT
.RECORDS MANAGEMENT FEE
101-0000-42416 0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: ' $10.00
DESCRIPTION
ACCOUNT QTY
AMOUNT
SMI - COMMERCIAL
101-0000-20308 0
$7.00
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $7.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
101-0000-42600
($5.00)
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $0.00
` ��!!•
-- curt .F,<,� DES T_'Wr ._.._.
-New SFD Construction:
PERMIT #
PLAN LOCATION:
_70
r
Project Address:
Garage SF.
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech '
APN #:
Email:
Fire Sprinklers SF
State Lic: City Bus Lic:
State Lic: us Lic:
I 'r !7
t
Applicant Name:
Address:No 7 1�u p 00 Rn
City, ST, Zip: C&L40D 40 ue-Z- CM q1 •
-7
Telephone:
Email:
S CSL G : AA
• Valuation of Project $
I
LG 600
Contractor Name:
-New SFD Construction:
Address:
Conditioned Space SF
City, St, Zip
Garage SF.
Telephone:
Patio/Porch SF
Email:
Fire Sprinklers SF
State Lic: City Bus Lic:
Arch/Eng Name: ` 5��� 6
Construction Type: Occupancy:
Address: Z
Grading:
City, St, Zip 7
Construction Type: Occupancy:
Telephone: / (�
l�
Bedrooms:
Stories:
# Units:
Email:
i
State Lic: us Lic:
I 'r !7
t
Property Owner's Name: Cl 6
New Commercial/ Tenant Improvements:
Address:
-Total Building SF
City, ST, Zip CDADIVA4
Construction Type: Occupancy:
Telephone: J^ ZIP-
Email:
78495 CALLE TAMPICO
LA QUINTA, CA M53
760-777-7000
#
Submittal
Req'd
•Rec'd
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
'
Grading Plan (PM 10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
'
Fire approval
City Business License
FI
PlanC,heck#
County of Riverside
DEPARTMENT OF ENVIRONMENTAL
404-88
P.O. BOX 7909 * RIVERSIDE, CA 92513-7909
STEVE VAN STOCKUM, DIRECTOR
MAR 0 2 2018
CITY OF LA QUINTA
V�"
&WTy
FOOD, ESTABUSHMENT PLAN APPRO DEVELOPMENT
Project Name Circle K
Plans Submitted by
Owner Circle K
Date 118117
Address 78364 Hwy 111, La Quinta CA
A & S Engineering Phone 661-250-9300
Ad d ress 255 RI n m.m St' Corona,.CA- 92M,! Phon&
The. plans; are. now approvedsubjects to then conditions- listed below and the.:attachad compliance. -sheet.
Th-islai=roijal is, For the. remodol"of the- customer self'se rvice area --only.
1. All drain lines to be rigid to floor sink with an minimum one inch air gap
2. The hand sink is to have soap and towel dispensers securely installed. The hand sink
to have .'plumbed 'hotand:cold water.
3. The walk in
, unit; to beself-contained unit,,o'r the con'densateis to &
ain into an
.,approved-�IoDr!sink.-Th�walk'musthav6'318' radius cove b6se, fn:shes-ivill
be
ev-Aivated. onsite.
CONSTRUCTION INSPECTIONS_ Conta ct th e. P1 an Checker for a Peel im i h ary 'Inspection whin construction is;
approximately 80%. complete, with plumbing, rough ventil'afiori, and rou'g*'_A,_'
quiorn,_eritinst' installed. . bequestfor inspection.
-should be made! at least five (514vrkin . 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 insPe dtiDnl;shoul.d be made. -at least five (5)-working.,days imadvance.
I
PLANS -CHECKED BY Tracey Ford Pho.ne 760-863-82-87
I acknowledge the corrections noted herein and as indicated on the plans and agree to incorporate them during
construction:
Signature Date
Company Name
Comm-, Hemet. Indio" MurrieM Pa1mSprings Rivem&-wesu. Riverside -Ease
2275S.; - Main SC9204 .;,BOOS: Sanderson #200' 47=950 Arabia St "A 3874a'.SkyCan ' yenM. '544,S:PasedDbr-etea 4.065-0," eirc.lL
e 3880 mon St.
-,-Corona�,CeRSR :,HcmmCa 92545 lDdia;C�92201 'Murrieta;,,Ca.�25A3 'PalmSphngs,Ga Riversick. Ca'92503 -Ri;verside,Ca-92501
+(951) 273-9140 .(951) 766-2824 Q6O)'Sf33-W87 k(951) 461}0284 92264 � 951z 358-5172 (951)1955=8982
760-320-1048
Office Locations 9 Blythe * Corona * Hemet e Indio * Murrieta 9 Palm Springs * Riverside
Phone (888)722-4234
www.rivcoeh.org
County of Riverside
DEPARTMENT OF ENVIRONMENTAL. HEALTH
P.O. BOX 7909 • RIVERSIDE, CA 92513-7909
STEVE VAN STOCKUM, DIRECTOR
FOOD ESTABLISHMENT PLAN APPROVAL NOTICE
Plan Check # 40488
Project Name Circle K
Plans Submitted by
Owner Circle K
Date 1/8/17
Address 78364 Hwy 111, La Quinta CA
A & S Engineering Phone 661-250-9300
Address 255 Rincon St. Corona CA 92879 Phone
The plans are now approved subject to the conditions listed below and the attached compliance sheet.
This approval is for the remodel of the customer self service area only.
1. All drain lines to be rigid to floor sink with an minimum one inch air gap
2. The hand sink is to have soap and towel dispensers securely installed. The hand sink
to have plumbed hot and cold water.
3. The walk in unit; to be self-contained unit, or the condensate is to d;-ain into an
approved floor sink. The walk must have 3/8" radius cove base, finishes will be
evaluated onsite.
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 Tracey Ford Phone 760-863-8287
I acknowledge the corrections noted herein and as indicated on the plans and agree to incorporate them during
construction:
Signature
Company Name
Date
Corona Hemet
Indio
Murrieta
Palm Springs
RiverEide-west Riverside -East
2275 S. Main St #204 800 S. Sanderson #200
47-950 Arabia St "A"
38740 Sky Canyon Dr.
544 S. Paseo Dorotea
4065 County Circle 3880 Lemon St.
Corona, Ca 92882 Hemet, Ca 92545
Indio, Ca 92201
Murrieta, Ca 92563
Palm Springs, Ca
Riversi& Ca 92503 Riverside, Ca 92501
(951) 273-9140 (951)766-2824
(760) 863-8287
(951) 461-0284
(951) 955-8982
922649SIVEm
760-320-1048C
Office Locations • Blythe • Corona • Hemet • Indio • Murrieta • PaIXUrWA
i0krerside
Phone (888)722-4234 CITY OF LA QUINTA
www.rivcoeh.org COMMUNITY DEVELOPMENT
RECEIVED
420,kCHELLA VALLP, V %VArb,,R DISTRICT
65.995 Avenue
nue 52 MAR i) 2 201 8
COUPhiellp, California 92236
(760) 398-2651 CITY oF LA
I LA
�DQUIE'Lloptq&,
AP PLICATION FOR WASTEWATER SOURCE COWRCOfhM
01, MAN' APPROVAII, rNTY
APPLICAt-Ir, Stibmit this farn N�illi a COPY 01'a SCALD iiiiii plan - 1' 20 to I' CY SCAIA) drawn in District specillmioni. A f. -C is ir4u;fcd
wtl;n tlic.appikiltion ;- 3ubrniutd Check rnusfbc rna-J- payalilt in (ht Coachella YWIcy, Water Visinct Appfuval of this application O.A ' 11 rrrmin valid fora perifid.jmiul to
cAmcd one (7) ycm lium doze orpa}-,iicoi. NOTE: ALL USERS DISCHARG INS FAT, OIL, ANWOR GREASF, LOCATED It; A Mjrj I-.Sjffj'E BI fj I nNr.
REQUIUCA SEPARA MAMSEWERAINEFOR(AF.A41P. CN-Wl3Source (.',onI,Oj will
IAYPM the C%poud grease plumbing and the inslatted interceptor. Picnic call (760) 398.2661 0536 48.houm In adviince to siliMuIr ifzpectjarljj,1L
Xgvli, C41111,40or. conttrcl Pemon
AcIdt.-vs Cily $lalc Zip
,8, VO F 6A tfo CA -040 &AZOA0 cj&ivod (0W
Telephoi:
4 Flo, ..In Qc
0"rcrAddress
city StamAh
E.. 0J ct
j Ic)cpkonc
Jot Site AddressCity
—7 34Ht�l(
awirim Typc Doing I3I]1ir4js.rz,
ao m t+R-r
SUIT: NU PLANS MIA. HE At'? ROVE0 tjNTL "Till" APPLICAHOSist. RE PA IF).
-0.NII%VTVANVP1.AN CHECKFEF.S A
'Cg Qc.a(Cgat{ruei:oa; Resr� de) iV_
t4—. 4,`c1woP —2tYL--7. CmI inp Totvcr S)
lbr
VehicIr Ner, . ice:
'Wand 'French
�Vor- Food Service!
bay.-, drain;
W41v Softener
F Galt4gi: Gntial(s)
Roil Over., - J---jSCrVict bagi)
Spill Contaiumm (56i'm
F-1)
Stating Capacity (fticrial Ltcrrad
17AIJGualit
'kinnip %ilh Misters orlIcurn
flat vditims ith Fczd Service
lccnifIia; l have icLd cihaj all mforrrtttin is euncU Iiin&fnxndihxI the let %nouniLl
based On m, drelmialoir. of tillormation On the loart and ilial -mima or.nn wion 4
d;scodcd. irook picked UDAilhis sixty (60LO clumand 1hitmlimna
'w
lia, becrt teceivtz! pd. plp%�h�S Ile,
21ZA
FOR DISTRICIF USF ONL%
Crease In"lleptof 1 Y iflrcuc 1w,ccP101 w4ivco
::::8
C,-nnu� ju!1xWt- pt ,
Urn Trip
RcpleccmKni
Si!,c
kE"I'll,i RKS-
NO 9,E66rAek A -n v, -r- Ty P-6 warms so rn�iry :y IA L t ow& D
'.Set fUinerks
title
jtnalw:
ikTm 2 i , K6, 5714
too"*� t {
ER 0
.:En i ne.e -i ; i'.r c .
Planning Engineering Project Management
28405 Sand Canyon Road, Suite "B", Canyon Country, CA 91387 Ph: 661.250.9300 Fax: 661.250.9333 4J
February 21; 2018-
City
018-City of La Quinta '
Design & Development Department
78-495 Calle Tampico
` La Quinta, CA 92253
Attn: Permit Services '
Re: Circle K Site #2705911 -
- 78-364 Hwy 111
La Quinta, CA 92253
Plan Check #BCOM2018-0002 '
Dear Permit Service; '
' x
Attached please find the following documents our office would like to respectfully submit to ,
• your office for review & in order to obtain permit/approval for the proposed .
upgrades/modifications to be performed at subject site.
• Original plan review set '
Correction letter with responses -
• • Two (2) revised sets of plans
• One (1) set of Assessors site/floor plan '
• County of Riverside Health Approval letter ,
Upon receipt & review of mentioned documents, please advise of any updates on this `
project as soon as available, feel free to contact me at ajaraPasengineer.com s:zould you
have any questions or need additional information.
Thank you, greatly appreciate your assistance on this project & look forward to your
department's approval.
Sincerely,
Abi Jara. i RECEIVE'
FEB 2 2 2018
CITY OF LA Q11lNTA
C®MMVURl119;� D�VE. LoKfi NT j