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BDEM2018-0006
78-495 CALLE TAMPICO DCU LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Permit Type/Subtype: DEMOLITION/COMMERCIAL/OTHER Application Number: BDEM2018-0006 Property Address: 78987 HIGHWAY 111 APN: 643020050 Application Description: PLANET FITNESS / INTERIOR DEMOLITION ONLY [NO OCCUPANCY] Property Zoning: Application Valuation: Applicant: ► L ARTAVIA, MARYANN tJ�t 7325 VINTON AVE # 8 SEP 2 5 2018 -70 LOS ANGELES, CA 90034 !` VOWUNTl "Mirml 1prin.",,mpp LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 {commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: Q License No.: 970950 Date: — �4tic_ " OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). L) I, as owner of the property, aril exclusively contracting with licensed contractors to construct the project. (Sec. 70444, 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,). (J I am exempt under Sec. . BAP.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 tender's VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/25/2018 Owner: OD LA QUINTA 80618 DECLARATION AVE INDIO, CA 92253 Contractor: J CHASE BUILDERS INC 3508 WOODLAND WAY CARLSBAD, CA 92008 (609)462-4234 Llc. No.: 970950 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the labor Code, for the performance of the work for which this permit Is issued. _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: EXEMPT Policy Number: ! certify that in the performance of the work for which this permit is issued, I shal I n employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, i shall forthwith comply with those provisions. Date: Applicant: N$NG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF P£NSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, 3EST, 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 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 city to enter upon t e above- mentionneed p ope for inspection purposes. /] pate: I �� Signature (Applicant or Agent): Date:. 9/25/2018 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: ARTAVIA, MARYANN 7325 VINTON AVE # 8 LOS ANGELES, CA 90034 BDEM2018-0006 78987 HIGHWAY 111 643020050 PLANET FITNESS / INTERIOR DEMOLITION ONLY [NO OCCUPANCY] Owner: OD LA QUINTA 80618 DECLARATION AVE INDIO, CA 92253 Contractor: J CHASE BUILDERS INC 3508 WOODLAND WAY CARLSBAD, CA 92008 (609)462-4234 Llc. No.: 970950 Detail: INTERIOR DEMOLITION OF EXISTING TENANT IMPROVEMENTS. THIS PERMIT DOES NOT INCLUDE OCCUPANCY OR CONSTRUCTION, OR ALTERATION TO EXISTING LOAD BEARING OR LATERAL RESISTING CONSTRUCTION. 2016 CALIFORNIA BUILDING CODES. DESCRIPTION ACCOUNT CITY AMOUNT Credit Card Fee 101-0000-43505 0 $2.85 Total Paid for Credit Card Fee: $2.85 DESCRIPTION ACCOUNT CITY AMOUNT DEMOLITION, INTERIOR 101-0000-42404 0 EACCOUNT $39.01 DESCRIPTION CITY AMOUNT DEMOLITION, INTERIOR PC 101-0000-42600 0 $104.55 Total Paid for DEMOLITION: $143.56 DESCRIPTION ACCOUNT CITY AMOUNT RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 DESCRIPTION ACCOUNT CITY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 �T a « � — cenn ofibr DesEkr ---- PERMIT # PLAN LOCATION: Project Address: 78-987 HIGHWAY 111 Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech APN#: DEMOLITION OF AN EXISTING RETAIL SPACE. MINOR USE CHANGE APPROVED 9/6/18, CHANGE IN OCCUPANCY, NO CHANGE IN AREA. DEMOLISH INTERIOR PARTITIONS, FINISHES AND FIXTURES. REMOVE EXISTING ELECTRICAL AND LIGHTING SYSTEMS. REMOVE MECHANICAL SYSTEMS AND CONTROLS.REMOVE TOILET PLUMBING AND FIXTURES. Applicant Name: ��(k�s01Pc Address: 7325 Vinton Ave #8 City, sT, zip: Los Angeles, CA 90034 Telephone: (310) 876-1141 Mai ;� Email: Valuation of Projects 25,000.00 Contractor Name: J CHASE BUILDERS Address: 3508 WOODLAND WAY city, st, zip CARLSBAD, CA 92008 Telephone: (609) 462-4234 Email: darren@dmachulsky.com State Lic: 970950 City Bus Lic: New SFD Construction: Conditioned Space SF Garage SF Patio/Porch SF Fire Sprinklers SF Arch/Eng Name: Robert J. Sargenti Construction Type: Occupancy: A 3 Grading: Address: 461 From Road city, st, zip Paramus, NJ 07652 Telephone: (973) 253-9393 Bedrooms: Stories: # Units: Email: rsargenti@sargarch.com State Lic: C-31054 City Bus Lic: Property Owner's Name: Jack Tarr New Commercial errant Improvements MAO - Total Building 14,926 SF Address: City, ST, zip Construction Type: I I B Occupancy: FITNESS CENTE Telephone: ( Email: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 d L r - t Recording. B`equested By r First ► Mericgn -fitiq Company Recording Requested By and When Recorded Mail To: Stradling Yocca Carlson & Rauth 660 Newport Center Drive, Suite 1600 Newport Beach, California 92660 Attn: Bruce C. Stuart, Esq. _ _ MAIL TAX STATEMENTS TO: OD La Quinta, LLC 30240 Rancho Viejo Road, Suite B San Juan Capistrano, California 92675 DCC . ss 2C�PJ5--O'�T39G2; 09/20/2003 06:00A Fee:33.00 Page i of 3 Recorded in 6fficiai Records County of Riverside Larry W. Ward illAssessor, County Clerk $ Recorder fI III Illlll II Illlll Illllll ll IllIIIII III Illli fill IIII � �emommmmm see��eee�� Documentary Transfer Tax $0 �D The Grantor and the Grantee in this Conveyance are comprised ofthe same parties who continue to hold the same proportionate interest in the property, R&T Section 11923(d). C44 GRANT DEED FOR VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Washington-111, Ltd., a California limited partnership ("Grantor"), hereby grants to OD La Quinta, LLC, a Delaware limited liability company, that certain real property, together with certain improvements thereon, Iocated in the City of La Quinta, County of Riverside, State of California more particularly described on Exhibit A attached hereto. IN VMMSS WHEREOF, Grantor has executed this Grant Deed as of Septembev/L 2005. WASHTNGTON 111, LTD., a California limited partnership By: Old Anchor, Inc., a California corporation Its: Managing General Partner By: Name: H.Oldham Title: President ECTIVED SEP 11 2018 DOCSOC/1127549v1/014474-0003 CITY OF LA GUINTA CCMMUN11 11- 2--VE OPYEI T STATE OF CALIFORNIA } ss COUNTY OF ) On 3 2005 before me, Notary Public, persona y appeared pi (or prm d to me on the basis of satisfactory evid nc4 to be the person(s) whose names(e) is/aye subscribed to the within instrument and acknowledged to me that he/sh*khey executed the same in his/he%47heir authorized capacity(iss), and that by his/herAkeir signatures) on the instrument the person(&), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal a ` me - SIGNATURE OF NOTARY W --ram A A' cC wtLv ��{,, �,,�,_.� k'" # ] 51S9�i4 Noftvv pub')IC - C01110r,110 Avc%rdn, 60res Muy 13.20 DOCSOM 127549v1/014474-0003 EXHIBIT A TO GRANT DEED LEGAL DESCRIPTION OF THE REAL PROPERTY Real properly in the City of La Quinta, County of Riverside, State of California, descn-bed as follows: PARCEL 6 AS SHOWN BY PARCEL MAP 32683-1, ON FILE IN BOOK 213, PAGES 53 THROUGH 55 OF PARCEL MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA. DOCSOC/1127549v 1 /0I4474-0003 Froin:W Legal 9164829780 03/21/2014 08:51 #015 P.002/003 Lr. Amendment to Certificate of Limited Partnership (LP) To change Information of record for your LP, fill out this form, and submit for filing along with_ A $30 filing fee. — A separate, non-refundable $15 service fee also must be Included, if you drop off the completed form. FILED ;Y-- -%Mewy Stift of C.aCi# alwo MAR 14 2014 Items 3-7: Only fill out the information that Is changing. Attach extra pages if you need more space or need to include any other matters. i CL This Space For office use only For questions about this form, go to www.sos.ca.gov/buslnessibel'r'iing-tips.htm (D LP's File No, (Issued by CA Secretary of State) I © LP's Exact Name (on file with CA Secretary of State) LIMITED PARTNERSHIP New LP Name Proposed New tP Name The new LP name; must end with: "Limited Partnership," "LP," or "L.P.." and may not contain "bank," "insurance," "trust," "trustao," Incorporated," lint.," "corporaiiun," or "corp." Now LP Addresses O a. 30240 Rancho- Viejo Road, Suite 6 _ San Juan Capistrano cA 92675 Street Address of Designated Ofoo in CA City (no abbreviarions) state zip b. _ Marling Address of LP, Ifdi ferent from 4a City (no abbreviations) State zip New Agent/Address for Service of Process (The agent must be a CA resident or qualified 1505 corporation in CA.) Q a. STEVEN MILMOK, ESQ.- Agent's Name b. 180 Newport Center Drive, Suite 230 Newpo_rt Beach K; cA 92660 Agent's Street address (if agent Is not a corpora don) city (no abbreviations) state _ zip General Partner Changes a. New general partner: Name Address City (no abbreviations) state zip b. Address change: Name New Address City (no abbreviations) State zip c. Name change: Old name: d. Name of dissociated general partner: -OLD ANCHOR, INC. New name: Dissolved LP (Either check box a or check box b and complete the Information, Note: To terminate the LP, also file a Certificate of Cancellation (Forth LP-4(7). available at www.sos,.ce.govtbusineGG/be/forMG.htm,) © a. 0 The LP Is dissolved and wrapping up its affairs. b. 0 The LP is dissolved and has no general partners. The following person has been appointed to wrap up the affairs of the LP: _ e NamAddress City (no a44reviptions) state zip Read and sign below: This form must be signed by (1) at least one general partner: (2) by each person listed In Item $a; and (3) by each person listed in item tad if that person has not filed a Certificate of Dissociation (Form LP-101). If item 7b Is checked, the person listed must sign. If a trust, association, attorney -In -fact, or any other person not listed above is signing, go to www,sos-ca.gov/business/be/filing-tlps.htm for more Information, If you need more space, attach extra pages that are 1-sided and on stands letter -sized paper (8 112" x 11"). Ail attachments are part of this amendment. Signing this document affirms under penalty of I erjury that the a ated facts are true. Jack Tarr, Mgr of JTDC , LLC 3 Doi iqn hers J Prfnt your name here Oafs Make checklmoney order payable to: Secretary of State Upon filing, we will return one (1) unrenlfied copy of your filed document for free, and will certify the copy upon request and payment of a $5 certification fee. your name here By Mai! Secretary of State business Entities, PA. Box 944225 Sacramento, CA 84244-2250 Drop -ON Secretary of State 1500 11th Street, 3rd Floor Sacramento, CA 95814 Corporauofs Code g 15902-02 LPQ (REV 0112013) 2013 Calffornla Secretary of State www-sos.w-9Qv1businessibe From:C8P LeAal 9164829780 03/21/2014 08:51 #015 P.003/003 r.,r endment to Certificate of Limited Partnership - Form LP-2 Washington-I'11, Ltd., a Califomia limited partnership Filing Number 199609400002 Page 1 Under the Amendment to Certificate of Limited Partnership filed on July 23, 2002, Jack H. Oldham is hereby removed as the person authorized to wind up the affairs of the Limited Partnership (Item H of said Amendment). JTDC, LLC is hereby designated as the sole Managing General Partner. ( q C(( 0�(`f 0000 Z C;\USERS\DFARAGALLI\DOCUMENTS\LEGAL\7625.D01\DOCS\WASHINGTON-111, LTD\LP-2 ATTACHMENT,W06-2014 DOM City of La Quinta Design and Development Department 78-795 Calle Tampico LaQuinta, CA 92253 To Whom it May Concern: PF Baseline Fitness, LLC dba Planet Fitness will operate within the Premises as Fitness Center. Our gym will be open 24/7 to provide facilities to all members despite their busy schedules. We will employ approximately 12-15 employees. We already operate in the state of California so we will be adding this location to the existing sales tax permit and state business registration. We will need to complete the County of Riverside business registration and the City of La Quinta Business License. The premises will contain typical fitness equipment, massage beds and chairs, as well as tanning rooms. Thank you for your consideration and prompt attention to this matter. We look forward to opening and operating a Planet Fitness in the City of La Quinta. Warm garVi 5co erns VP of Development 314-346-1826 sbernstein@pfbaseline.com RECTIVED SEP I Z zr ; OD La Quinta, LLC C/O Jack Tarr Development Company 30240 Rancho Viejo Road Suite B San Juan Capistrano, California 92675 September 9, 2018 PFBaseline Fitness, LLC 3475 56t' Street South Suite 200 Fargo, North Dakota 58104 Attention: Mr. Scott Majkrzak Re: 78-987 Highway 1 l 1 — La Quinta, California 92253 Dear Mr. Majkrzak: Please consider this Fetter as OD La Quinta, LLC authorization for PFBaseline Fitness, LLC to apply for a Demolition Permit for the space located at 78-987 Highway 111, La Quinta, California 92253. Very truly yours, OD La Quinta, LLC By: Washington- 111, Ltd., a California limited partnership Its: Managing Member By: JTDC, LLC, a Delaware limited liability company Its: General P By: Jack Tarr Its: Managing Member R E C E IVED, SEP 11 2018 CITY O I.A OUINTA C®I}AMUNIP'1 CcVE? CQ!�Irl+IT Building Permit Number: Project Description: New Construction Exempt: ❑ (Materials may contain hazardous wastes and are not subject to recycling provisions) Construction Debris Management Plan Plan Submittal Datel 9/7/2018 Job Site Owner's Name Number, Street, or PO Box City, State, Postal Code Owner's Phone Number Owner's E-Mail Address Project Manager's Name Project Manager's Phone Number Project Manager's E-mail Address Builder / Contra Number, Street or PO City, State, Postal C Project Square City Approval By Date of City Approval Materials To Be Discarded: Product Trash Asphalt Brick/Block Cardboard Commingled Concrete Drywall Donated / Reuse* 78987 Hwy 111 CD La Quinta LLC 30240 Rancho Viejo Rd San Juan Capistrano, CA. 92675 949-795-1401 John Ranous 310-880-7859 lah natior�wFdegerrnits.cam TBD (c/o John Ranous) Approx. 14,925 sq ft Renado Gouldlock-DEC/Burrtec Waste' L Tons 60.001 Not recyclable 0.00 Recyclable 0.00 Recyclable 0.00 Recyclable 66.00 Recyclable 7.25 Recyclable 0.00 Recyclable Product Masonry (broken) Plaster Scrap Metal Tile (floor) Tile (root) Wood Landscape Debris RECEIVED SEP 11 2018 CITY LA QU,NTA Tons 0.00 Recyclable 15.00 Recyclable 0.00 Recyclable 1.50 Recyclable 0.00 Recyclable 26.50 Recyclable 0.00 Recvclable *Describe Items Totals: Recycle Trash Projected Diversion: 116.3 60.0 65.96% I understand It is the property owner's responsibility to submit copies of weight tickets or receipts to the District Environmental Coordinator as these hauls occur. I hereby certify that completion, implementation and adherence of the Debris Management Plan (DMP) for the above named project shall guarantee that at least 65% of the jobsite waste is diverted from landfilling. The remaining material will be recycled or reused. I will divert, for recycling or re -use, remaining materials generated from the first day of the project through the completion of the project in accordance with this plan. This DMP is issued in the name of the property owner(s) and shall remain their property throughout the construction and/or demolition project. A contractor serving as agent of the owner may obtain a DMP for the owner. However, the DMP is still issued in the name of the property owner(s) and the owner retains legal responsibility for ensuring that the provisions of the DMP are adhered to. The property owner contractor shall be kept informed of the diversion progress through bi-monthly r oft. (Self- uling, all r material from thi roject site must be taken to an approved recycler or transfer r / 10 erl P ct Manage Date