10-0281 (RC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tity/ 4 4 Qumi&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 10-0,0&00283
Property Address: 45280 SEELEY DR
APN: 604-040-094- - -
Application description: REMODEL - COMMERCIAL
Property Zoning: TOURIST COMMERCIAL
Application valuation: 1500000
Applicant: Architect or Engineer:
£�s6rtO&OCA
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.
License Class: B License No.: 741137
4
XDate:� Contractor: _ 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 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:
LQPERMIT
Owner:
EISENHOWER MEDICAL CENTER
39000 BOB HOPE DR
RANCHO MIRAGE, CA 92270
Contractor:
WDL CONSTRUCTION
74075 EL PASEO, SUITE B _.
PALM DESERT, CA 92260
(760)674-9553 L
Lic. No.: 741137
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/10/10
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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 DELOS INS Policy Number 01DKRM12007667
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
// 3700 of the Labor Code, I shall f rthwit omply with those provisions.
Date: I� f� 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 propeerrty�/J r i cti p oses.
pat€p P�/�> Signature (Applicant or Agent): f .V
Application Number . . . . . 10-00000281
------ Structure Information 13,937SF TI/II-A/B-OCC/139-OL/SPRINKLED -----
Other struct info . .
. . . CODE EDITION
2007/2008
FIRE SPRINKLERS
FULLY
MIXED -USE OCCUPANCY
B
OCCUPANT LOAD
139.00
----------------------------------------------------------------------------
2ND FLOOR SQUARE FOOTAGE
13937.00
Permit . . . BUILDING PERMIT - ADA INV FEE
Additional desc . .
Permit Fee . . . .
9079.00 Plan Check Fee
2950.68
Issue Date . . . .
Valuation . .
. . 1500000
Expiration Date . .
12/07/10
Qty Unit Charge
Per
Extension
BASE FEE
7079.00
500.00 4.0000
----------------------------------------------------------------------------
THOU BLDG 1,000,001 - UP
2000.00
Permit . . .
ELECT - ADD/ALT/REM INV FEE
Additional desc . .
Permit Fee . . . .
677.48 Plan Check Fee
84.69
Issue Date . . . .
Valuation . .
. . 0
Expiration Date . .
12/07/10
Qty Unit Charge
Per
Extension
BASE FEE
30.00
13937.00 .0400
ELEC GARAGE OR NON-RESIDENTIAL
557.48
1.00 30.0000
EA ELEC PWR APP >10 TO <=50
30.00
1.00 60.0000
----------------------------------------------------------------------------
EA ELEC PWR APP >50 TO <=100
60.00
Permit . . .
MECHANICAL INV FEE
Additional desc . .
Permit Fee . . . .
335.00 Plan Check Fee
41.88
Issue Date . . . .
Valuation . .
. . 0
Expiration Date . .
12/07/10
Qty Unit Charge
Per
Extension
BASE FEE
30.00
31.00 9.0000
EA MECH VENT INST/ DUCT ALT
279.00
2.00 13.0000
----------------------------------------------------------------------------
EA MECH VENT FAN
26.00
Permit . . .
PLUMBING INV FEE
Additional desc . .
Permit Fee . . . .
768.00 Plan Check Fee
96.00
LQPERMIT
Application Number . . . . . 10-00000281
Permit . . . . . . PLUMBING INV FEE
Issue Date . . . . Valuation . . .
. 0
Expiration Date . . 12/07/10
Qty Unit Charge Per
Extension
BASE FEE
30.00
61.00 12.0000 EA PLB FIXTURE
732.00
1.00 6.0000 EA PLB WATER INST/ALT/REP
----------------------------------------------------------------------------
6.00
Special Notes and Comments
13,937SF TI/II-A/B-OCC/139-OL/SPRINKLED
[EISENHOWER MEDICAL CENTER - 2ND FLOOR
TI WEST] ATRIUM SEPARATION EXEMPT PER
IBC INTERPRETATION 54-07 OF CBC 404.4
(DATED 4/10/2008) - LOBBY EXIT DISCHARGE
PERMITTED PER CBC 1024.1 (SPRINKLER
SYSTEM INSTALLED). THIS PERMIT DOES NOT
INCLUDE ALTERATIONS TO THE BUILDING
SHELL OR EXTERIOR SIGNAGE. 2007
CALIFORNIA BUILDING/MECH/ELEC/PLUMB
CODES AND THE 2008 CALIFORNIA ENERGY
CODE. ***INVESTIGATION FEE ASSESSED PER
2007 CALIFORNIA BUILDING CODE APPENDIX
CHAPTER 1 §108.4 FOR WORK COMMENCING
BEFORE PERMIT ISSUANCE***
June 10, 2010 3:06:25 PM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . . . ACCESSIBILITY PLAN REVIEW
707.90
BLDG STDS ADMIN (SB1473)
60.00
ENERGY REVIEW FEE
707.90
STRONG MOTION (SMI) - COM
315.00
Fee summary Charged Paid Credited
-----------------
Due
----------------------------------------
Permit Fee Total 10859.48 .00 .00
10859.48
Plan Check Total 3173.25 .00 .00
3173.25
Other Fee Total 1790.80 .00 .00
1790.80
Grand Total 15823.53 .00 .00
15823.53
LQPERMIT
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Certificate of Occupancy
Building & Safety Department
This Certificate is issued pursuant to the requirements of Appendix Chapter 1 Section 110 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: 45-280 SEELEY DRIVE - 2"d FLOOR (WEST) TENANT IMPROVEMENTS
Use classification: EISENHOWER MEDICAL CENTER - COMMERCIAL
Occupancy Group: B Type of Construction: it — A
Sprinklers Installed: YES Sprinkles Required: YES
Building Official
Building Permit No.: 10-0281
Land Use Zone: CT
Occupant Load: 139
Owner of Building: EISENHOWER MEDICAL CENTER
Address: 39000 BOB HOPE DRIVE
City, ST, ZIP: RANCHO MIRAGE, CA 92270
By: _ AJ ORTEGA
Date: NOVEMBER 10, 2010