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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 f4 it Ctt`t tz ct�tfireQ; ��, 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 •:.d `��'�' chi y � � d w = ba b N v w v U. t G7 A14 w w I\� o z kW �^y V o o o F �cl, ate, H V Z N ei o-i o a O a O co°`Ln W" o o �t Oa C V � � I- .ryeJ!. i" 'O ar V C vi V O C O r.� i' CG v+ w :•ti;:;'.yyr :4��`•{E � n,'�. :v t,'•+'Li`}•'J.. `,.,`�`rf'' ` L O L •Y'`'}:};i2 '` �k. CK h'k' 'A 6! t#Ti L 'C7 r" L •b1 C R (� :�.: 2.r.:.,}{{..i:�<:{i+.•: � .o •a' L �. 'v c I [" :.;<:;`n?: E ',,yr'{•.;,'.?i'b<n a U C '� Sri :: C C y Chi C C a _ Cd it *V a V N a �. a a A d U a e A `t c Y w N N d y ti ci w O a ain It c •v 0 °' o v V 0 T 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