BSPN2014-0033D M�
78-495 CALLE TAMPICO VOICE (760) 777-7125 _ FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 10/14/2014
Application Number: BSPN2014-0033 Owner:
Property Address: 78370 HIGHWAY 111 POINT HAPPY REALTY
APN: 604050068 8665 WILSHIRE BLV STE 410
Application Description: SPECIAL INSPECTION FOR IID RELEASE BEVERLY HILLS, CA 92253
Property Zoning: �
Application Valuation: In
Applicant: Contractor: tUl`
M & M TOTAL SERVICES M & M TOTAL SERVIC 4 2014 `J 1
74260 VELARDO DR 74260 VELARDO DR QC�
PALM DESERT, CA 92260 PALM DESERT, CA 9226 OF �QUJwvA TMENT
C pEVEIAPMEN( DEPiyP
(760)779-0736 cclo*wNIN
Llc. No.: 934412
---------------------------------------------------------------------------------------------
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: B, C30 License No.: 93441.Q/�2
te D/
Da7 ocu/ Contractor
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.).
(_) 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 Na
Lender's Address:
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 ork 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: Policy Number: _
fel 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 forthwith
comply with those provisions.
Date: / / —Applicant:�l
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 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 the above-
mentioned property for inspection purposes.
Date: ./ / 2�/ %/ Signature (Applicant or Agent):' c
FINANCIAL INFORMATION
DESCRIPTION
ACCOUNT
QTY AMOUNT PAID
PAID DATE
SPECIAL INSPECTION
101-0000-42404
1 $72.52 $0.00
PAID BY
,:;.METHOD f _' =,4;
-RECEIPT # CHECK #
CLTD BY
Total Paid forCOMPLIANCE SURVEY/SPECIAL INSPECTION: $72.52 $0.00
TOTALS:00
Description: SPECIAL INSPECTION FOR IID RELEASE
Type: SPECIAL INSPECTION
Subtype: Status: SUBMITTED
Applied: 10/14/2014 SKH
Approved:
Parcel No: 604050068 Site Address: 78370 HIGHWAY 111LA QUINTA,CA 92253
Subdivision: PM 29736
Block: Lot: 11
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $0.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No.•Stories: 0 No: Unites: 0
Details: SPECIAL INSPECTION - IID RELEASE. THIS PERMIT IS NOT, FOR WORK. 2013 CALIFORNIA BUILDING CODES.
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
DESCRIPTION I ACCOUNT( QTY I AMOUNT I PAID I PAID DATE I RECEIPT # I CHECK # I METHOD I PAID BY I C T
BY
SPECIAL INSPECTION 1 101-0000-42404 1 1 $72.52 $0.00
Total Paid forCOMPLIANCE SURVEY/SPECIAL INSPECTION: $72.52 $0.00
Printed: Tuesday, October 14, 2014 1:48:35 PM 1 of 2 CI?srs TEMs
TOTALS: $72.52 $0.00
INSPECTIONS
SEQID INSPECTION TYPE ! INSPECTOR SCHEDULED COMPLETED • RESULT REMARKS NOTES
DATE DATE
FINAL"
PARENT PROJECTS
REVIEWS
REVIEW TYPE 'REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS DATE NOTES`
BOND INFORMATION
ATTAC H M E NTS
Printed: Tuesday, October 14, 2014 1:48:35 PM 2 of 2 CRWsrsTEMS
Bin #
Permit #
?Swzo-0033
Project Address:w
City of La Quinta
-Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico.
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking-Sheet
`� S!>�6 j Owner's Namc:
A. P. Number:
Address: .1-Baf-O ke'w 111
Legal Description:
City, ST, Zip:
Contractor: a
t . c!
Telephone: 3/b%,2f/—.Z33
Address: �,�0 a� p
Project Description:
City, ST, Zip:
Telephone: O 2:-�
`•.' :<: .:.,.;.;; :,>;:>::::r»« `'
State Lic. #:
City Lie. #;
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
Construction Type: o,n Occupancy:
3tatc Lic.
Project type (circle one): New Add'n Alter Repair Demo
�Iamc of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Ccicphone # of Contact Person:
Estimated Value of Project:
t< Submittal Req'd
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rec'd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance.
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections issue
Electrical
Subcontactor List
Callcd Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
Ii.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'rd Review, ready for corrections(ssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fecs
Total Permit Fees
Cardinal Equities LLC
8665 Wilshire. Boulevard, Suite 410
Beverly Hilis, California 90211
Telephone (3 10) 271-7273
Facsimile (31:0) 724-5705
October 14, 2014
N
City of La Quirnta / Building Division
78-495 Calle Tampico
La Quinta, CA 92253
Re: Authorization to Request Special Inspection to Release Power
78370 Hwy 111, Suite 265, La Quinta; CA
Point Happy Realty LLC — Landlord
Fed Tax IN 45-2639599 .
To Whom it May Concern,
Please note that Point Happy Realty LLC, dba Cardinal Equities LLC, is Landlord to
78370 Hwy 111, in La Quinta, CA.
We hereby present this letter as formal authorization for Mr. Mihai Dan and Virgil Dan
(M & M Total Services) to request a special inspection to release power and to fill out
application on behalf. of Landlord.. Our intent is to schedule an Inspection with City of La
Quinta, in order to start electricity service in vacant space (78370 Hwy 111, Suite 265, La
Quinta).
r
Should you have any questions or concerns, please contact me directly at (310) 271-7273
x 1006.
Sincerely,
esse alvez Jr.
Property Manager
Point Happy Realty LLC - Landlord