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07-0818 (DEMO)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: ` Property Address: APN: Application description: Property Zoning: Application valuation: 07-00000818 ' 78411 HIGHWAY 111 604 -050 -008 - DEMO - COMML/OTHER COMMUNITY COMMERCIAL T -4w -t 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: . M,& H REALTY PARTNERS II C/O PETER MERLONE 353 SACRAMENTO ST 21ST FL SAN FRANCISCO, CA 94111 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/27/07 Contractor: v MA Applicant: Architect or Engineer: BIG HORN BUILDERS INC R / P O BOX 13793 / Do PALM DESERT, CA 92255 /] (760) 341-3338 N HcL4�U� / ---------------------------------------------------------------------------------------------- Lic. No.: 376108 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 and1ProfeLsionall s Code, and my License is in full force and effect. Lice Class: B ense No.: 376108 Data Ji ntractor: - / OWNER-BUILDE ECLARATION 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 1, 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.). (_ d 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.). 1 _ 1 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 Name: Lender's Address: LQPERMIT 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 STATE FUND Policy Number 046-0016022 _ '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 subje t to the workers' compensation laws of California, and agree that, if I should become subject t e the compensation provisions of Section 3700 of the Labor C a o with om ly with these provisions. , WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGEVI UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP T NE 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 isc re I agree to comply with all city and county ordinances and state laws relating to building const tion, and er y aut 'ze representatives of this county toe ter upon the above-mentioned propert nsp on purpo ate' re (Applicant or Agentl Application Number . . . . . 07-00000818 ' Permit . . . DEMO PERMIT Additional desc . . Permit Fee . . . . 45.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/23/07 Qty Unit Charge Per Extension BASE FEE 45.00 ---------------------------------------------------------------------------- Special Notes and Comments PARTIAL DEMO OF INTERIOR PARTITION WALLS, PER APPROVED PLAN Fee summary Charged Paid ------------------------------------- Credited -------------------- Due Permit Fee Total 45.00 .00 .00 45.00 Plan Check Total .00 .00 .00 .00 Grand Total 45.00 .00 .00 45.00 Bin # City of La Quinta Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit .# Project Address:' —' g ' �W Owner's Name: A. P. Number: Address: —7J11,01 Nw 3v.� Legal Description: Contractor: b e rL S �LN G City, ST, Zip:LA t) I A)7-4 Z Telephone: ~j / — t] Address: p `� 0)< 137g3 Project Description: if KI O City, ST, Zip: im tf Telephone (QD / [ R`L State tic. #: 3 �% (p D City Lic. #: Arch., Engr., Designer: O N I Address: Q p iti10 N 1 t e t`i t City, ST, Zip: Telephone7(z0) � _ 3 1- State Lic. #:�' Name of Contact Person: D Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: T# Units: Telephone # of Contact Perso 7(oQ S = Z Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance . Energy Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading. plan 2°" Review, ready for correction ass Electrical . Subcontactor List Called Contact Person Plumbing ' Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Review, ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees i HARSCH INVESTMENT PROPERTIES March 20, 2007 City of La Quinta ' . VIA HAND -DELIVERY Building Department 78-495 Calle Tampico 4 La Quinta, CA 92253 RE: 78-411 Highway 1 11, La Quinta, CA) 92253 — Plaza La Quinta Authorized Representative/Contracto'r- To Whom It May Concern: 1 t Please accept this letter as the Landlord's authorization for r the following representative and/or contractor to perform work at the abo�- -ve-noted property: Rod Sharp Big Horn Builders,-Inc.- This uilders; Inc:This contractor will be submitting all required paperwork, plans, 'etc., on the Landlord's behalf for the construction projeci at 78-411 Highway 111, La QUinta, CA 92253. Thank you for your assistance in this matter. If you have further'questions or concerns, please don't hesitate to contact us at any of the numbers listed below. Sincerely, HOeccaMankiller ENT REALTY, LLC, SERIES F a YRe Retail Property Manager i :rkm cc: Rod Sharp, Big Horn Builders, Inc., iia hand -delivery i - - 1 78.401 Highway 111, Suite C • La Quinto, CA 92253 • Phone 760) 771-4580 • Fax (760) 771-4680 • www.harsch.com 0 Certificate of Occupancy OF9�S Building & Safety Department This Certificate is issued pursuant to the requirements of Section 109 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: 78411 HIGHWAY 111 Use classification: COMMERCIAL (COACHELLA VALLEY INSURANCE Occupancy Group: B Type of Construction: VN Building Permit No.: COURTESY Land Use Zone: CC Owner of Building: M & H REALTYPARTNERS 11 Address: 353 SACRAMENTO ST 21st FL City, ST, ZIP: SAN FRANCISCO, CA 94111 By: STEVE TRAXEL Date: 07-12-2007 Building Official