08-0471 (DEMO)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tdy/
449
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 08-0000_
:Property Address:78447 HIGHWAY 111 SUITE B
APN: 604-050-016-5 -000000-
Application description: DEMO - COMML/OTHER
Property Zoning: COMMUNITY COMMERCIAL
Application valuation: 0
Applicant: Architect or Engineer:
rlA
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 Professionals Code, and my License is in full force and effect.
License Class: 13 License No.: 893549
Date: _7/ !�S tractor:
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 _ 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.). -
(_ I 1, 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 _ 1 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:
LQPERA11T
Owner:
HARSH INV PROPERTY
78447 HIGHWAY 111
LA QUINTA, CA 92253
Contractor:
O R D INC.
82950 WILLIAM WAY
THERMAL, CA 92274
(760)578-0992 ,
Lic. No.: 893549
V
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/18/08
NAle
1(9
T��B lD
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ 1 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.
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 E EMPT Policy Number EXEMPT
•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 bor Code, I.sha _ with comply with th rovisions.
aD te: plicant: `
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 Ouinta, its officers, agents and employees foi 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 ounty to enter upon the move -mentioned property for' coon purposes.
te: Sig ure (Applicant or Agent):
LQPERn4IT
Application Number 08-00000471
Permit DEMO PERMIT
Additional desc .
Permit Fee• 45.00
Plan Check"Fee
.00
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date 9/14/08
Qty Unit Charge• Per
Extension
BASE
FEE
45.00
Special Notes and Comments
DEMO WALLS PER APPROVED PLANS PER
AJ
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
c
Bin #
Permit: # A\
Project Address:' 8 Ct
A. P. Number:
Legal Description:
Contractor: C>
Address:
AJ
City, ST, Zip: 411`"M
Telephone:
State Lie. # : 0°51 7.'5 `f .
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person: p
'tl4v
Telephone # of Contact Person: '7h�
# Submittal
Plan Sets
Structural Calcs.
Truss Calcs.
Energy Calcs.
Flood plain plan
Grading. plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE:-
Planning- Approval
Pub. Wks. Appr
School Fees
City of La Quinta
Building 81 Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
jAddress:
wner's Name:
Zg`5 .-Tity, ST, Zip:ala„h ...e.
Project Description: De 0- D pl, N
C^ Z Z
Lic. #:
Construction Type:
Occupancy:
E:
P Y
fi Project type (circle one): New Add'n Alter Repair Demo
Ss°t CE—s- Sq. Ft.: # Stories: T# Units:
15- % E? 05 Estimated Value of Project: :;2. � 00
APPLICANT: DO NOT WRITE BELOW THIS LINE
Recd TRACKING
PERMIT FEES
Plan Check submitted Item Amount
Reviewed, ready for corrections Plan Check Deposit
Called Contact Person Plan Check Balance
Plans "picked up Construction
Plans resubmitted Mechanical
2°" Review, ready for corrections/issue Electrical
Called Contact Person Plumbing
Plans picked up S.M.I.
Plans resubmitted Grading
3- Review, ready for corrections/issue Developer Impact Fee
Called Contact Person A.I.P.P.
Date of permit issue
Total Permit Fees
r
�J
HARSCH
LVVESTMENT PROPERTIES
March 17, 2008
City of La Quinta VIA HAND -DELIVERY
Building Department
78-495 Calle Tampico
• La Quinta, CA 92253
RE: 78-447 Highway I 11, Suite, B, La Quinta, CA 92253 — Plaza La Quinta
Authorized Tenant Contractor
To Whom It May Concern:
Please'accept this letter as the Landlord's authorization for the following representative
and/or contractor to perform work at the above -noted property:
Octavio Rosales
O.R.D., Inc.
This contractor'will be submitting all required paperwork, plans, etc., on the Tenant's behalf
for the construction project at 78-447 Highway 1 11, Suite B, 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.
Sinc ly,
A I E T REALTY, LLC, SERIES F
r
't
ebecca Mankiller
Retail Property Manager
Arn
I ,
s cc: Octavio Rosales, O.R.D., Inc., via electronic mail
78401 Highway l 11, Suite E • to Quinto, (A 92253 • Phone (760) 771-0580 • Fox (760) 771-0680 • www.horsch.com