14-0626 (SPIN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
C�.
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Application Number:
14-00000626
Property Address:
78575 HIGHWAY 111 STE 400
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APN:
643-020-002- - -
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Application description:
SPECIAL INSPECTION
Property Zoning:
COMMUNITY COMMERCIAL
Application valuation:
0
T44t 4 4a Q"
Applicant:
Architect or Engineer:
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LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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: License No.:
Datc: Contractor:
OWNER -BUILDER DECLARATION
1 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 r she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
an pplicant for a permit subjects the applicant to a civil penalty of not more than fivehundred 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.).
(_ 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' Stat:ense Law.).
(_) I am exempt under Sec. , &P C. for this read \n
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.).
w 1a 'Lender's Name: _
Lender's Address:
L �
LQPERMIT
Owner:
JDD LLC
78555 HIGHWAY 111
C/O DALE F FRANK JR
LA QUINTA, CA 92253
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/14/14
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 malntaln 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
I certify that, in the performance of the work for which this permit is issued; I shall not employ any
person in any any s to become subject to the workers' compensation laws of California,
and agree that, if I sho d b come subject to the workers' compensation provisions of Section
3700 of the Labor Coda I lhall forthwith co ply with those provisions.
o/Applicant: 1�
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
IMPORTANTApplication 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 information is correct. I agree to comply with all
city and county ordinances and state laws relating to buildi g c nstruction and hereby authorize representatives
pf this county tooeenter upon the above-mentioned property r nspecti pu poses.
e/ 5yt
Dat / � Signature (Applicant or Agent):
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Application Number . . . . . 14-00000626
Permit . . . SPECIAL INSPECTION
Additional desc .
Permit Fee . . . . 71.50 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 11/10/14
Qty Unit Charge Per Extension
1.00 71.5000 EA MISC SPECIAL INSPECTION 71.50
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Special Notes and Comments
SPECIAL INSPECTION FOR METER RELEASE TO
IID BY SPINELO PROPERTY MANAGEMENT CO.
Fee summary Charged Paid Credited Due
------=--------------------------------------------------
Permit Fee Total 71.50 .00 .00 71.50
Plan Check Total .00 .00 .00 .00
Grand Total 71.50 .00 .00 71.50
Diane Sampson
Lic'# 01507324
• 760.318.7484 ext. 222
Cell 760.272.7083
Fax 760.318.7483
PO BO_)( 1419 Cathedral City, CA 92235
68936'i4delina Rd Cathedral City, CA 92234
diane, spinellopropertymanagement.com
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-- 'CT
Bin #
City of La Quinta
Building 8L 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:
Owner's Name: LL G
A. P. Number:
Address:
Legal Description:
City, ST, Zip: Z,
Contractor:
Tele hone:
P /�vD �/�' "%mo
Address:
Project Description:
City; ST, Zip:
Telephone:
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Stats Lic. # :
City Lie. #;
., Engr., Designer:
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Ad ess:
City., ST, Zip:
Telephone:
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Construction Type: Occupancy:
Projecttype(circleone): New Addn Alter Repair Demo
State .Lie. #:
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Name of Contact Person:
Sq. Ft.:
# Stories:
#Units:
Telephone #,of Contact Person:
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 Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
i
IN HOUSE:-
'"' Review, ready for correctionsrissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees