14-0828 (SPIN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c '4Q
&t�t 4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/11/14
Application Number: 14-00000828 Owner:
Property Address: 79650 CORTE DEL VISTA STRATIGIC ACQUISTIONS
APN: 609-380-997-20 -293233- P.O. BOX 1136
Application description: SPECIAL INSPECTION AGOURA HILLS, CA 91376
Property Zoning: LOW DENSITY RESIDENTIAL --------- -----------------------
Application' valuation: 0
c
Contractor:
Applicant: Architect or Engineer: Owner Ei
-------------=------- i�D -------- I�qp�
�wy Of
-------------------------------------------------------------------- - - - --- r14�r��c� --- - -
—
LICENSED CONT CTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury that I am licensed nder provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Profes onals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: License No.: for by Section 3700 of the Labor Code, for the erformance of the work for which this permit is
issued.
Date: Contractor: i _ 1 have and will maintain workers' compensatio insurance, as required by Section 3700 of the Labor
Code, for the performance of the work f which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION insurance carrier and policy number ar .
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier Pol' Number
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of a work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to come subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should be me subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I all forthwith comply with those provisions.
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 applicantto a civil pen ty of not more than five hundred dollars ($500).: Date: Applicant:
(_ 1 1, as owner of the property, or my employees with ages as their sole compensation, will do the work, and
the structure is not intended or offered for sal (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not ap y to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself rough his 'however,
own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offer for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
one year of completion, the owner -but er will have the burden of proving that he or she did not build or
improve for the purpose of sale.). APPLICANT ACKNOWLEDGEMENT
(_ 1 I, as owner of the property, am exclus' ely contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions ode: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improve thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' S to License Law.). _ whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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
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 property for inspection purposes.
Date: G Signature (Applicant or Agent):
Application Number . . . . . 14-00000828
Permit . . . SPECIAL INSPECTION
Additional desc . .
Permit Fee . . . . 71.50 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 0
Expiration Date 12/08/14
Qty Unit Charge Per Extension
1.00 71.5000 EA MISC SPECIAL INSPECTION 71.50
----------------------------------------------------------------------------
Special Notes and Comments
SPECIAL INSPECTION - SPECIAL INSPECTION
FOR IID RELEASE. NOT GOOD FOR WORK. 2013
CALIFORNIA BUILDING CODES.
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
LQPERMIT
Qin #
City Of La Quinta
-Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
!.i'• Qj
Project Address:�r��C LZ S!
Owner's Name: Cj_AoM-�W &4v/�7oA/5
A. P. Number:
Address: /' 0 ��
Legal Description:
City, ST, Zip: p VKA 141 e.eS CO 9137,a
Contractor:
Telephone:
< %``•<>'>af `<<'`z`"> -i';<=
Address:
Project Description:
City, ST, Zip:
Telephone:
^ii%::$i�ti'":ijy?Siv`vvii;i.m2�
State Lie. # :
City Lie. C
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
iitr!•in:�iiJ ��:�f::r+�:?�i i':i•): ii iiiiiii:i:
:.s ....;:.,:.-....::•:: -,.,.v- ::::..:•:::
Construction Type: Occupancy:
State Lie. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: q91 7 �5� 78
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 Cala.
Called Contact Person
Plan Check Balance.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2qd Review, ready for correctionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'"' 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
CALIFORNIA ALL-PURPOSE
CIVIL CODE
:�N%aJ�.l-2< � <�<.c:<�-.�.!tC<,:�� a<�-.�.:ri<!�<�a< :'C.�•`<!y�c�a�:�<: �< �i.:�.{.�<r..:e4 �<�t!:�<.^<�c �:(.:�Ja<�• �C!s�<�<�<.�<!:�•; �<�<..�<!:'<l"•
State of California
County of 1. &_h(mks
On before me, &Q,YX.VX2 CA 1r et ti L
Date Name and Title of the Officer
personally appeared
SITYANNE MCAFEE
Commission s 20019
`z -• 4 Notary Public • Cawontls
Los AnWas County
mm
Co• k:s .. 25 mils
Name(s) of Signer(s)
who proved to me on the basis of satisfactory
evidence to be the person`e whose nameof is are
subscribed to the within instrument and acknowle ged
to me that (5/she/they executed the same in
e5/her/their authorized capacityJies?, and that by
i her/their signature on the instrument the
or the entity upon behalf of which the
personf
personVacted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
WITNESS my hand and official seal.
Place Notary Seal Above Signature: j
!� Si nature of Notary Public
OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Document L 1
Title or Type of Document: �eX OT �r\Z , Document Date: (D o ' 4
r '
Number of Pages: \ Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:,
❑ Corporate Officer — Title(s):
❑ Partner -- ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing: _
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
Strategic Acquisitions Inc. •
P.O Box 1136 • Agoura Hills, California 91376 s (818) 769-7880 • Fax: (818) 769-7959
June 10, 2014
LETTER OF AUTHORIZATION
City of La Quinta
Re: 79650 Corte Del Vista, La Quinta, CA 92253
To Whom It May Concern:
This letter hereby authorizes Jeffrey Gandy to obtain any necessary plans, documents and permits on behalf of
Strategic Acquisitions, Inc.
Responsible party:
Peter Baer
Strategic Acquisitions, Inc.
P.O. Box 1136
Agoura Hills, CA 91376
California Drivers License: V9058081
Tax ID #: 95-4611832
Corporate ID #: 19961794784
Sincerely,
Peter Baer
President