14-0351 (SPIN)r' '.. 0. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:.
Application description
Property Zoning:
Application valuation:
Applicant:
0�
14-00000351
44025 JEFFERSON ST STE
604-521-005- -
SPECIAL INSPECTION
NEIGHBORHOOD COMMERCIAL
0
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
104 REGENCY MARINITA LA QUINTA LLC
- 36 EXECUTIVE PARK STE 100
IRVINE, CA 92614
(949)726-6028
Date: 4/01/14
Contractor: 1�D
Architect or Engineer: Owner
A PR 21!2 000 111 ]1
CITY OF LA QUINTA
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under v�f Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Profession.,S'lt oj,' Y License is in full force and effect.
License Class: r Lic se
Date: 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).:
1 _ 1 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 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.).
1 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
1 hereby affirm under penalty of perjury that
work for which this permit is issued (Sec. 3
Lender's Name:
Lender's Address:
LQPERA1IT
AGENCY
agency for the performance of the
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.
—.1 have and will maintain workers' omp a n insurance, as required by Section 3700 of the Labor
Code, for the performanc f t w which this permit is issued. My workers' compensation
insurance carrier and policyum er e:
Carrier - - - - - - -------- - -- -- - lic Number
I certify that, in the perfor a of the work for which this permit is issued, I shall not employ any
person in any manner s 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:
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 1$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 Quints, 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 1 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:Signature (Applicant or Agent
Application Number . . . . . 14-00000351
` Permit . . . . . SPECIAL INSPECTION
Additional desc .
Permit Fee . . . . 71.50 Plan Check Fee
.00
Issue Date Valuation
0
Expiration Date 9/28/14-
/28/14Qty
QtyUnit Charge Per -
Extension
1.00 71.5000 EA MISC SPECIAL INSPECTION
71.50
Special Notes and Comments
SPECIAL INSPECTION FOR IID RELEASE. THIS
PERMIT IS NOT 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
420 Stevens Avenue
Regency Suite 320
G Solana Beach, CA 92075.
Centers. RegencyCenters.com
DELIVERY OF POSSESSION DATE CERTIFICATE
LANDLORD: Regency Marinita – La Quinta, LLC
TENANT: Norman Perry and Elizabeth Perry D/B/A Perry Physical Therapy
SHOPPING CENTER: Jefferson Square
LEASE DATE: March 26, 2014
DELIVERY OF POSSESSION DATE: March 27, 2014
RENT COMMENCEMENT DATE: The Commencement Date shall be ninety (90) days after the date of
Landlord's delivery of the Premises to Tenant. Tenant shall begin paying Minimum Annual Rent on the
Commencement Date. Notwithstanding anything to the contrary set forth in this Lease, Tenant shall begin
paying Tenant's Proportionate Share of Common Area Costs, Taxes and Insurance on the date on which
Tenant first opens for business in the Premises
PREMISES NUMBER: 44-025 Jefferson Street, Suite 104 La Quinta, CA 92253
SQUARE FOOTAGE: 1,713 square feet
Landlord and Tenant acknowledge and agree that the Leased Premises described in the
above referenced Lease will be delivered to Tenant for the performance of Tenant's Work (as said term is
defined in the Lease) on Delivery of Possession Date noted above.
Tenant understands that Tenant may not begin any construction in the Leased Premises
until Tenant has satisfied the insurance and other requirements as referenced in the Lease.
Tenant acknowledges and agrees that all utilities will be transferred within two (2) working
days from Delivery of Possession Date to avoid disconnection of service, except whereas provided for in
the lease.
Tenant further acknowledges that Landlord will deliver possession of the Premises to
Tenant in its current "as -is" condition; broom clean, free of debris and personal property and trade
fixtures, pursuant to said Lease. Landlord acknowledges that during the construction period, if tenant
finds an existing unsanitary condition determined to be solely related to rodent infestation, that Landlord
will employ it's contractors to assist in curing the problem.
LANDLORD:
Name: Laura Borenstein
Title: Assistant Property Manager
Date: March 27, 2014
TENANT:
Name: �0
:Title: (MAW
Date: 3 —2 ;p r / L�
Bin #
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 #
Project Address: .Y G z.,! �e�,So %O
Owner's Name:A.
P. Number: L Q
Address:
Legal Description:
City, ST, Zip:
tr e
Con a t r•
telephone:
Address:
Project Description:
City, ST, Zip:
s ct. �n.S Y�Ci ► OY1
Telephone:
riI/ ` ot�S
State Lic. # :
City Lic. #:
Arch., Engr., Designer: r i k
Address:
City., ST, Zip:
Telephone: f�63� 6
onstruction Type: e: Occu ane .
State Lic. #:
Project tYPa (circle one • New Add'n Alter Repair r D emo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
li
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss.Cales.
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 Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date.of permit issue
School Fees
Total Permit Fees