BSPN2015-005578-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
VIRGIL DAN
72831 SIERRA VISTA RD
PALM DESERT, CA 92260
c&ty/ 4 4 QUM&
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BSPN2015-0055
78370 HIGHWAY 111 STE 280
604050068
POINT HAPPY / RELEASE FOR IID
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 and Professions Code,
and my License is in full force and effect.
License Class: _ License No.:
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).:
( ) 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' State License Law.).
( I 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
Lender's
11111111111111111111
45
VOICE (760) 777-7125
FAX (760) 777-7011
IN5PECTIONS (760) 777-7153
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 polity number are:
Carrier: _ Polity Number: _
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 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 ($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 Building Official 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 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 city to ent upon the
above-ment�o�rty for inspection purposes.
Date: < t / Signature (Applicant or Agent):
Date: 11/25/2015
Owner:
POINT HAPPY REALTY
8665 WILSHIRE BLV STE 410
BEVERLY HILLS, CA 92253
Contractor:
Lic. No.:
-
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 polity number are:
Carrier: _ Polity Number: _
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 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 ($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 Building Official 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 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 city to ent upon the
above-ment�o�rty for inspection purposes.
Date: < t / Signature (Applicant or Agent):
,DESCRIPTION
FINANCIAL •• •
�ACCOUNT''s' MQTY. :` AMOUNT =.,r.: r PAID '°+ :,
PAID DATE
SPECIAL INSPECTION
101-0000-42404 0 $72.52 $0.00
• PAID BY
METHOD,,.,, "° ! RECEIPT # " CHECK #: r
CLTD BY
Total Paid for COMPLIANCE SURVEY/SPECIAL INSPECTION: $72.52 $0.00
TOTALS:$0.00
Description: POINT HAPPY / RELEASE FOR IID
CONDITIONS
Type: SPECIAL INSPECTION
Subtype:
Status: UNDER REVIEW
Applied: 11/25/2015 SKH
Approved:
Parcel No: 604050068 Site Address: 78370 HIGHWAY 111 STE 280 LA QUINTA,CA 92253
Subdivision: PM 29736
Block:
Lot: 11
Issued:
Lot Sq Ft: 0
Building Scl Ft: 0
Zoning:
Finaled:
Valuation: $0.00
Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0
No. Unites: 0
Details: SPECIAL INSPECTION FOR IID RELEASE. THIS PERMIT IS NOT FOR WORK. 2013 CALIFORNIA BUILDING CODES.
Printed: Wednesday, November -25, 2015 2:36:19 PM 1 of 2 CN?
SYSTEMS
CONDITIONS
CONTACTS
NAME•TYPE NAME ADDRESS1
CITY
STATE
ZIP PHONE FAX
EMAIL
APPLICANT VIRGIL DAN 72831 SIERRA VISTA RD
PALM DESERT
CA
92260 (760)702-6842
OWNER POINT HAPPY REALTY 8665 WILSHIRE BLV STE
410
BEVERLY HILLS
CA
92253 (760)702-6842
Printed: Wednesday, November -25, 2015 2:36:19 PM 1 of 2 CN?
SYSTEMS
INSPECTIONS
PARENT PROJECTS
BOND INFORMATION
Printed: Wednesday, November 25, 2015 2:36:19 PM 2 of 2 CR?W
srsrrnns
Card.14811, E40.11.103- LLC
'8865:-Wi),Wre Boulevard,. Suite -.410.
ei'y
T-6.1 e.p h oAe `(:31Q):271-72.73
F a c. s, i,.*M,l 1. e (;31.0.) `72:4-'570:5
'November 25".20.15
City of -La. Qtdrita-/- Bifilding Division
78-4,95'CalkTanipico
La; QuI.nta, CA 02253 -
Re: AuffiOrinfion: to. Requegf$,Pocial. Inspection to. Rel.08e%Power
7$370. Hwy I.] 1,.SuiU-..280, La QpintaX.-A
Point: Happy Realty LLC .Landlotd
Fed Tax JD# 45-2.639:599:
To WhornifMav-Concern,
Please noie,ihat P.ci.*inf Happy Realty :,LLC; .dba.Cardiiial..Equities LLC, is .Landlord to
78370 Hwy I I 1,:in.'L.a -Q.U:intq.,'C.A,.
W:e:hereb.y present thisaetter.:as formal or.).zatiOn- for .Mr. Virgil Dan (M 9.,*,M Total.
Servioes) to request aspecial. nspedi6n:*f6.rel(ase 'power and. afill. outa Olicat-ion-ori
behalf OfLandl6rd.. Our intent is to schedule an. i"pdcfi6h with City-of'La Quinta,in:
order to starcele6tri.city-servi . ce-in vacant space 7,83 7.0'Hwy I l:1,.SuItd:280,,.La Qu*inta
�Shoufd*you have ahy-quest ionis br-concems,p, Ida§e.cofi.tact.rnc directly at: (1.1.0)2717*72.-1-3
x
Sincerely,
ess.e GAI.ve.zJr.
Senior- Manager
. ) Y
Poinf.Happy.RQalty LLC -Latfdlbrd
Bin #
City of La Quinta .
Building & Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
oje'ct Address: �T� - o ��.� �Sd wner's Name: � � LLC
A. P. Number: Address: (Ll s 81V�l S4-- 1/c� .
Legal Description: City, ST, Zip:
tra t
Con c or. eleP hone:
Address: Project Description: fa ,seas
City, ST, Zip: ,V1 q C ci 22 �3
h
Pne•
Tele o .
State Lic. # : City Lic. #•:
Arch., Cngr., Designer:
Address:
City, ST, Zip:
h
Tele o
Telephone: uctio
s tr n Type: Occupancy:
ConYP P Y:
e Lic. #
State L
S t m
New d'n ]ter Repair Demo
e it n Ne Ad A
Project (circle one): c
J type ) P
Name of Contact Person: 112 L Sq. Ft.: # Stories: # Units:
00�elephone # of Contact Person: d)_ 682 Estimated Value of
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Cales.
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.
II.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'rd Reyiew, 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