BCOM2015-0062l llllll VIII IIII I'll
-� 53
���, VOICE (760) 777-7125
Q�i
78-495 CALLE TAMPICO Ct 0 V 4 N.N1�C(/
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Application Number:
BCOM2015-0062
Property Address:
78555 HIGHWAY 111 #100
APN:
643220025
Application Description:
JJD LLC / T.I. REAL ESTATE OFFICE
Property Zoning:
Application Valuation:
$35,000.00
Applicant:
GABRIEL LUJAN & ASSOCIATES
45175 PANAORAMA DR. SUITE A
PALM DESERT, CA 92253
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: B License No.: 884711
Dafie: Contractor:l� i•� yL1Se �UP� O (� 2i�5
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.).
(__j 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 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 permitis issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
Owner:
JDD
78555 HIGHWAY 111
LA QUINTA, CA 92253
Contractor:
MIRAGE DEVELOPERS INC
121 S PALM CANYON DR #208
PALM SPRINGS, CA 92262
(760)864-9448
LIC. No.: 884711
Date: 2/25/2016
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 policy number are:
Carriew. z Policy Number: _
I certify that in the performance of the work for which this permit is issued, I
sshall 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.
ate: Z Z� 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 enter upon the
above-mentioned property for inspection purposes.
Dat -.-Signature (Applicant or Agent
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Total;Paid for ELECTRICAL: $256.72 $256.72
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2/25/16,
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2/25/16
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OUNT��� ���PAID��;,
REMODEL, FIRST 100 SF
101-0000-42400
0
$49.31
$49.31
2/25/16
PAID BY.
METHOD
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R13262
9808
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DESCRIPTION
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QTY
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PAID
PAID DATE,
REMODEL, FIRST 500 SF PC
101-0000-42600
0
$134.88
$134.88
2/25/16
PAID BY
METHOD
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CLTD B.Y:. ;
HLH ENTERPRISESK INC.
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R13262
9808
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Total Paid for REMODEL:. $575.69 $575.69
i
Description: JJD LLC / T.I. REAL ESTATE OFFICE
Type: BUILDING, COMMERCIAL Subtype: REMODEL Status: APPROVED
Applied: 11/9/2015 SGU
Approved: 2/18/2016 BHA
Parcel No: 643220025 Site Address: 78555 HIGHWAY 111 #100 LA QUINTA,CA 92253
Subdivision: PM 29791 Block: Lot: 1
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $35,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
KAY HENSEL
Details: TENANT IMPROVEMENT FOR REAL ESTATE OFFICE
4,951 SF INTERIOR TENANT IMPROVEMENT FOR "BERKSHIRE HATHAWAY / CALIFORNIA PROPERTIES" REAL ESTATE OFFICES. "B"
OCCUPANCY, TYPE V -B CONSTR. 48 OCC. LOAD. 2013 CODES.
._ i Applied to Approved
ADDITIONAL
CHRONOLOGY
CHRONOLOGY TYPE
STAFF NAME-
ACTION DATE COMPLETION DATE
NOTES
NOTE
KAY HENSEL
2/5/2016
2/5/2016
GABRIEL LUJAN BROUGHT IN THE ENERGY CALCS THAT HE
FORGOT ON 2/3 WHEN HE RESUBMITTED
NOTE
STEPHANIE KHATAMI
2/3/2016
2/3/2016
CHANGE OF APPLICANT (LETTER ATTACHED FOR APPROVAL)
PLAN CHECK PICKED UP
STEPHANIE GUMPERT
11/24/2015
11/24/2015
PUBLIC COUNTER VISIT
RAMSES SEVILLA
2/22/2016
2/22/2016
GABRIEL DROP OFF ASSESOR SET AND FIRE LETTER
APPROVOL
TELEPHONE CALL
BURT HANADA
11/24/2015
11/24/2015
NOTIFIED TOD DAVIDSON THAT CORRECTIONS ARE READY
FOR PICKUP
TELEPHONE CALL
BURT HANADA
2/18/2016
2/18/2016
CONTACTED GABRIEL LUJAN THAT PLANS.ARE APPROVED,
NEED FIR LETTER AND 1 SET OF PLANS FOR ASSESSOR.
CONDITIONS
Printed: Thursday, February 25, 2016 10:26:40 AM 1 of 4
SYSTEHIS
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CONDITION
CONTACT
DATE
DATE
DATE
STATUS
REMARKS
NOTES
TYPE
DESCRIPTION
ADDED
REQUIRED
SATISFIED
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
1 SET FOR ASSESSOR COPY REQUIRED PRIOR TO
BY
BSAS SB1473 FEE
101-0000-20306
0
$2.00
$2.00
2/25/16
R13262
9808
CHECK
PERMIT ISSUANCE.
READY TO ISSUE
BURT HANADA
2/18/2016
2/22/2016
2/22/2016
COMPLETE
FIRE DEPT. APPROVAL LETTER.
CHECKLIST
Total Paid for BUILDING STANDARDS ADMINISTRATION
$2.00
$2.00
BSA:
1 ASSESOR COPY REC'D; 1 FIRE APPROVAL LTR
101-0000-42403
0
$166.98
$166.98
2/25/16
R13262
9808
CHECK
HLH ENTERPRISESK
SKH
RECD.
INC.
DEVICES, ADDITIONALHLH
101-0000-42600
0 �
$41.40
$41.40
2/25/16
R13262
9808
CONTACTS
NAME TYPE
NAME
PC
ADDRESSI
CITY -
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
GABRIEL LUJAN & ASSOCIATES
45175 PANAORAMA
PALM DESERT
CA
92253
(760)578-8545
$24.17
2/25/16
R13262
9808
CHECK
DR. SUITE A
SKH
CONTRACTOR
MIRAGE DEVELOPERS INC
121 S PALM CANYON
PALM SPRINGS
CA
92262
(760)578-8545
101-0000-426000
$24.17
$24.17
2/25/16
DR #208
9808
CHECK
HLH ENTERPRISESK
SKH
OWNER
JDD
78555 HIGHWAY 111
LA QUINTA
CA
92253
(760)578-8545
Printed: Thursday, February 25, 2016 10:26:40 AM 2 of 4 cJ
SYSTEMS
FINANCIAL
INFORMATION
DESCRIPTION
ACCOUNT
QTY
`AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY
BSAS SB1473 FEE
101-0000-20306
0
$2.00
$2.00
2/25/16
R13262
9808
CHECK
HLH ENTERPRISESK
SKH
INC.
Total Paid for BUILDING STANDARDS ADMINISTRATION
$2.00
$2.00
BSA:
DEVICES, ADDITIONAL
101-0000-42403
0
$166.98
$166.98
2/25/16
R13262
9808
CHECK
HLH ENTERPRISESK
SKH
INC.
DEVICES, ADDITIONALHLH
101-0000-42600
0 �
$41.40
$41.40
2/25/16
R13262
9808
CHECK
ENTERPRISESK
SKH
PC
INC:
DEVICES, FIRST -20
101-0000-42403
0
$24.17
$24.17
2/25/16
R13262
9808
CHECK
HLH ENTERPRISESK
SKH
INC.
DEVICES, FIRST 20 PC.
101-0000-426000
$24.17
$24.17
2/25/16
R13262
9808
CHECK
HLH ENTERPRISESK
SKH
INC.
Total Paid for ELECTRICAL:
$256.72
$256.72
Printed: Thursday, February 25, 2016 10:26:40 AM 2 of 4 cJ
SYSTEMS
DESCRIPTION
ACCOUNT.
QTY
AMOUNT .
PAID
PAID DATE
RECEIPT # •
CHECK #
METHOD
PAID BY
CLTD
RETURNED
REVIEWS
STATUS
REMARKS.
REVIEW TYPE REVIEWER
SENT DATE
DUE DATE
BY
FIXTURE/TRAP
101-0000-42401
0
$12.09
$12.09
2/25/16
R13262
9808
CHECK
HCH ENTERPRISESK
SKH
BURT
11/9/2015
11/24/2015
11/23/2015
REVISIONS REQUIRED
1ST BLDG NS (2 -WK)
INC.
FIXTURE/TRAP PC
101-0000-42600
0
$12.09.
$12.09
2/25/16
R13262
9808
CHECK
HLH ENTERPRISESK
SKH
1ST PLANNING (2
JAY WUU
11/9/2015
11/24/2015
12/7/2015
READY FOR APPROVAL
INC.
Total Paid for PLUMBING FEES: $24.18 $24.18
REMODEL, EA
101-0000-42400
0
$217.50
$217.50
2/25/16
R13262
9808
CHECK
HLH ENTERPRISESK
SKH
ADDITIONAL 500 SF
WK)
HANADA
CONDITIONS
COPY.
INC.
2ND PLANNING (2
REMODEL, EA
101-0000-42600
0
$174.00
$174.00
2/25/16
R13262
9808
CHECK
HLH ENTERPRISESK
SKH
ADDITIONAL 500 SF PC
NEW DESIGNER PLEASE REVIEW
INC.
REMODEL, FIRST 100 SF
101-0000-42400
0
$49.31
$49.31
2/25/16
R13262
9808.
CHECK
HLH ENTERPRISESK
SKH
INC.
REMODEL, FIRST 500 SF
101-0000-426000
$134.88.
$134.88
2/25/16
R13262
.9808
CHECK
HLH ENTERPRISESK
SKH
PC
INC.
Total Paid for REMODEL: $575.69 $575.69
TOTALS:
INSPECTIONS
Printed: Thursday, February 25, 2016 10:26:40 AM 3 of 4
SYSTEM S
PARENT
RETURNED
REVIEWS
STATUS
REMARKS.
REVIEW TYPE REVIEWER
SENT DATE
DUE DATE
NOTES M
DATE
-.;.
BURT
11/9/2015
11/24/2015
11/23/2015
REVISIONS REQUIRED
1ST BLDG NS (2 -WK)
HANADA
1ST PLANNING (2
JAY WUU
11/9/2015
11/24/2015
12/7/2015
READY FOR APPROVAL
WK)
2ND BLDG NS (2
BURT
2/3/2016
2/18/2016
2/18/2016
APPROVED-
1 SET FOR ASSESSOR
WK)
HANADA
CONDITIONS
COPY.
2ND PLANNING (2
JAY WUU
2/3/2016
2/18/2016
2/8/2016
READY FOR APPROVAL
WK)
NEW DESIGNER PLEASE REVIEW
Printed: Thursday, February 25, 2016 10:26:40 AM 3 of 4
SYSTEM S
BOND INFORMATION 11
Printed: Thursday, *February 25, 2016 10:26:40 AM 4 of 4 ,.
SYS7EnAS
ATTACHMENTS
Attachment Type
CREATED
OWNER
DESCRIPTION PATHNAME
SUBDIR
ETRAKIT ENABLED ,
78-555 Highway 1111.00 78-555 Highway 111 100
DOC
11/24/2015
BURT HANADA
T.I..docx T.I..docx
0
DOC
2/22/2016 ,
RAMSES SEVILLA
APPROVE FIRE LETTER approv fire letter.pdf
1
DOC
2/3/2016
STEPHANIE KHATAMI
CHECK LIST 2-3-16.pdf CHECK LIST 2-3-16.pdf
0
REQUEST TO CHANGE REQUEST TO CHANGE
DOC
2/3/2016
STEPHANIE KHATAMI
DESIGNER -APPLICANT 2 DESIGNER -APPLICANT 2
0
-3-16.pdf-3-16.pdf
Printed: Thursday, *February 25, 2016 10:26:40 AM 4 of 4 ,.
SYS7EnAS