BSPN2014-0034r
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BSPN2014-0034
c&h. 4 4 Q"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Property Address: --"79785 HWY 111 STE 102
APN: 600440006
Application Description: SPECIAL INSPECTION TO RELEASE POWER
Property Zoning:
Application Valuation:
Applicant:
P6K PORTFOLIO KDP
23 CORPORATE PLAZA STE 207
NEWPORT BEACH, CA 92660
OCT 15 2014
CITY OOOUINTA
COMMUNITDEVLPMM
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/15/2014
Owner:
P6K PORTFOLIO KDP
23 CORPORATE PLAZA STE 207
NEWPORT BEACH, CA 92660
Contractor:
Llc. No.:
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9
1 hereby affirm under penalty of perjury one of the following declarations:
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and
_ I have and will maintain a certificate of consent to self -insure for workers'
my License is in full force and effect.
compensation, as provided for by Section 3700 of the Labor Code, for the performance of
License Class: _ License No.: _
the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Date: Contractor:
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:
OWNER -BUILDER DECLARATION
Carrier: _ Policy Number: _
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
_ I certify that in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair any
compensation laws of California, and agree that, if I should become subject to the
structure, prior to its issuance, also requires the applicant for the permit to file a signed
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
statement that he or she is licensed pursuant to the provisions of the Contractor's State
comply with those provisions.
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
Professions Code) that he is basis for
10J,S
and or or she exempt therefrom and the the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the
Date: Applicant:
applicant to a civil penalty of not more than five hundred dollars ($500).:
WARNING: FAILURE TO SECURE WORKERS' COMPENS TION COVERAGE IS UNLAWFUL,
(_X1, as owner of the property, or my employees with wages as their sole
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
compensation, will do the work, and the structure is not intended or offered for sale.
HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
apply to an owner of property who builds or improves thereon, and who does the work
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
within one year of completion, the owner -builder will have the burden of proving that he
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
or she did not build or improve for the purpose of sale.).
the conditions and restrictions set forth on this application.
(_) I, as owner of the property, am exclusively contracting with licensed contractors to
1. Each person upon whose behalf this application is made, each person at whose
construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State
request and for whose benefit work is performed under or pursuant to any permit issued
License Law does not apply to an owner of property who builds or improves thereon, and
as a result of this application , the owner, and the applicant, each agrees to, and shall
who contracts for the projects with a contractor(s) licensed pursuant to the Contractors'
defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
State License Law.).
employees for any act or omission related to the work being performed under or
(_) I am exempt under Sec.' B.&P.C. for this reason
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
Date: d Owner: �. for 180 days will subject permit to cancellation.
CONSTRUCTION LENDINGAGENCY 11 certify that I have read this application and state that the above information is correct
I hereby affirm under penalty of perjury that there is a construction lending agency for I agree'to comply with all city and county ordinances and state laws relating to building
the performance of the work for which this permit is issued (Sec. 3097, Civ. Q. construction, and hereby authorize representatives of this city to enter upon the above-
mentioned property for inspection purposes.
Lender's Name: 2
Date: S I Signature (Applicant or Agent): Z45wv
Lender's Address:
PAID
PAID DATE.
FINANCIAL •
- DESCRIPTION' ACCOUNT
•
QTY AMOUNT
SPECIAL INSPECTION 101-0000-42404
1 $72.52
$0.00
PAID BY METHOD
RECEIPT #
CHECK.#
'"CLTD BY
Total Paid forCOMPLIANCE SURVEY/SPECIAL INSPECTION: $72.52 $0.00
TOTALS:• 0•
(ADO- qy�U-�or�
Bin # City of La Q grin to
'PVJ -Building &r Safety Division
Permit # `L P.O. Box 1504, 78 495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: 7 S (,1/l� l� a Owner's Name: 6 cATTFp(,4(0
A. P. Number:
Req'd
Address: 2-3 cow-poief TE ri-&-m _5' j tE
Legal Description:
PERMIT FEES
City, ST, Zip: 05VJP0,e( gFftr- d- c A-, 9 a (,(, O
Contractor: N
Telephone:/ L - 719 -t (��(
Address:
Item
Project Description:
City, ST, Zip:
Structural Calcs.
Telephone:
Reviewed, ready for corrections
%.::..;.:..::.,:::::,..,::., ,::•::�;:;:_:-.:
�UR ((� %��-�(Z. �/1%S• �LC�
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Called Contact Person
Address:
City., ST, Zip:
Telephone::;;
:;>.: ><z: :sa;:>:z:> ;:>
Construction Type: CUMa1F_9CfA"COccupancy:
Project type (circle orie): New dd'n Alter Repair Demo
State Lic. #:
Flood plain plan
........................ ...................
Mame of Contact Person:
(LEG�P•-]S0_M &J .
Sq. Ft.:
# Stories:
# Units:
(cicphonc #,of Contact Person: 7 trj®--7 %%- H
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal I
Req'd
Recd
TRACKUVG
PERMIT FEES
Plan Sets.
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
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 corrcctionsrssue
Electrical
Subcontacior List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
I1O.A. Approval
Plans resubmitted
Grading
IN IiOUSE:-
'`" Review, ready for eorrectionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
7
October 14, 2014
Imperial Irrigation District
PO Box 937
Imperial, CA 92251
RE: Komar Desert Center-P6K Portfolio KDP LLC
79-785 Highway 111, Unit #102, La Quinta
This letter authorizes the said Tenant — Gregory and Sara Waterman dba Fit Gals Closet,
The landlord, P6K Portfolio KDP LLC allows tenant to apply for an application for a
meter installation for the above referenced property.
Please allow tenant for a meter installatiori'as soon as possible.
If you -should have any questions or need additional approval I can be reached at (949)
718-4847. Thank you.
Sincerely,
G
Jill Mathews
Property Manager
KMS Properties, Inc.
23.Corporate Plaza, Suite.247, Newport Beach,:CA92660 TEL 949.718.4847 FAX: 949.718.4845
Description: SPECIAL INSPECTION TO RELEASE POWER
CONDITIONS
NAME TYPE
Type: SPECIAL INSPECTION
Subtype:
Status: ISSUED
Applied: 10/15/2014 PJU
Approved: 10/15/2014 AZA
Parcel No: 600440006 Site Address: 79785 HWY 111 STE 102 LA QUINTA,CA 92253
Subdivision: PM 036269
Block:
Lot: 6
Issued: 10/15/2014 AZA
Lot Scl Ft: 0
Building Scl Ft: 0
Zoning:
Finaled:
Valuation: $0.00
Occupancy Type:
Construction Type:
Expired: 4/13/2015 AZA
No. Buildings: 0
No. Stories: 0
No. Unites: 0
NEWPORT
BEACH
Details: SPECIAL INSPECTION TO RELEASE POWER TO IID.
92660
(949)718-4847
CHRONOLOGY
CONDITIONS
NAME TYPE
NAME
ADDRESSI
CONTACTS
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
P6K PORTFOLIO KDP
23 CORPORATE PLAZA
STE 207
NEWPORT
BEACH
CA
92660
(949)718-4847
OWNER
P6K PORTFOLIO KDP
23 CORPORATE PLAZA
STE 207
NEWPORT
BEACH
CA
92660
(949)718-4847
Printed: Monday, October 20, 2014 12:36:45 PM 1 of 2 Irm
Printed: Monday, October 20, 2014 12:36:45 PM 2 of 2