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BCOM2014-103978-495CALLETAMPICiO f ,' LA QUINU, CA.L1 611 1A 92253 4 gra&.fw4u&rw COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: " BCOM2014-1039 Property Address: 79825 HIGHWAY 111 STE 101 APN: 600440007 Application Description: INTERIOR PARTITION WALL Property Zoning: Application Valuation: $1,000.00 J Applicant: MORRIS SHEPPARRD DESIGN 35362 MOORBROOK ROAD PALM DESERT, CA 92211 DEC 16 2014 COMMUNI I(DEV, �P QUA rA ,I MENrOEPgMnyEWT VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: P6K PORTFOLIO KDP 2301 ROSECRANS STE 2110 EL SEGUNDO, CA 92253 Contractor: ROBERT POLLOCK 2929 VIA VAQUERO PALM SPRINGS, CA 92262 (760)799-9805 Llc. No.: :LIC -0103431 Date: 12/16/2014 N --------------------------------------------------------------------------------------------- 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.: :LIC -0103431 ate: 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 A basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for 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, 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. . BAP.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 Name: Lender's Address: 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: Carrier: _ Policy 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 C*UNLAWF comply with those provisions. I Date: 4 Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COV 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. Dater l -Signature (Applicant or Agent): FINANCIAL •• • DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE ` BSAS 591473 FEW 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE PARTITION 101-0000-42400 0 $72.52 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE PARTITION PC 101-0000-42600 0 $133.43 $0.00 RAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PARTITION: $205.95 $0.00 DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE SMI - COMMERCIAL 101-0000-20308 0 $0.50 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $0.50 $0.00 TOTALS:i • •0 ' - Permit OilM lS PERMIT NUMBER Giof La Quna Rill OM2014-1039 Description: INTERIOR PARTITION WALL Type: BUILDING, COMMERCIAL Subtype: REMODEL Status: APPROVED Applied: 11/17/2014 SKH Approved: 11/17/2014 AOR Parcel No: 600440007 Site Address: 79825 HIGHWAY 111 STE 101LA QUINTA,CA 92253 Subdivision: PM 036269 Block: lot: 7 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $1,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 711/17/20147 Details: PARTITION WALL ONLY AT FRONT ENTRY [CONVENTIONAL) THIS PERMIT DOES NOT INCLUDE MECHANICAL, ELECTRICAL OR PLUMBING INSTALLATIONS, CHANGES TO OCCUPANCY OR OCCUPANT LOAD. FIRE DEPARTMENT APPROVAL REQUIRED PRIOR TO FIRST INSPECTION. 2013 CALIFORNIA BUILDING CODES. 1Proce�Summary n J Applied to Approved •�.."r • � � � a,.R� .-::. rry5 ' r ' �` : � �.J L ..aa.4t'!� �+`: f �,. 'may.`, n .S� � � f :5t. ,..;r> -..S 4.+* A` • � .,�� i �� r�.._a's+."r.` 'aa �' � Fay �`�'' s �'. � „y�*rf a C". .=� CHRONOLOGY TYPE STAFF NAME 711/17/20147 COMPLETION DATE NOTES PLAN CHECK COMPLETE/READY FOR PICK AJ ORTEGA 11/17/2014 OK TO ISSUE WITH CONTRACTOR UPDATE. UP CALLED MR. MORRIS (DESIGNATED CONTACT PERSON) ADVISED CONTRACTOR NEEDS TO UPDATE BUSINESS LICENSE TELEPHONE CALL . STEPHANIE KHATAMI 11/17/2014 11/17/2014 AND THAT FIRE APPROVAL IS REQUIRED BEFORE 1ST INSPECTION. (SK) 7 ✓' -a--- 5rt�. A - ter. 7 g ' F r.#`�f 0 r�k,-.�{ 3'ua}i »� ;' *p '� � +.�/f `- O • n -- tiC KS•M y.•> ;. � x '7 Y 'Y�; .5 ... .1.:. NAME TYPE NAME ADDRESS1 CITY STATE ZIP PHONE FAX EMAIL APPLICANT MORRIS SHEPPARRD DESIGN 35362 MOORBROOK PALM DESERT CA 92211 (310)625-0009 ROAD CONTRACTOR ROBERT POLLOCK 2929 VIA VAQUERO PALM SPRINGS CA 92262 (310)625-0009 Printed: Tuesday, December 16, 2014 9:42:15 AM 1 of 3 t7LJ FLJ LJ SYSTEMS FINANCIAL •• • DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: PARTITION 101-0000-42400 0 $72.52 $0.00 REVIEW TYPE REVIEWER SENT DATE DUE DATE PARTITION PC 101-0000-42600 0 $133.43 $0.00 DATE BUILDING Total Paid for PARTITION: $205.95 $0.00 SMI -COMMERCIAL 101-0000-20308 1 0 $0.50 $0.00 FIRE DEPARTMENT APPROVAL REQUIRED PRIOR Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $0.50 $0.00 TOTALS:00 Printed: Tuesday, December 16, 2014 9:42:15 AM 2 of 3 RWYSTEMS REVIEWS RETURNED STATUS REMARKS REVIEW TYPE REVIEWER SENT DATE DUE DATE NOTES DATE BUILDING AJ ORTEGA 11/17/2014 11/17/2014 11/17/2014 APPROVED FIRE DEPARTMENT APPROVAL REQUIRED PRIOR W/CONDITIONS TO FIRST INSPECTION FIRE JACQUELINE 11/17/2014 12/3/2014 12/3/2014 APPROVED GARCIA W/CONDITIONS Printed: Tuesday, December 16, 2014 9:42:15 AM 2 of 3 RWYSTEMS Permit Detrails PERMIT ' City of La Quinta BCOM20UMBER -N43 e is Attachment Type CREATED OWNER DESCRIPTION PATHNAME SUBDIR ETRAKIT,ENABLED DOC 12/3/2014 JACQUELINE GARCIA LAQ-I4-TI-044 LAQ-I4-TI-044 19 0 AcQPoint.doc AcQPoint.doc Printed: Tuesday, December 16, 2014 9:42:15 AM 3 of 3 (CONWlYSTEMS tQiR, Q # 4 (. C( Of La E1In •� ' . fv R. 'x-11 ta Bulldu1g 8L 5arety Dildsion Permit # , 314 P.O. Box 1504,78-495 Calle Tampico La.Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet bQJe'ct Address: L -�er's Name:. � 01 G✓ .. A. P. Number. Legal Description: A rty, ST, ntractor. elephone lett Description: itep $T, Zip: 9 i hane: rp = a� r?? - r/ %111 O N ' ! / eZ 4�✓K L '' i -tate Lic. # : �. �a • Arch,Engr., Designer. d r Address: , ST, Zip: . Telephone: �!!J •�. �O,_ . �: Construction Type:. Occupancy: State Lic. #: t ✓ icleone)' New Add'n Alter Repair tYPa (cDemo Name of Contact Person: O/Z�lsi�°�°ft' Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: QQ Estimated Value of Project Q p Q 2G7�-7T� APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACMG PERMIT FEES PlanSels j Plan Check submitted. (? Item Amount Structural Calls. Reviewed, ready for corrections Plan Check Deposit. . Truss Calls. Called Contact Person Plan Check Balance _ Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted.*. Mechanical Grading plea 2" Review, ready for correctiouslissue Electrical Subeoatactor List Called Contact Person Plumbing Grant Deed Plans picked up S bLL H-O.A. Approval Plans resubmitted Grading IN HOUSE-- '"' Review', ready for correctionsAme Developer Impact Fee Planning Approval Called Contact Person AJ.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees CA -7 t PW, two" 4N-1