BCOM2017-004178-495 CALLE TAMPICO C� 0 D �IL(II�Cl/
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: BUILDING. COMMERCIAL/REMODEL
Application Number: BCOM2017-0041 .
Property Address: 78401 HIGHWAY 111 SS A
APN: 604050059 I� .
Application Description: HARSCH INVESTMEN 74F"1OFFICE TI NI_9 B -B--0-
-,+0
OL/NS
Property Zoning: 11 l
Application Valuation: $50,000.00 1
`r CITt' OF LAQUINTA
Applicant: CO,mk mTYDEvELOF,)AENTDEFART1;1EtFT
SUTTON REMODELING SPECIALISTS DBA SRS -BU
41905 BOARDWALK STE I
PALM DESERT, CA 92211
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.: 837914
Date: I 2 ' 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.).
(_) 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 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 Address:
VOICE (760) 777-7125
FAX.(760) 777-7011
INSPECTIO/Date:
S (760) 777-7153
1/2/2018
Owner:
HARSCH INV REALTY
1121 SALMON ST 4TH FL
PORTLAND, OR 92253
Contractor:
SUTTON REMODELING SPECIALISTS DBA SRS -BU
41905 BOARDWALK STE I
PALM DESERT, CA 92211
(760)674-9000
Llc. No.: 837914
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' corn pensation 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: EXEMPT Policy Number --
-
umber:__ 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 enter upon the
above-mentioned property for inspection purposes.
Date: rZ P Signature (Applicant r Agent
;e
--
Date: 1/2/2018
Application Number: BCOM2017-0041
Owner:
Property Address: 78401 HIGHWAY 111 STE A
HARSCH INV REALTY-
APN: 604050059
1121 SALMON ST 4TH FL
Application Description: HARSCH INVESTMENT / 2,074SF OFFICE TI/VB/B-OCC/20-OL/NS
PORTLAND, OR 92253
Property Zoning:
Application Valuation: $50,000.00
Applicant:
Contractor:
SUTTON REMODELING SPECIALISTS DBA SRS -BU
SUTTON REMODELING SPECIALISTS DBA SRS -BU
41905 BOARDWALK STE 1
41905 BOARDWALK STE I
PALM DESERT, CA 92211
PALM DESERT, CA 92211
(760)674-9000
-----------------------------------------------------------
Llc. No.: 837914
Detail: 2,074SF TENANT IM PROVE MENT/VB/B-OCC/20-OL/NON-SPRINKLED (OFFICE LEASE SPACE - NO CURRENT TENANT) THIS PERMIT DOES NOT INCLUDE
ALTERATION TO EXISTING LOAD BEARING OR FIRE RESISTIVE CONSTRUCTION. ACCESSIBILITY UNREASONABLE HARDSHIP APPROVED BASED ON
IMPROVEMENTS BEING PERFORMED CONCURRENTLY, REFERENCE BCOM2017-0042 AND ATTACHED
FORMS. 2016 CALIFORNIA BUILDING CODES.
DESCRIPTION ACCOUNT QTY AMOUNT
—+BSAS SB1473 FEE 101-0000-20306 0 $2.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
Credit Card Fee
101-0000-43505
0
$2.25
DESCRIPTION
ACCOUNT
QTY
AMOUNT
Credit Card Fee
101-0000-43505
0 .
$12.11
Total Paid for Credit Card Fee: $14.36
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20
101-0000-42403
0
$26.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20 PC
101-0000-42600
0
'$26.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES/FIXTURES, ADDITIONAL
101-0000-42403
0
$41.60
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES/FIXTURES, ADDITIONAL PC
101-0000-42600
0
$10.40
Total Paid for ELECTRICAL: $104.02
DESCRIPTION
ACCOUNTQTY
AMOUNT
FIRE COMMERCIAL Ti PC
101-0000-42420
0
$234.00
Total Paid for FIRE FEES: $234.00
DESCRIPTION'
ACCOUNT
QTY
AMOUNT
PLAN CHECK DEPOSIT - ADDITION/REMODEL
101-0000-42600
1
$125.00
Total Paid for PLAN 'CHECK DEPOSIT - ADDITION/REMODEL: $125.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP
101-0000-42401
0
$26.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT ,
FIXTURE/TRAP PC
101-0000-42600
0
$26.00
Total Paid for PLUMBING FEES: $52.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RECORDS MANAGEMENT FEE - MAJOR
.101-0000-42416
0
$20.00
Total Paid for RECORDS MANAGEMENT FEE - MAJOR: $20.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
101-0000-42600
($125.00)
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF
101-0000-42400
0
$93.64
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$74.88
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 100 SF
101-0000-42400
0
$53.05
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 500 SF PC
101-0000-42600
0
$125.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 500 SF PC
101-0000-42600
0
$20.12
Total Paid for REMODEL: $241.69
DESCRIPTION
ACCOUNT.
QTY
AMOUNT
SMI - COMMERCIAL
101-0000-20308
0
$14.00
Total Paid for STRONG MOTION INSTRUMENTATION SMI: .$14.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS: $812.01
City Of La* ta
Qi11>�t
Building 8t Safety Aivfsion
P.O. Box 1504, 78-495 Calle Tampico
La..Quinta, CA 92253 -:(760) 77T7012
v y / ilding PermitAppiicatioi7 and Tracking Sheet
Permit #
dCo94VI I=o
Project Address: 78401 HWy 111S6ite A
Owner's Name: Harsch Investment Realty
A. P. Number. 604050059-3
Address: 1121 Salmon Street 4th Floor
Legal Description: Lot 1 PM 124/047 19028
City, ST, Zap: Portland OR 97205
Contractor: .SRS -Builders
Tel hone; 760.771.4580 - Steven Chaffee y .. s3 g.� .
ep
Address:41905 Boardwalk, Suite. i
Project Description: Build.demising wall. Remodel offices,.
city, ST, zip: Palm Desert CA 92211
framing, electrical, plumbing, drywall, finish carpentry,
Telephone: 790.674.90.00
ryz
flooring, paint.
_�OUT ("MPRpt)
te Lic. # : 837914
City Lie'. #;
LAArch.jEngr., Designer, Same as Above
dress: ----
City., ST, Zip; ----.----- -- --- - -
Telephone: ------------=
>�
x�
State Lic. #: --' ----------- .. £ `'
p. C
Name of Contact Person: Billy Sutton
Construction Type:. Occupancy
w✓
Project type (circle one): New Add'n V`? Repair Demo
Sq.Ft.: 2074 #Stories: # Unita:
Telephone # of Contact Person: 760.8802552
Estimated Value of Project $50,000.00.
APPLICANT: DO NOT WRITE BELOW THIS LINE
0 Submittal Req'd heed TRACKING PERMIT FEES
Plan Sets
Pian Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss COO,
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
r! Review, ready for correctionsl'issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.1.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A LP.P.
Pub. Wks. Appr
Dale,orpermit issue
School Fees
Total Permit Fees