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BELC2015-003078-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: MRC ENGINEERING 34300 GATEWAY DR. #120 PALM DESERT, CA 92211 4 sj� Q94& COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT BELC2015-0030 78601 HIGHWAY 111 643220007 LA QUINTA SQUARE/EXTERIOR LIGHTING AND PEDESTAL $125,000.00 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.: 397892 Date: /Z f'Contract�y/'`P o�P_/V c{�� 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 Name: Lender's VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: ACM LA QUINTA IV B 1800 AVE OF THE STARS 105 LOS ANGELES, Oc.92253 Contractor: MOOREFIELD CONSTRUCTION 600 N TUSTIN AVENUE SUITE I SANTA ANA, CA 52705 (714)972-0700 Llc. No.: 397892 Date: 9/14/2015 WORKER'S COMPENSA710N DECLARATION I hereby affirm under penalty of perjury one o- 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 oft a work for which this permit is issued. 4cI 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 insuranca 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 3s 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 3.700 of the Labor Code, I shall forthwith comply with those provisions. ,� L Dately: / �S Applicant��:e// aoI e< / el�% �S/ 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 ($100,007). 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 perform --d under or pursuant to any permit issued as a result of this application , the ownea., and the applicant, each agrees to, and shall defend, indemnify and hold harmless the •=ity of La Quinta, its officers, agents, and employees for any act or omission related to tl:e work being performed under or following issuance of this permit. 2. Any permit issued as a result of this applic:,tion 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 I agree to comply with all city and county ordinances and state laws rel n construction, and hereby authorize representatives of this city nt p mentioned p operty for inspection purposes. /f Datej y Signature (Applicant or Agent):I 71-0 FINANCIAL •1• DESCRIPTION `�'•"ACCOUNT QTY- AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $5.00 $0.00 PAID BY.' METHOD RECEIPT #. CHECK # = CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $5.00 $0.00 'DESCRIPTION ?s, ACCOUNT QTY AMOUNT PAID PAID DATE POLE LIGHTS 101-0000-42403 0 $338.38 $0.00 .PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION . ACCOUNT- QTY AMOUNT = PAID PAID DATE POLE LIGHTS PC 101-0000-42600 0 $338.38 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION'.: ACCOUNT QTY AMOUNT PAID, PAID DATE SERVICES 101-0000-42403 0 $24.17 $0.00 PAID BY METHOD .RECEIPT # CHECK # ,CLTD BY . ,ate DESCRIP..TION yap y ,,,,.�rA000UNT: QTY AMOUNT PAID ' PAID DATE SERVICES PC 101-0000-42403 0 $12.09 $0.00 PAID BY.. • . METHOD RECEIPT # CHECK #. �. • ;CLTD BY R Total Paid for ELECTRICAL: $713.02 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT f' T f PAID ? * PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 -- .,,. PAID BY METHOD RECEIPT # ., :� CHECK # CLTD BY . Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS::0• •• ffMOF.'Ct�" `'tj - _ .: ,^+.r„ t.• -r, i_ � , ...ae'�' �,,,� _ � y '�'e ...y�.� "'u �syy O ` r-. ' ��'y`.�•-•t!vi :,1T s...-af'w —re :�2•..--:•"^':2_..�� ..rX'- ,� ..-.-s.M. -.w+s 'C-,°�'it+ry.Ri.:-�.a. .s-� * c� ���..wi Description: LA QUINTA SQUARE/EXTERIOR LIGHTING AND PEDESTAL Type: ELECTRICAL Subtype: Status: APPROVED Applied: 4/21/2015 SKH Approved: 6/24/2015 BHA Parcel No: 643220007 Site Address: 78601 HIGHWAY 111 LA QUINTA„CA 92253 Subdivision: PM 36791 Block: Lot: 1 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $125,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: PARKING LOT LIGHTING - "ALDI GROCERY” LA QUINTA SQUARE. 14 QTY AT 20'-6" HGT ABV. GRADE PER ENGINEERED DESIGN: 2013 - CODES. 5/11/2015 STRUC RFC. 5/8/2015 64 Applied to Approved -� . 'r�'.T �E:' 'fh✓ fi 3w4 .r. s"`'Fr.• x • }*Y'F.' ..*;x. r..;. x :, ;�.-.,� S'r'tti-�....w • • • �;: s : -'� �-' x°�x�'' < M � ,� . �- nom. i� . � r Tr CHRONOLOGY TYPE "� `;'" �STAFF NAME _ ;, ' ACTION DATE - ' COMPLETION DATE i c• _` " NOTES _»* PLAN CHECK COMMENTS FROM CONSULTANT KAY HENSEL 5/8/2015 5/11/2015 STRUC RFC. 5/8/2015 RECEIVED PLAN CHECK COMMENTS FROM CONSULTANT MARY FASANO 6/22/2015 6/22/2015 RECEIVED FROM YOUNG APPROVABLE RECEIVED PLAN CHECK PICKFD I IP STFPHANIF KHATAMI 5/14/2015 5/14/3015 PICKED UP BY GILBEnT PLAN CHECK SENT TO STEPHANIE KHATAMI 6/8/2015 6/8/2015 OUTSIDE PC SUBMITTED 4-14-15 WITH NO STRUCTURAL, ADVISED VICTOR PLAN CHECK SUBMITTAL LEON. VICTOR SAID HE WOULD SEND IT OVER. CAN'T SEND STEPHANIE KHATAMI 4/14/2015 4/21/2015 RECEIVED - TO ESGIL UNTIL STRUCTURAL IS RECEIVED. WILL SEND TO _ PLANNING. Printed: Monday, September 14, 2015 11:36:45 AM 1 of 4 CRSYSTEMS Printed: Monday, September 14, 2015 11:36:45 AM 2 of 4 CewsrsreMS, RECEIVED INCOMPLETE SUBMITTAL 04-21-15 (NO PLAN CHECK SUBMITTAL STEPHANIE KHATAMI 4/24/2015 '7-17 0 STRUCTURAL). RECEIVED STRUCTURAL CALCULATIONS ON RECEIVED Printed: Monday, September 14, 2015 11:36:45 AM 2 of 4 CewsrsreMS, RECEIVED INCOMPLETE SUBMITTAL 04-21-15 (NO PLAN CHECK SUBMITTAL STEPHANIE KHATAMI 4/24/2015 5/1/2015 STRUCTURAL). RECEIVED STRUCTURAL CALCULATIONS ON RECEIVED 4/24/15, SENT TO YOUNG ON 5/1/15. PLAN CHECK SUBMITTAL STEPHANIE KHATAMI 6/8/2015 6/8/2015 RECEIVED VOICEMAIL TO VICTOR LEON TO NOTIFY HIM THAT TELEPHONE CALL BURT HANADA 5/13/2015 5/13/2015 CORRECTION PACKAGE IS READY FOR PICKUP AT BLDG. DIV. NOTIFIED VICTOR LEON THAT PLANS ARE APPROVED AND TELEPHONE CALL BURT HANADA 6/24/2015 6/24/2015 PERMIT IS READY TO ISSUE WITH A VALID CONTRACTOR. ':� S' •�' � , ,l. �Ct` v�Y .� "6t�+3t '� � � ,�� 3 � &�L� � r ';x !Y' d "'rF•-xP -y �; �' ,��,t 4s y .5 . CONDITION DATE DATE ' ,; F;'t .. CONTACT DATE ADDED • STATUS REMARKS NOTES TYPE REQUIRED SATISFIED READY TO ISSUE BURT HANADA) 6/22/2015 PROCESS N^v ,'�� i gIN T',���h .� I..- Ct i ��rt.6Y .q �4�.. �� � .. �'.(4 •�2���iF °y 'tS L. -ti. �-� 1 t�ti' 55..t r':. �..�xi- �..i.� { .1 '"`� "�``S"r�3+ t. J .. 'J. -ter ,x=. 4• .a .+-s:�y ;fA � . x i -_ ."'qtr ._�,i �,, .. :� J !'p �i... ,, i '1'!.• _Y3+ � ✓,'f•.. NAMETYPE ' NAME7 -ADDRESS1 .. t CITY _ :' STATE ZIP PHONE FAX ','EMAIL APPLICANT MRC ENGINEERING 34300 GATEWAY DR. PALM DESERT CA 92211 (214)637-6219 (214)637- #120 6997 CONTRACTOR MOOREFIELD CONSTRUCTION INC 600 N TUSTIN AVENUE SANTA ANA CA 92705 (214)637-6219 (214)637 - SUITE #210 6997 ENGINEER RONALD A ROBERTS, 2948 STEMMONS DALLAS TX 75247 (214)637-6219 (214)637 - FREEWAY 6997 OWNER ACM LA QUINTA IV B 1800 AVE OF THE STARS LOS ANGELES CA 92253 (214)637-6219 (214)637- KSTALEY@MAGELLANG 105 6997 RP.COM C LTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY Y BSAS SB1473 FEE 101-0000-20306 0 $5.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $5.00• $0.00 BSA: POLE LIGHTS 101-0000-42403 0 $338.38 $0.00 Printed: Monday, September 14, 2015 11:36:45 AM 2 of 4 CewsrsreMS, r DESCRIPTION ACCOUNT.- QTY _• AMOUNT; PAID PAID DATE' r� : RECEIPT # K CHECK # METHOD PAID.BY. • ^ * CLTD BY' POLE LIGHTS PC 101-0000-42600 0 $338.38 $0.00 5/12/2015 REVISIONS REQUIRED NON-STRUCTURAL SERVICES 101-0000-42403 0 $24.17 $0.00 HANADA SERVICES PC 101-0000-42403 0 $12.09 $0.00 d/7a/7nl S S/R/7m 5 5/R/2015 REVISIONS REQUIRED Total Paid for ELECTRICAL: $713.02 $0.00 PERMIT ISSUANCE 101-0000-42404 T -0-T- $91.85 $0.00 ENGINEERING Total Paid forPERMIT ISSUANCE: $91.85 $0.00 TOTALS::0• i0 fl • SEQID_ INSPECTION TYPE INSPECTOR- SCHEDULED COMPLETED RESULT REMARKS NOTES, z GATE DATE ---t r. ELECTRICAL FINAL" BLD PARENT PROJECTS REVIEWS RETURNED' STATUS s' REMARKS REVIEW TYPE REVIEWER SENT DATE. .'DUE DATE NOTES DATE s PLANNING JAY WUU 4/21/2015 5/5/2015 5/7/2015 READY FOR APPROVAL BURT 4/24/2015 5/8/2015 5/12/2015 REVISIONS REQUIRED NON-STRUCTURAL HANADA d/7a/7nl S S/R/7m 5 5/R/2015 REVISIONS REQUIRED STRUCTURALY01ING ENGINEERING NON-STRUCTURAL - BURT 6/8/2015 6/22/2015 6/22/2015 APPROVED 2 WK HANADA YOUNG 6/8/2015 6/22/2015 6/22/2015 READY FOR APPROVAL STRUCTURAL - 2 WK ENGINEERING - - ��- -- -- - - — _ - BOND INFORMATION - - ----- - - Printed: Monday, September 14, 2015 11:36:45 AM 3 of 4 OrwSYSTEMS y a < U ?gum p - •� - Ab OFTNF'� �., - .. • '`t k':.+' r^-vr'r"'•7 t �. .�`a ...Nw.'T� 3..bti..r._..t.'... "L.�+. 'ry _3.._-.� „_t..rd• ..mw -.-c..? 1�•J+ F 1 i J T.y S .NFA '.Y rc F tsa N VI - r A7a nt—T-y REATED OWNER'}s DESCRIPTION `< 'rPATHNAME SUBDIR' ETRAKITfNABLED _ La Quinta Square Light La Quinta Square Light , DOC 4/27/2015 _ BURT HANADA Standard 15171SK1 SK -1 Standard 15171SK1 SK -1 1 _ (1).pdf - (1).pdf La Quinta Square - Light La Quinta Square - Light DOC 4/27/2015 BURT HANADA Standard calcs.pdf Standard caics.pdf 1 1ST SUBMITTAL NON 78-601 HIGHWAY 111- DOC 5/13/2015 BURT HANADA STRUCTURAL 1 SITE LIGHTING_l.docx CORRECTION LIST 1ST STRUCTURAL - BELC 2015-0030 KS DOC 5/8/2015 KATHRYN SAMUELS COMMENTS (ist).doc_ 0 NEW CITY TRANSMITTAL DOC 5/8/2015 KATHRYN SAMUELS 1ST STRUCTURAL - BELC 2015-0030 0 TRANSMITTAL (lst).pdf 2ND SUBMITTAL CHECK 2ND SUBMITTAL CHECK DOC 6/8/2015 STEPHANIE KHATAMI LIST AND COMMENTS LIST AND COMMENTS 0 06-08-15.pdf 06-08-15.pdf ' Printed: Monday, September 14, 2015 11:36:45 AM 4 of 4 CAW& srsrEMs