BELC2017-0030Applicant:
Contractor:
Ct i(.uU�l/
HEGGE ELECTRICAL CONTRACTORS, INC.
83852 AVE 45
83852 AVE 45`'
INDIO, CA 92201
VOICE (760) 777-7125
78-495 CALLE TAMPICO
(760)775-4855
0 D
LIc. No.: 748171
apply to an owner of property who builds or improves th(ireon; and who does.the work
INTEREST, AND ATTORNEY'S FEES.
.+
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
he or she did not build or improve for the purpose of sale.).
BUILDING PERMIT
(_) I, as owner of the property, am exclusively contracting with licensed contractors :
`. 1.• Each person upon.whose behalf this application is made, each person at whose
to construct the project. (Sec. 7044, Business and• Professions Code: The Contractors'
request and for whose benefit work is performed under or pursuant to any permit
Date: 4/3/2017
Application Number:
BELC2017-0030
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
Owner:
Property Address:
54805 OAK HILL
following issuance of this permit.
GARY CHASE
APN:
775141005
not commenced within 180 days from date of issuance of such permit, or cessation of
54805 OAKHILL
Application Description:
CHASE / INSTALL (1) 240V 30AMP DEDICATED CIRCUIT AT GARAGE
La Quinta, Ca 922S3
Property Zoning:
Application Valuation:
$2,449.00
Applicant:
Contractor:
HEGGE ELECTRICAL CONTRACTORS INC
HEGGE ELECTRICAL CONTRACTORS, INC.
83852 AVE 45
83852 AVE 45`'
INDIO, CA 92201
INDIO, CA 92201
compensation, will do the work, and the structure isnot intended or offered for sale.: `
(760)775-4855
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
LIc. No.: 748171
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: C10 License No.: 748171
Date
Contractor:
OWNER -BUILDER DECLARATION ,
I'hereby affirm under penalty of perjury that lam exempt from the, Contractor's State.
License Law for the following reason (Sec. 7031.5, Business and.Professions {ode: Any
city or county that requires a permit to construct, al-iu,'improve, demolish;:of 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 Section7606)'of Division
WORKER'S COMPENSATION DECLARATION
Fhereby 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 tFiemork for which this permit is issued.
I have and will maintain workers: compensation insurance, as required by
Section 3700 of the.LaborCode, for the performance of the work for which this permit
is.issued.',Myworkers' compensation insurance carrier and policy number are:
Carrier: HDI GLOBAL INSURANCE'COMPANY Policy Number: EWGCCDO02066
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.
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 '
Date: Applicant:
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
(_) I, 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
compensation, will do the work, and the structure isnot intended or offered for sale.: `
ONE 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 th(ireon; and who does.the work
INTEREST, AND ATTORNEY'S FEES.
himself or herself through his or her own employe-es,provided that the improvements;
are not intended oroffered 'for sale: If, however,the buildingior improvement is sold
APPLICANT ACKNOWLEDGEMENT
within one year of completion, the owner -builder will have the burden of proving that-,
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
he 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 :
`. 1.• Each person upon.whose behalf this application is made, each person at whose
to construct the project. (Sec. 7044, Business and• Professions Code: The Contractors'
request and for whose benefit work is performed under or pursuant to any permit
State License Law does not apply to an owner.of property who builds or improves
issued as a result of this application ,.the owner, and the applicant, each agrees to, and
thereon, and who contracts for the projects with a contractors) licensed pursuant.to
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
the Contractors' 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. forthis'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
Date: Owner:
work for 180 days will subject.permitto cancellation.
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:
I certify that (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
wmtruction,.and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
Lender's Address:
Application Number:
BELC2017-0030
Property Address:
54805 OAK HILL
APN:
775141005
Application Description:
CHASE / INSTALL (1) 240V 3'OAMP DEDICATED CIRCUIT AT GARAGE
Property Zoning:
Application Valuation:
$2,449.00
Applicant:
HEGGE ELECTRICAL CONTRACTORS INC
83852 AVE 45
INDIO, CA 92201
Date: 4/3/2017
Owner:
GARY CHASE
54805 OAKHILL
La Quinta, Ca 92253
Contractor:
HEGGE ELECTRICAL CONTRACTORS, INC.
83852 AVE 45
INDIO, CA 92201
(760)775-4855
LIC. No.: 748171
Detail: INSTALL (1) 240V 30AMP. DEDICATED CIRCUIT AT GARAGE FOR VEHICLE CHARGING. 2016 CALIFORNIA BUILDING CODES.
,
. i 2
,, i. ♦ _ } ... ..,. � *4-f••s- ,!4. '� .s .�n i��:Q 1�ct [ a. � iLi.:V! 1, L_ { f'.. ..
`. hill; 114 If '!1! 0111 11111'111& A
RF
DESCRIPTION' ` ',A00OUNT , QTY
s'
AMOUNT
BSAS 561473 FEE 101-0000-20306 0
$1.00
Total Paid for, BUILDING STANDARDS. ADMINISTRATION BSA: $1.00
DESCRIPTION
>• 'ACCOUNT` `
QTY
AMOUNT
Credit Card fee .,
101-0000-43505
0
$2.30
y s: •x :Total Paid for Credit Card Fee: $2.30
DESCRIPTION, ' '
; ACCOUNT,
QTY
AMOUNT
APPLIANCES, RES ''
r 101-0000-42403
0
$12.67
DESCRIPTION'
"' k" c ACCOUNT •.
QTY
AMOUNT
APPLIANCES, RES PC;`"101-0000-42600
0
$12.67
'Total Paid for ELECTRICAL: $25.34
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE.
[.',c`; 101-0000=42404
0
$96.27
Total Paid for, PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNTr "
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT;FEE"502-0000-43611
t:
0`
$5.00
Y
Total'Paid for TECHNOLOGY ENHANCEMENT FEE: N $5.00