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BELC2015-007778-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: BLAUVELT ELECTRIC 1525 VERBENA PALM SPRINGS, CA 92262 BELC2015=0077 51660 AVENIDA OBREGON 773124008 Tit 44aw COMMUNITY -DEVELOPMENT DEPARTMENT, BUILDING PERMIT DOOLEY / ELECTRIC CAR CHARGER IN GARAGE $500.00 VOICE (760) 777-7125. FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: ROBYN DOOLEY 51660 AVENIDA OBREGON LA QUINTA, CA 92253 Contractor: BLAUVELT ELECTRIC 1525 VERBENA PALM SPRINGS, CA 92262 (760)835-6858 Llc. No.: 402340 Date: 8/26/2015 CIc R ormance of the work for which this permit C-) n OWNER -BUILDER DECLARATION To 0 I hereby affirm under penalty of perjury that I am exempt from the Contractor's State that in the performance of the work for which this permit is issued, I O T a no$employ anyperson'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 , . 11 '' m� F any structure, prior to its issuance, also requires the applicant for the.permit to file a workers" compensation provisions of Section 3700 of the Labor Code, I shall forthwith : N O C� M D a CA permit subjects the applicant to a civil penalty.of not more than five hundred dollars WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, LICENSED CONTRACTOR'S7DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that am licensed under provisions of Chapter. I I hereby affirm under.penalty of perjury one of the following declarations 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,. _ I have and will maintain a certificate of consent to self -insure for workers' and my License is in full force and effect. compensation, as provided for by Section3700 of the Labor Code, for the performance License Class: C10 License No.: 40234 of a work for whichthis aintain issued. • .: ave.and will maintain workers' compensation insurance, as required,by D � L6I � S Con .a or: S.ection:3700 of the Labor Code, forthe perf 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 permiris issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: not commenced within"180 days from datebf 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 t ' city to enter upon the above. mentioned for inspection purposes. D�etLL Signature (Applicant or Age ormance 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 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 , a no$employ anyperson'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 , . 11 '' compensation laws'of California, and agree that, if I should become subject to the any structure, prior to its issuance, also requires the applicant for the.permit to file a workers" compensation provisions of Section 3700 of the Labor Code, I shall forthwith signed statement that he or she is licensed pursuant to the provisions of the comply with those provisions. 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 Applicants 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ($500).: AND.SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO (� I, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF compensation, will do the work, and the structure is not intended or offered for: sale. COMPENSATION,, DAMAGES AS:PROVIDED'FOR IN SECTION 3706 OF THE LABOR CODE, (Sec. 7044, Business and Professions Code: The Contractors' State License.Law does not INTEREST, AND ATTORNEY'S FEES. apply to an owner of property who builds or improves thereon,'and who does the work himself or herself through his or own employees; provided that the improvements APPLICANT ACKNOWLEDGEMENT are not intended or offered for sale. If, however, the building or improvement is sold IMPORTANT: Application is hereby made to the Building Official for a permit subject to within one year of completion, the owner -builder will have the burden of proving that the condiitions and restrictions set forth on'this application. he or she did not build or improve for the purpose of sale.). 1. Each person upon whose behalf this application is made, each person at whose (� I, as owner of the property,.am exclusively contr'acting with licensed contractors, request and for whose benefit work is performed under or pursuant to any permit to construct the project. (Sec. 7044, Business and.Professions Code: The'Contractors'• issued as a result of this application, the owner, and the applicant, each agrees to, and State License Law does not apply to an owner of property who builds or improves shall defend, indemnify and.hold harmless the City of La Quinta, its officers, agents, and thereon, and who contracts for the projects with a contractor(s) licensed pursuant. to employees for any act or omission related to the work being performed under or the Contractors' State License Law.). following issuance of this permit. U I am exempt under Sec. B.&P.C. for this reason 1. 2_. Any permit issued as'a.result of this'application becomes null and void if work is 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 permiris issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: not commenced within"180 days from datebf 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 t ' city to enter upon the above. mentioned for inspection purposes. D�etLL Signature (Applicant or Age i-1111Ii' B ` `, , `x. ,I:=q-:.:sem 'a sj ::�; } y .: "tt r" �y, r&' =&t�°'c'. . -`"`�':.�'<3f , .2 , ' ' Ek Via- & (t<Rs, "a`x �:e:, °' „ s ""y l':! . I V h" tK r - -. <Tlm . g x ��DESCRIPTION� `g TY `rAINIOUNT _Pi41D� Q Yt�`f c'¢y�ACCOUNT� : >PAIDxDATE �y��J �q A5"i��"4 i'. fn ....� E.pp .; i C 'f C't�S` S < 3 4 '�.+h',�'Y4.' y _. d"ft�w«f :-k.::' ut.8t;i•.. }r7 <rhi .sf:$.f',:�a k i'{'YV.. ,.��s< :t�s< C' .: £x'bi:9" +Y're w :b:. lEty,fRi i ,..�T�<a¢.''rs;., ° .rbv .°i "ta, Si+>,.:4.a.c.4.:X«'S` "w:m4E'3"�-,� _4F.<e r. ,'S <O, A:,„a+.`-�w..w.:.:.,s..rc?Rii.-�..,�`os.*w'.w •BSAS S91473 FEE ,1010000,20306 -t; ;.r0 4.. . $1.00.1 $0.00. PAID`?BY� �`�� `METHOD, �FRECEIPyT#' �FO',�'.e�.:2:.s+.<'`kaS`t1Y�tFf"S,,'w;`�..^uYc�.Q:d`s.'k",.s,3L �*k"�Tn%1?kL6.i<.`-:YY'tkw�?; E t CHCK#CLTDBY <.rr<,�,;Y7 Sn1,.4XTIft't✓L.b' Td:` i.'l:S.zE": Total Raid forBUILDING STANDARDS ADMINISTRATION BSk . $1 00 • .$0.00 . - r?a:.• "t ,. :-.""„e i * ... ' ::: , .+ , ; a?� DESCRIPTION 4c'72 w i w e z :si s a za r �z �y�z PAID D u; �� -- �� j�Yy y sAUbUNT 'aCF.IX'Ea:nY;.:.t_a:kx<S'�-x.:t-.3*r..,; L.::.SY:':c2&.iHi: LISP. 4'•'�.Y:.:?J I.M.: s.}dt�ns�4'F.Y YF�t'„'3T-..::t:l'era<..5..�. .Z"�Y” x.QTY •�..'4� LAMOUNT Pr.i�??.4:�?n:ni:i':4... ��..��.e . a Yi�?5„3.Y� E:'.:& .?::�$:��e'r ;PAID{DATEx .ri�'b�iS_.ti'k::eT^.': 42 APPLIANCES, RES t 101 0000-403 0 $12 09,£ $0.00 g*a•3's Y": ':.xb'#F "�'s`Si �4...,-,y9T L cPr - PAID BY METHOD F�� ¢"" „�:e3�' 4 € .;.:Fw g z�""3 t 2S "� RECEIRtT # ',E'ty4 i t -,£"s '-, '". _ `& `*"+ ,�" GLTDBY MAP :x.°CHECK VN �� '.:' CCUUNT _ TYdp MOUNTPAID�#sPAID¢DATEY r �i 3k :4$`«..= r `v`T. k n St:d v y'kDESCRIPTION t-s.T:iC I'ii ".`F�* �+:a,v4WO'�'Y�Ydt3ii'mw';k.NOR:`r`a3a PA ii. "I' §i x.3�`"'a s�.�E;dE R?�T,:&`3: ���N��fir �;'�e��,S�S>:�£`ak:,�:�$�+ns,�t�% vfs�s4s....:.,;%���+`.w41r:�s APPLIANCES, RES PC. 101-000042600 '0"_$12.09,' $0.00 PAID�iBY� r�'METFIOD� •Yw RECEIPT# #CLTD BYE r�}�g . 4_ �fso _�3:^ a:T•i.� zu.�_ A���'s :.'Y. rKeTP. ti??�F�". sT�va�i, 5-F�tiiY�v � �( 2�e- 4e"�k"tSt��'a4%rS{;,.r- �.i:�.L�v C4:ik 6: { � �iv...,vr.�+i,# . 3s ryE$_:k,.�f : NS$ x.x`A _ �i^.a'.v"�.:ddi.Fi.d r �CMEGK :�i�:::#`xx ^,4:#..t'.-,1nix.•z:. # . d. `f Td+.+�'.s..e < svw Zh,�+�z�-�' Totalpaid for.ELECTRICAL $24.18 $0.00 • :t sg(Rf.�k`A..:ati.".».a..,,bMai DESCRIP4TION� .' F ".: ; iACCOUNT ` W • °r QTfY t .:.$A`r-:,�:,tf" r'•i AMOUN#I>""PAID sem, ;�. +. E� +savS•'.1dE'� PAID<D'ATE4 kt �".+n�`9 eYa.er:'•r-.a'�•F»!ii '{b`: `".`L.iYR. ��a.".•"YL� hyk gym• 1�'�°Yan..L..ik uE%`r7'n rsa`..'? s�l..i aeh4h. '[,xC'km.�Pc.}:ti. EP, s:ni:?F"�sn�,rc! an<.rvctf.s���"f..'6: M�":'k&=-em:."5.'=S.'s: PERMIT ISSUANCE 101 0000;424044 .'' 0 ,; ' :$9185.; $0:00 "= ��-'9A.`F%ii f-'.+..t:af',:�yv d �rr%,+xdmn4i'..`l+`Ame,isa%TYyh:yTY+"'E`mv,iR'6npaKtr(,aa"bv�i`�c":ialxxTX:a,iS`.dv.;&iN..3.'d'`sn(a3 i 'e.rL` R k'`aaS vnS4S:4"3EEa�: 'r-;-4-1"-- h.✓-. rri=✓_�!£"•.1�r�:'a<_': Z`c§ RECEIP.T #. aCHEGK#�Er" mi'• �- :R�,. '?T,Z.�tiFP� �y� 4 6 g � ?�.¢ ^'C•�s�S y.'(±. CL�TDBYn�`! :ti*'�.S'"�+'xtw'.w+1Y,iiN:'Q�? a d * Total PaidforFxERMIT ISSUANCE $91 85 $0.00 a11Y.l�.,G:tn t.f- Description: DOOLEY / ELECTRIC CAR CHARGER IN GARAGE Type: ELECTRICAL Subtype: Status: UNDER REVIEW Applied: 8/26/2015 SKH Approved: 8/26/2015 SKH Parcel No: 773124008 Site Address: 51660 AVENIDA OBREGON LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 20 Lot: 4 Issued: UNIT 2 Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $500.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: ELECtRICAL - INSTALL (1) ELECTRIC CAR CHARGER IN GARAGE. 2013 CALIFONRIA BUILDING CODES. Printed: Wednesday, August 26, 2015 2:53:24 PM 1 of 2 ' SYSTEMS PARENT PROJECTS ., . BOND. INFORMATION .ATTACHMENTS Printed: Wednesday, August 26, 2015 2:53:24 PM 2 of 2 ' SYS iFN1S Bin # Cis ' of La Qurnto Building 8t Safety Division 78495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building 'Permit Application,.and Trackrrig,Sheet Permit # Project Address: SI (Q (��� o.� . Owner's Name:J. A. P. Number: Address: S (0 c) Avc,�l m� Legal Description: City, ST, Zip: '�:�, CPr •22'3 tra v-- Con ct r 0 t C T2 L -E l Telephone: ' 5. �. P Address: IS2s''.,•\J�clZ(3ENfl- JJ_►v� Project Description: City, ST, Zip: (wk" . cik (12 Z Jucxln ` Tele h n P o e. 3 k S •e � State Lic. # : C I 0 9 Q2 -S q O City Lie. #; Lo �S. '1 C©✓ 1'u` \- s 1cN.� Arch., Engr., Designer: 1J t.�e eA tev�. Address: City, ST, Zip: Telephone: IP one: aneY: Construction Type: Occupancy: StateL ic. # ' rPoJect type ('circle: one):: New Add'n Alter Repairair Demo t��.•.. Name of Contact Person: ueen: # Stories: Units: Telephone # of Contact Person: �'�qQ �3 (a. � Estimated Valueof Project: APPLICANT: DO NOT'WRITE.BELOW THIS LINE 9 Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections . Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review,:ready for. correclionsrssue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. I-I.O.A. Approval Plans resubmitted Grading IN ROUSE:- '"! Review, ready for corrcctionsrssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees, Total Permit Fees � � � y J�[,c.�..c.. .� � ��