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BELC2014-1051 (BELC)47750 Adams Street 1313 s, - 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: BELC2014-1051 Property Address: 47750 ADAMS ST 1313 APN: 600020015 Application Description: METER INSTALL ADJU Property Zoning: Application Valuation: $0.00 Applicant: CALIFORNIA WIDE ELECTRIC P.O. BOX 1425 MORENO VALLEY, CA 92256 T4tr ^F 1wQubt& COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT DEC 04 2014 `CIfY OF LA QUINTA COMMUNITY DEVELO7MEtvR DEPARTMENT 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.: _ J Date: Z Contractor, / OWNE - UILDER 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 DivisionA3 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 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: I - 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: 1111 11111IIIIIIIII1 15 IE VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/4/2014 Owner: AVENTINE DEV 7131 OWENSMOUTH AVE NO 6D CANOGA PARK, CA 92253 Contractor: CALIFORNIA WIDE ELECTRIC P 0 BOX 1425 MORENO VALLEY, CA 92253 (951)906-7680 Llc. No.: 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 Code, I shall forthwith comply with t ose proS. ;4/4/Applicant: Date: WARNING: FAILURE TO SECURE W ERS' 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 buil 'ng construction, and hereby authorize representatives of this city to enter upon t o e• mgntioned property f inspection purposes. o bate: Z Signature (Applicant or Agent): FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SERVICES 101-0000-42403 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SERVICES PC 101-0000-42403 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL: $36.26 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT 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:• 00 Permit Details PERMIT NUMBER �-7City of La Quinta BELG214-1051 Description: METER INSTALL ADJUST CLIP "CH• Type: ELECTRICAL Subtype: Status: SUBMITTED Applied: 12/4/2014 PJU Approved: Parcel No: 600020015 Site Address: 47750 ADAMS ST 1313 LA QUINTA,CA 92253 Subdivision: Block: Lot: Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $0.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 STATE Details: ADJUST METER CLIP FOR METER INSTALLATION 2013 CEC. FAX EMAIL APPLICANT [Process S-um� m Printed: Thursday, December 04, 2014 12:56:55 PM 1 of 2 L! 1..1 Ll LI SYSTEMS "CH• • • • -WINIDIT10NS x NAME TYPE NAME ADDRESS1 CITY STATE ZIP PHONE FAX EMAIL APPLICANT CALIFORNIA WIDE ELECTRIC P.O. BOX 1425 MORENO CA 92256 VALLEY CONTRACTOR CALIFORNIA WIDE ELECTRIC P 0 BOX 1425 MORENO CA 92253 VALLEY OWNER AVENTINE DEV 7131 OWENSMOUTH CANOGA PARK CA 92253 AVE NO 6D Printed: Thursday, December 04, 2014 12:56:55 PM 1 of 2 L! 1..1 Ll LI SYSTEMS ' Permit Details 111RERMIT BERELC•214;IKM4 051 DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY SERVICES PC 101-0000-42403 0 $12.09 $0.00 Total Paid for ELECTRICAL: $36.26 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid forPERMIT ISSUANCE: $91.85 $0.00 .ry Printed: Thursday, December 04, 2014 12:56:55 PM 2 of 2 L U LJ LJ SYSTEMS 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation:, BELC2014-1051 47750 ADAMS CT' 3" 600020015 METER INSTALL 3 �`ski I Applicant: CALIFORNIA WIDE ELECTRIC P.O. BOX 1425 MORENO VALLEY, CA 92256 rd `&ttf41wQuiKz COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT 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. j License Class: _ License No.: _ /,Date: Contractor, / OWNE - UILDER 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 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 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 Addre! IIIIIIIIVIIIIIIVIIIIIII 16 IE VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/4/2014 Owner: AVENTINE DEV 7131 OWENSMOUTH AVE NO 6D CANOGA PARK, CA 92253 Contractor: CALIFORNIA WIDE ELECTRIC P 0 BOX 1425 MORENO VALLEY, CA 92253 (951)906-7680 Llc. No.: 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 Code, I shall forthwith comply with t ose proZApplicant: te: WARNING: FAILURE TO SECURE W ERS' 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 buil 'ng construction, and hereby authorize representatives of this city to enter upon t o e• mentioned property f inspection purposes. a 'Date : Z ` Signature (Applicant or Agent): sir _'tel DESCRIPTION FINANCIAL • ACCOUNT 1 QTY AMOUNT PAID PAID DATE SERVICES 101-0000-42403 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SERVICES PC 101-0000-42403 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL: $36.26 _ $0.00 DESCRIPTION ACCOUNT QTY AMOUNT 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 $0.00 Description: METER INSTALL ADJUST CLIP Type: ELECTRICAL Subtype: Status: SUBMITTED Applied: 12/4/2014 PJU Approved: Parcel No: 600020015 Site Address: 47750 ADAMS ST 1313 LA QUINTA,CA 92253 Subdivision: Block: Lot: Issued: Lot Scl Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $0.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 92256 Details: ADJUST METER CLIP FOR METER INSTALLATION 2013 CEC. Printed: Thursday, December 04, 2014 12:56:55 PM 1 of 2 NAAF CP SYSTEMS CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT CALIFORNIA WIDE ELECTRIC P.O. BOX 1425 MORENO CA 92256 VALLEY CONTRACTOR CALIFORNIA WIDE ELECTRIC P O BOX 1425 MORENO CA 92253 VALLEY OWNER AVENTINE DEV 7131 OWENSMOUTH CANOGA PARK CA 92253 AVE NO 6D Printed: Thursday, December 04, 2014 12:56:55 PM 1 of 2 NAAF CP SYSTEMS DESCRIPTIONI ACCOUNT I QTY I AMOUNT I PAID I PAID DATE I RECEIPT # I CHECK # I METHOD I PAID BY I BY SERVICES PC 101-0000-42403 1 0 $12.09 $0.00 Total Paid for ELECTRICAL: $36.26 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 PARENT PROJECTS BOND INFORMATION ATTACHMENTS Printed: Thursday, December 04, 2014 12:56:55 PM 2 of 2 V? SrSTEMS