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BELC2014-1026 (BELC)'78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: BELC2014-1026 `ter O& COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Property Address: 78625 ALDEN CIR APN: 604225024 Application Description: 200A SERVICE CHANGEOUT Property ZoniAg: Application Valuation: $1,400.00 Applicant: MARTINEZ ELECTRIC 0 OUTSIDE CITY LIMITS LA QUINTA, CA 92253 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: MAUREEN CARROLL 78625 ALDEN CIR LA QUINTA, CA 92253 II II Contractor: SEP 17 2014 U MARTINEZ ELECTRIC 0 OUTSIDE CITY LIMITS LA QUINTA, CA 92253 CIN OF LA QUINTA CAMMUNfTY DEVELOPMENT DEPARTMENT (760)834-5570 Llc. No.: :LIC -0103068 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjuDabat I am licensed under provisions of Chapter 9 {commencing with Section 7000}Division 3 of the Busi saiond Profes s Code, and my License is in full force; nd ect. License Class: _ License No.: IC -010306 1�Date: Cont :to I hereby affirm under penalty of perjury that I)am exempt from the Contractor's State License Law for the following reason (Sec. 70 .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.). U 1, 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.). U 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. Q. Lender's N Lender's Address: -' IIIIIIIIIIIIIIIIIIIIIIIII 66 IE Date: 9/17/2014 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 w rk 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 anyperson in any aper so as to become subject to the workers' compensation laws of California and agreia that, if I should comes bject to the workers' compensation provisi ns of Section 3 j00 of the L b r Cod , I shall forthw' h comply with those provisions. Date: 1-7 _ / A licant: WARNING: FAILURE TO SECURE WORKERS' C MPENSATION 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 ordinance nd tate laws relating to wilding construction, and hereby authorize representative of this c ty to enter uon t e above- mentioned property for inspection purposes. F All Date: r/ —/ Signature (Applicant or I -DESCRIPTION INFORMATIONFINANCIAL ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 9/17/14 PAID BY. METHOD :. RECEIPT # CHECK # CLTD BY MARTINEZ ELECTRIC DEBIT R1228 AOR Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SERVICES r; 101-0000-42403 �,/ 0 $24.17 $24.17 9/17/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY MARTINEZ ELECTRIC DEBIT R1228 AOR DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SERVICES PC 101-0000-42403 0 $12.09 $12.09 9/17/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY MARTINEZ ELECTRIC DEBIT R1228 AOR Total Paid for ELECTRICAL: $36.26 $36.26 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 9/17/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY MARTINEZ ELECTRIC DEBIT ' 1R1228 AOR Total Paid for PERMIT ISSUANCE: $91.85 $91.85 Description: 200A SERVICE CHANGEOUT Type: ELECTRICAL Subtype: Status: ISSUED Applied: 9/17/2014 AOR Approved: 9/17/2014 AOR Parcel No: 604225024 Site Address: 78625 ALDEN CIR LA QUINTA,CA 92253 Subdivision: TR 23268 Block: Lot: 107 Issued: 9/17/2014 AOR Lot Sq Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $1,400.00 Occupancy Type: Construction Type: Expired: 3/16/2015 AOR No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 200A SERVICE CHANGEOUT - 2013 CALIFORNIA BUILDING CODES. Applied to Approved M.Approved to. Issued Printed: Wednesday, September 17, 2014 9:33:21 AM 1 of 2 raw_ __ DESCRIPTION ACCOUNT - QTY AMOUNT PAID PAID DATE RECEIPT # CHECK #� METHOD PAID BY CLTD BY SERVICES 101-0000-42403 0 $24.17 $24.17 9/17/14 R1228 DEBIT MARTINEZ ELECTRIC AOR SERVICES PC 101-0000-42403 0 $12.09 $12.09 9/17/14 R1228 DEBIT MARTINEZ ELECTRIC AOR Total Paid for ELECTRICAL: $36.26 $36.26 PERMIT ISSUANCE 101-0000-42404 1 0 $91.85 $91.85 9/17/14 111228 DEBIT MARTINEZ ELECTRIC AOR Total Paid for PERMIT ISSUANCE: $91.85 $91.85 TOTALS: $129.11 $129.11 INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT' REMARKS` "°° "' NOTES DATE DATE ELECTRICAL FINAL" ATTACH M E NTS Printed: Wednesday, September 17, 2014 9:33:21 AM 2 of 2 IcIpw_ ........ Bin # City of La Quinta -Building 8t: Safety Division P.O. Box 1504, 78 495 Calle Tampico . La Quinta,CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # 4 Project Address: 71' LZA I " l v-, -L--Q Owner's Name:MA U R .-C -Cq 9 Ro LL- A. P. Number: Address: 7 ^ (0 2 %4 t C LQ C_1'0`- _[v'Legal LegalDescription: City, ST, Zip: Cl 2 Contractor: ��Z � Telephone: 4�0 'qCi Address: — (� Project Description: City, ST, Zip: dZil M/ Telephone: State Lic. # : 0 8 City Lic. #: Arch., Engr., Designer: Address: City., ST, Zip: Telephone: an tie . ConstructionT e: Occupancy: Project type (circle one): New Add'n Alter Repair Demo' State Lic. #: •..;:: ._-;::::._> <.;::-.«..:;•>. - : Name of Contact Person: Sq. Ft.: / Jdo # Stories: 1 # Units: Telcphone # of Contact Person: e9 Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE t/ Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cala. Called Contact Person Plan Check Balance. Title 24 Cala. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2.' Review, ready for corrcctionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Decd Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN IiOUSE:- Jrd Review, ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue Schodl Fees Total Permit Fees