BELC2014-102178100 Main St Ste 110
BELC2014-1021
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
78100 MAIN ST A-110
770121010
RELOCATE SUB PANEL
$700.00
Applicant:
HEGGE ELECTRICAL CONTRCTRS INC
0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
a& Qa& VOICE (760) 777-7125
D 5
FAX (760) 777-7011
OMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/11/2014
FPSOwner:
1OLD TOWN LA QUINTA LLC
: 7
78010 MAIN ST NO 201
1 1 ZO 4 LAQUINTA,CA92253
CITY OF LA QUIWA
COWAPMOEyEIOPtiENTDEPARTMENT
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.: :LIC -0000218
ate: —G — Contractor:
OWNER-BUILDE/315,.rBusiness
RATION
I hereby affirm under penalty of perjury thampt from the Contractor's State
License Law for the following reason (Sec. 7 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).:
( 11, 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.).
(_J 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
Lender's
Contractor:
HEGGE ELECTRICAL CONTRCTRS INC
0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
(760)775-4860
Llc. No.: :LIC -0000218
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
those provisions.
Dae / / Ap nt:
WARNING: FAILURE TO SECURE WORKERS' 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 ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned property for i spection purposes.
I t"re / Signaturey pplicant or Agent):
T
FINANCIAL
.`.DESCRIPTION _.,` fi s r Q A; ACCOUNT QTY s,. ,A OUNT,` PAID '•k PAID DATE
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 9/11/14
:PAID BY"°METHOD ,; 3 < itECEIPT # x'CHECK # r CLTD BY '
HEGGE ELECTRICAL CONTRCTRS INC CHECK R1097 29543 MFA
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00
r DESCRIPTION "r=°ACCOUNT'°QTY
, AMOUNT.
PAID
PAID.DATE
SERVICES
101-0000-42403
0
$23.83
$23.83
9/11/14
w- PAID
, ii METHOD
RECEIPT ,#.,
7' CHECK #
C.LTD BY-`
HEGGE ELECTRICAL CONTRCTRS INC
CHECK
R1097
29543
MFA
i DESCRIPTION ". , i'l g.
t < . `ACCOUNT ' 6
Q TY
A T a"
MOUN
E' , AID
-PAID
PAID DATE'
SERVICES PC
( 101-0000-42403
0
$11.92
$11.92
9/11/14
PAIDBY ,
y a METHOD
,RECEIPT #"
`CHECK # a;
CL TO
HEGGE ELECTRICAL CONTRCTRS INC
CHECK
R1097
29543
MFA
Total Paid for ELECTRICAL: $35.75 $35.75
-,
< `DESCRIPTI ON:'
ACCOUNT .,
QTY
AMOUNT; -g
=PAID"<
, PAIDDATE
PERMIT ISSUANCE
101-0000-42404
0
$90.57
$90.57
9/11/14
PAID BYV',
METHOD ;`_
RECEIPT # f '
CHECK #..
CLTD BY ".
HEGGE ELECTRICAL CONTRCTRS INC
CHECK
R1097
29543
MFA
Total Paid for PERMIT ISSUANCE: $90.57 $90.57
TOTALS: $127.32 $127.32
f
4
Description: RELOCATE SUB PANEL
Type: ELECTRICAL
Subtype: -
Status: ISSUED
Applied: 9/11/2014 MFA
Approved: 9/11/2014 MFA -
Parcel No: 770121010 Site Address: 78100 MAIN ST A-110 LA QUINTA,CA 92253
Subdivision: PM 30850
Block:
Lot: 4
Issued: 9/11/2014 MFA
Lot Sq Ft: 0
Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $700.00
Occupancy Type:
Construction Type:
Expired: 3/10/2015 MFA
No. Buildings: 0
No. Stories: 0
No. Unites: 0
Details: RELOCATION OF SUB PANEL
Printed: Thursday, September 11, 2014 1:14:02 PM 1 of 2
SYSTEMS
SEQID INSPECTION TYPE INSPECTOR ." .SCHEDULED COMPLETED RESULT REMARKS NOTES
DATE DATE
ELECTRICAL FINAL"
Printed: Thursday, September 11, 2014 1:14:02 PM 2 of 2 i sysirMs
ui
Permit
Details
PERMIT
NUMBER
'•
a , o
w
,qV
Gff f
•
OF1? '9V
DESCRIPTION
ACCOUNT. QTY
AMOUNT
PAID.
PAID DATE
RECEIPT#
CHECK#
METHOD
PAID, BY
BY.,
SERVICES
101-0000-42403
0
$23.83
$23.83
9/11/14
R1097
29543
CHECK
HEGGE ELECTRICAL
CONTRCTRS INC
MFA
SERVICES PC
101-0000-42403
0
$11.92
$11.92
9/11/14
R1097
29543
CHECK
HEGGE ELECTRICAL
CONTRCTRS INC
MFA
Total Paid for ELECTRICAL:
$35.75
$35.75
PERMIT ISSUANCE
101-0000-42404 0
$90.57
$90.57
9/11/14
R1097
29543
CHECK
HEGGE ELECTRICAL
CONTRCTRS INC
MFA
Total Paid for PERMIT ISSUANCE:
$90.57
$90.57
SEQID INSPECTION TYPE INSPECTOR ." .SCHEDULED COMPLETED RESULT REMARKS NOTES
DATE DATE
ELECTRICAL FINAL"
Printed: Thursday, September 11, 2014 1:14:02 PM 2 of 2 i sysirMs
Bin #
City of La Quinta
. - Building Sz Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
La Quints, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: _:is_ . a mo 0A v
Owner's Name:
A. P. Number: —700-16r6 / lqr S f
Address` l nqC .v r7e
Legal Description:
City, ST, Zip:a a s3
✓(
Contractor:
eL
Telephone:
Address: 6 S S D{ 4 ,
Project.Description:
City, ST, Zip: 6 V1'
/a,_) d
Q oa. e_ A- 2S.4 _4 ;u cz q e
Telephone: _37t'--/AS`
State Lie. # : 74/9 /-7 (
City Lic..#...::::::.::.:::::::.:.:.....
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
«•:€.>.::;>:;:;r;-
:..; .
Construction Type: Occupancy '
State Lie. #:
Project type (circle one): New Add'n . Alter Repair Demo
Name of Contact Person:
Sq. Ft.:#Stories:
#Units
Telephone #,of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN I10USE:-
''d Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Is