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BELC2014-103651930 Avenida Martinez BELC2014-1036 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4ty4 4 Q" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BELC2014-1036 Property Address: 51930 AVENIDA MARTINEZ APN: 773181009 Application Description: .200A SERVICE UPGRADE Property Zoning: Application Valuation: $3,000.00 Applicant: TAK ELECTRIC INC OUTSIDE CITY LIMITS OCT 14 21014 CITY OF LAQUINTA COMMUNITY DEVELOPMENT 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. Lic tr se Class: License No.: :LIC -762388 Date: 1A Contractor:--Z---/.,i OWNER -BUILDER 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 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.). (_) 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 Add VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/14/2014 Owner: KATHLEEN HERRING 51930 AVENIDA MARTINEZ LA d.UINTA, CA 92253 Contractor: TAK ELECTRIC INC OUTSIDE CITY LIMITS Llc. No.: :LIC -762388 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 thew 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. Date: .4(l —17 / 7 Applicant: WARNING: FAILURE TO SECURE WORKERS' 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 building construction, and hereby authorize representatives of this city to enter upon the above- mentioned property for inspection purposes. 'Date: _/ Signature (Applicant orAgent):ted/.2 ( . ✓L— v FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID• PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 10/14/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY TAK ELECTRIC INC CHECK R2034 50548 AOR- Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SERVICES 101-0000-42403.__ 0 $24.17 $24.17 10/14/14 PAID BY METHOD "' RECEIPT # CHECK # CLTD BY TAK ELECTRIC INC j _ CHECK . ; `-' R2034 50548 AOR DESCRIPTION t ACCOUNT QTY AMOUNT PAID PAID DATE SERVICES PC 101-0000-42403 01 $12.09 $12.09 10/14/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY' TAK ELECTRIC INC CHECK R2034 50548 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 10/14/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY TAK ELECTRIC INC CHECK R2034 50548 AOR Total Paid for PERMIT ISSUANCE: $91.85 $91.85 TOTALS: $129.11 $129.11 Description: 200A SERVICE UPGRADE • • NAME TYPE Type: ELECTRICAL Subtype: Status: ISSUED Applied: 10/14/2014 AOR Approved: 10/14/2014 AOR Parcel No: 773181009 Site Address: 51930 AVENIDA MARTINEZ LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA AT VALE LA QUINTA Block: 118 Lot: 16 Issued: 10/14/2014 AOR NO 12 CONTRACTOR Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $3,000.00 Occupancy Type: Construction Type: Expired: 4/12/2015 AOR No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 200A ELECTRICAL SERVICE UPGRADE - 2013 CALIFORNIA ELECTRICAL CODE. ' 1 Applied to Approved Approved to Issued CHRONOLOGY • • NAME TYPE NAME ADDRESSI CONTACTS CITY STATE ZIP PHONE FAX EMAIL APPLICANT TAK ELECTRIC INC OUTSIDE CITY LIMITS CONTRACTOR TAK ELECTRIC INC OUTSIDE CITY LIMITS OWNER KATHLEEN HERRING 51930 AVENIDA MARTINEZ LA QUINTA CA 92253 Printed: Tuesday, October 14, 2014 1:20:44 PM 1 of 2 er _ DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY SERVICES 101-0000-42403 0 $24.17 $24.17 10/14/14 R2034 50548 CHECK TAK ELECTRIC INC AOR SERVICES PC 101-0000-42403 0 $12.09 $12.09 10/14/14 R2034 50548 CHECK TAK ELECTRIC INC AOR Total Paid for ELECTRICAL: $36.26 $36.26 PERMIT ISSUANCE 101-0000-42404 1 0 $91.85 $91.85 10/14/14 R2034 50548 CHECK TAK ELECTRIC INC AOR Total Paid for PERMIT ISSUANCE: $91.85 $91.85 TOTALS: BOND INFORMATION Printed: Tuesday, October 14, 2014 1:20:44 PM 2 of 2 ICBP_. INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES DATE DATE ELECTRICAL FINAL" PARENT REVIEWS RETURNED STATUS REMARKS REVIEW TYPE REVIEWER SENT DATE DUE DATE NOTES DATE BUILDING AJ ORTEGA 10/14/2014 10/14/2014 1 10/14/2014 - APPROVED BOND INFORMATION Printed: Tuesday, October 14, 2014 1:20:44 PM 2 of 2 ICBP_. 1. S Bin # City of La QUinta Building 8L Safety Division P.O. Box 1504, 78-495 Calle Tampico. ' La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking -Sheet Permit # . e Project Address: Gj Owner's Name: A. P. Number: Address: 5 1 3 C Legal Description: City, ST, Zip: Contractor: _ Telephone / 30 to Address: ' S e, g Project Description: City, ST, Zip: C C ki Telephone:r-V - ?1^<j (J Statc Lic. # : / ' 1 City Lic.+C Z a6 C e Arch., Engr., Designer: Address: City, ST, Zip. Telephone:>>.>..><: P :::: . ......;.:;::.:.:,...,:-:.,; Construction Type: Occupancy State Lie. Project a circle one): New Add'n Alter Repair J type ) P Demo Name of Contact Person: Sq. Ft.: # Stories: #Units: Telephone # of Contact Person: Estimated Value of Project APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. 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 2°" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Decd Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN IiOUSE:- Review, ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees