ELEC (14-0901)54075 Avenida Martinez
14-0901
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
14-00000901
Property Address:
54075 AVENIDA MARTINEZ
APN:
774-221-017-5 -000000-
Application description:
ELECTRICAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
100
T4ht °f 4 Q"
Applicant: Architect or Engineer:
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LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perju that I a licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Bu i ess an Professionals Code, and my License is in full force and effect.
License Class: B License No.: 727199
Date' Contract`:.
V ` 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 1$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.).
( 1 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 Address:
LQPERMIT
Owner:
RW REAL ESTATE
42760 MADIO
INDIO, CA 92201,
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/19/14
Contractor:
CORONEL ENTERPRISES
42760 MADIO STREET O Q n
INDIO, CA 92201 11
(760)775-1234 I'
Lic. No.: 727199 JU I JUN
19 2014
CITY OF LA QUINTA'
----------- FJNA zt¢pr----- -----
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
C / insurance carrier and policy number are:
Carrier STATE FUND Policy Number 9090158-2014
_ 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 aft to btecoqftubjecorkers' compensation laws of California,
and agree that, i houldecome bject t the wo kers' compensation provisions of Section
3700 of the Labo ode, 1 hall fo hwith/ omply ith those provisions.
i
tDate: 1`f -I 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 Director of Building and Safety 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 ork 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 not co enced
within 180 days from date of issuance of such permit, or cessation of work f r 180 da s will subject
permit to cancellation.
I certify that I have read this application and stateItatio is c rrect. I a ree to omply with all
city and county ordinances and state laws relatingion, nd hereby auth ize epresentativesof this county to enter upon the above-mentioned n p poses.
Date: 9 / Signature (Applicant or Agen
V
Application Number . . . . . 14-00000901
Permit . . . ELECTRICAL 2013
Additional desc . .
Permit Fee . . . . 23.83 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 12/16/14
Qty Unit Charge Per
Extension
1.00 23.8300 LS ELEC DEVICES, FIRST 20
23.83
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Special Notes and Comments
ELECTRICAL - (2) LIGHT FIXTURES @ FRONT
GATE COLUMNS. 2013 CALIFORNIA BUILDING
CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . PLAN CHECK, ELECTRICAL
23.83
PERMIT ISSUANCE M/P/E
90.57
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total 23.83 .00 .00
23.83
Plan Check Total .00 .00 .00
.00
Other Fee Total 114.40 .00 .00
114.40
Grand Total 138.23 .00 .00
138.23
LQPERMIT
Bin #
Qty of La QUinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: -Q-TS M ,
c.tf � the Z
Owner's Name: y■■
lJ �+ •l
A. P. Number:
Address: '-A Z _-7 Cj M
Legal Description:
City, ST, Zip:
Contractor: CUB
Teicphonc:
Address:.y a _~7 M � u
Project Description:
,o
City, ST, Zip: 2Da(D
CA
r� 1.N�'xy'r cvti�.
Telephone: D
State Lic. # : `7 , . � � City Lie. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone: _
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type circle one New Add'n Alter Repair Demo
Sq. Ft.: # Stories:
# Units:
Telephone #,of Contact Person: Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
# 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 Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calls.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'J Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Dccd
Plans picked up
S.M.I.
H.O.A. Approval
I
Plans resubmitted
Grading
IN HOUSE:
'"' 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