Loading...
BELC2016-008178-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: BELC2016-0081 Property Address: 81600 AVENUE 58 APN: 764010012 Application Description: IID Property Zoning: Application Valuation: $10,000.00 • Applicant: SERGIO PETERSSON 333 E BARIONI BLVD ' V VOICE (760) 777-7125 FAX (760) 777-7011 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/15/2016 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.: Date: - r 2- '- 6 . /Contra OW R -BUILDER DECLEsm TION I hereby affirm under penal of perjury that I am pt m the Contractor's State License Law for the folio ng reason (Sec. 7031.5, ness 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 Lender's Address: Owner: v \ IMPERIAL IRR T N Ta P 0 BOX 98 IMPERIAL A 253`S�iO 19 Contractor: NTS 4 OWNER BUILDER IID 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.vyoyk for which this permit is issued. -v 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 polity 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 Aould become subject to the workers' compensation provisions of Section 370 f t e Labor ode, I shall I forth�rth comply with those provisions. i Z- �/ Date: App it WARNING: FAILURE TO SECURE WO ERS' COMPENSATION COVEBAIS IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOY TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DO RS ($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 ipfQrmation is correct. I agree to comply with all city and county ordinances and stat aws lelating to building construction, and hereby authorize representatives of this ' y to en er upon above-mentioned property for inspection purposes. Date: , Z.i" Signature (Applicant or Age t s Date: 9/15/2016 Application Number: BELC2016-0081 Owner: Property Address: 81600 AVENUE 58 IMPERIAL IRRIGATION DIST APN: 764010012 P 0 BOX 987 Application Description: IID - IMPERIAL, CA 92253 Property Zoning: Application Valuation:' $10,000.00 Applicant: Contractor: SERGIO PETERSSON OWNER BUILDER IID 333 E BARIONI BLVD IMPERIAL, CA 92253 , Llc. No.: ----------------------------------------------------------.--i--------------------------------- DeCaili tNSTALLATION-OF 1 DUAL PEDESTAL. MOUNT ELECTRICAL VEHICLE CHARGING STATICH�r&'A*A"(MeSPECS. LEVEL 2 CHARGING STATION INSTALLATION AT IID FACILITY FOR IID ONLY. A ' t t s FINANCIAL INFORMATION DESCRIPTION ACCOUNT . CITY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT CITY AMOUNT POWER APPARATUS 101-0000-42403 0 $24.17 DESCRIPTION ACCOUNT CITY AMOUNT POWER APPARATUS PC 101-0000-42600 0 $24.17 DESCRIPTION ACCOUNT CITY AMOUNT SERVICES 101-0000-42403 0 $24.17 DESCRIPTION ACCOUNT CITY AMOUNT SERVICES PC 101=0000-4P600' ° 7 ' "' " 0 .$'12.09 Total Paid for ELECTRICAL: $84.60 DESCRIPTION ACCOUNT CITY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $91.85 Total Paid for PERMIT ISSUANCE: $91.85 • P.O. BOX. 1504 LA QUIN_tA; CALIFORNIA- 92247-1504 78-495 CA[ LE TAMPICO LA.QUINTA, CALIFORNIA 92.253 CJJ BUILDING & SAFETY DEPARTMENT (760) 777-70.12 FAX (760) 777-7011 PROPERTY WNER'S .PACKAGE Disclosures &Forms for Owl er-BWers. Applying for Construction Permits IMPQR� IY t MICE TO PROPERTY OWNER Dear Property Owner. An.: application for a building Permit has been .submitted. in your name listing yourself as the builder of the :property :impFdvements specified at 8 !(00.0 St3 'fb • [Ay ENyE , : Lx Q ul N ra co, q 2:2 s 3 .We are .providing you vgith an Owner -Builder Acknowledgmentand lnforma- tion Verification.Forcn to make you awara:of your. responsibilities and possible risk you may incur by having tlrispermit•isss led• m your name as the Owner -Builder. We rv(11 not issue a buiidiug•permit until -yo Whaveread, initialed your understanding.ef each'provision, signed, and returned this form to us at our okra, address indicated. An agent of the owner cannot execute this -notice .unless you, the property owner, obtain the prior approval of the permitting authority. OV I�CNk? R'S ACWT:EDO . AND'VERMCATI ON OE Il (iRitiiATIETI�t DIRECTIONS, - Read and initial each, statement beta v tesignify you uriddrstand`or verif y th4'-information. I understand a frequent practice of unlicensed persons is to have the property owner obtain an Owner-Buider' building permit that erroneously implies that the property owner is providing his or her own labor and rrraterial pers6nifiy:1, as an Owner -Builder, may be'held liable and subject to serious. financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. 'My homeowner's insurance may not provide coverage .for those injuries. I.am willfully acting as.an Owner -Builder and am aware of the limits of my insurance -coverage for injuries to workers on my property. GC.2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are. not. hiringaceedContacor.to.assume this responsrbility_ . 6 .3. I.understand as an "Owner -Builder" I am:tiie responsil to:party of eecord ori the perruit I understand that I..may protect mysel€frons potential financial risk by hiring a licensed C own. ontractor and having the permit filed in his or her name instead of my Gr— 4. I understand Contractors are required by law to be licensed and bonded in California and to list their License numbers on permits and contracts. G C5.1 uiuderstand if i employ or otherwise engage any persons; other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. C7 6, I..understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' cvmpen' sation disability insurance, and contributeto unem iloyment . compensation for each "employee:" I" atso understand my failure to abide by these laws may subject me, to serious fiiiancial risk::. G 7.. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential ..structures cannot .legally build them with the .intent to offer them for sale, unless all worm is performed by licensed subcontractors and the number of structuresdoes not exceed four' within any calendar. year, .or all of the work is performed ,under. contract with a licensed general building Contractor. 8. 1 understand as an 0-wner-130der if I sell the property for which this permit is issued, I may be held. liable for any financial or personal. (.juries : sumked by _any subsequent owners) that, result from any latent construction defects in the workmanship or materials. GC 9. 1 understand I may obtain more information regarding my obligations as an "employee from. the Internal' e, Revenue Service, the United States SmallSmallBusiness Administration, the California Department of Benefit Payments, and.the, California of Industrial Accidents. I also understand I bray contact the California Contractors' State License Board (CkE6, at I- 8.00.-321-:CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. (7 am aware of and consent to an. Owner -Builder building permit applied for in my name, and understand that I am the party legally and - financially responsible . Cox . proposed construction activity. at the following address: 91600 !;18114 _,,A�J F_ we '-Q vViow.. .-.CAq22 5 ..... .. .... G C- 11. I agree. ffiat,:as the party legally and financially responsible for this proP osed. construction ac ivity,.I will. abide by all aP—pt-ica6ie taws and.4,1 requirements that govern Owner=Atdldersas well at eimployen. C 12. 1 agree to notify 7 no the issuer of this 'form immediately ofanyadditions deletions, orchanges'. wany of the information I have provided on this form. Licensed contractors are.regu'lited by laws designed to protect the public. If you contract with :someone who does. not have ar license,.tate Contractors' State License Board may be unable to.assist,you with any financial loss . you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors way. be,iwcivil. COWL. It is also ..important for. you -to understand that if art u4ticensed.Contractor or employee of that -individual. -or firm is injured while working on your property, you may be held. liablefordamages.. If you obtain a permit as . Owner -Builder and wish to hire Coriftctors, -you will* be responsible- for verifying.whetier or - not .-those Contractors are propeAylicensed and the status of`thcif workers' compensation -insurance coverage,. Before a building permit can be issued, this form must be completed and signed- by the property owner and returned to the agency responsible forlsstdftg.tfre permit. Note. A copy of the -property owner, form nqta�,, or other verification acceptable to theag Isbe pre;ented` when. 0-0 p 1s. usued 10--yerift.-thei.property ..lied, to W owner's signature. Signature of property owner Date: r ..Note:* The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY 0WNVK'9'kHAV Excluding the Notice to Property Owner, the execution of which I understand is my.personal responsibility,_I hereby authorize -the following Person(0 to act as, MY agen*)V:'apply for, sign; and file the documents necessary. to obtain an, Ownir-Buildet Permit for my Project. Xnffix'11.41*6%o&V At# D V,� Ped e r f 6 M4. !I Scope of Construction Project (or Description of Work)-: CJett-r,.'c Vek.-C re C kwf3 it.5iV,+;0" - op 'Fac.. k17 il 'Project 1,6cation''or Address:' el (000 -56+4 AVenve' LA Qu-ittot -'CA q 125 Name of Authorized Agent: Serjio.. 'Pe-TerSow Tel No .06m) y S 7 G89 I .'Address ofAuthorized Agent: 333 E. Pcormor:; BIV-61. lmper;a l, CA 1 declare under penalty of perjury that I am the property owner for the address listed above and .1 personally filled out the above I infofmatiori and certify its accuracy. Note: A c'(? oif- the driver's U notarization,. or other verification i -c e owner's drive license, fonn acceptable: to the agewnwcy is regal '46 When the permit is issued to verify the p property owner's signature.. Property Owner's Signature: Date: V-1 Bin # City. of La Quints Building 8L Safety Division P.O. Box 1504,70-495 Calle Tampico La.Qulnta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: 810, 0 516+4 Av: La CA Owner's Name:. Iro I r6 stiiop ;C f (1 l A. P. Number. Address: 3'2,,3 E. g qro o ff 1 81 V A. Legal Description: Contractor. Q W Nte 15V; kat e ( 1A D) City, ST, Zip: Ir'1 er[t q L to 12251 n : °.... Telephone: `%G o N J % ' G $9 . $ .x ! Address: Project Description: City, ST, Zip: �h S'igl� A` toN o V•V ak QtAe Stwl MvJ h,�,• Telephone: {p ': EjtG�-no �%t�1ic1L G�►qr �� SfiaT1•04 Per oit AC11.t l Specs LtV G 1 5J;C I Rr i H State Lie. #: City Lie. #; Arch., Engr., Designer. ''► -014 t V1 S'�a�I RZ ` O H a D FA ti I t Address: t s Ve,�Aic43 . oral No{•' o+/• City, ST, Zip: Q Al;c, V S e .. Telephone: :• Construction Type:. Occupancy: B State Lic. #: project type (circle one): N Add'n Alter Repair Demo Sq. Ft : •-- #Stories: 1 # Units: ' Name of Contact Person:$ Cr 1 o Ptte f S o H Telephone # of Contact Person: (7 ��. S 7 % to B 9 ( Estimated Valine of Project 10,00() APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACIMG PERMrr FEES Plan Sets Pian Check submitted Item Amount Structural CaIcs. Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs• Called Contact Person Plan Check Balance Title 24 Calci. Pians picked up Construction Flood plain plan Plans resubmitted.. Mechanical Grading plan 2`. Review, ready for correctionsrissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '^' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person AJ.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees 4'�ual Pedestal Mount — AeroVironment, Inc. Online Store tip,_ a•{ovtrQnmQot�'"� ; r;tl2cEft��VP,t1'�tl@ Chdrgv't��PrCdUCtS"8�,$eMces Page 1 of 2 belecr a Category TurboCord EV Charger TurboDock EV Charging Stations Installation Bundles AV Home EV Charging Stations Nissan EV Charging Stations Ford EV Charging Stations FIAT EV Charging Stations Kia EV Charging Stations Mitsubishi EV Charging Stations Volvo Charging Stations Chevy Compatible EV Charging Stations BMW Compatible EV Charging Stations Tesla Compatible EV Charging Stations Toyota Compatible EV Charging Stations Plug-in EV Charging Stations Canadian Charging Stations Commercial & Workplace EV Charging Stations N RS Dual Pedestal Mount Price: $3,275.00 Ship To: I yourself v 1 Add To Cart Share: `_✓ __............ _._-- Summary I Customer Reviews G+1. Pin It The powerful and easy to use AeroVironment RS is the choice of thousands of drivers and preferred by more manufacturers including Nissan, Ford, Fiat, BMW and Mitsubishi. For commercial applications the EVSE-RS Charging Station is offered in single and dual pedestal configurations for commercial, workplace and public charging applications. The attractive, weather -resistant housing provides a polished look that complements professionally maintained properties. Commercial EVSE-RS pedestal systems are designed to be compatible with all SAE J1772 compliant electric vehicles (EVs) and plug-in hybrids (PHEVs). Each charge port complies with all features and specifications of the wall -mounted EVSE-RS. AV has 20 years of charging expertise helping car manufacturers design and test EV battery systems. With nearly 90 EV- related patents we've put all of this knowledge into our charging products to ensure your charging experience is easy and reliable. SPECIFICATIONS - • 25 foot charging cable • SAE J1772 connector http://store.evsolutio s.com/rs-dual-pedestal-mount-p62.aspx Residential orders qualify for FREE UPS Ground Shipping* Log In Contact Your Shopping Cart The Shopping Cart is currently empty Enter Coupon All prices in $USD *Free 3-5 day shipping in the Continental US only. TRUST GUARD 104.255.215.12 CITY OF LA QUINTA BUILDING & SAF\E,T, TY DEP APPRED FOR CONRUCTION 9/7/2016 `I FEATURES { • Industry standard SAE -J1772 connector 1 • Underwriters Laboratory (UL) listed • Outdoor rated enclosure, • Americans with Disabilities Act (ADA) compliant installation • Auto restart in event of power outage or ground fault • Breakaway safety cable • Integrated cable stowage • Optional network communication module (EVSE-RS+) SERVICE AND INSTALLATION' • Expanding network of independent certified, trained electricians • Convenient customer site assessments and installation 1 . • 24-hour response time during business hours SPECIFICATION EVSE-RS Connector SAE J1772 compliant Voltage 208VAC to 240VAC t Frequency 60/50Hz Output Current 30A max' Input Current - 40A max Operating Temperature -22°F to 122°F 1 -30°C to 50°C Enclosure NEMA 3R Regulatory Compliance UL; cUL, CE, CTick listed • inio:marion ar:dsp�rO.carons subject to' change 02011 Aero\Aronff a t, Inc 17.0111.10149 The safe, reliable EVSE-RS Charging Station is available in single port, dual -port and quad -port configurations for higher -traffic commercial and public charging applications. While maintaining the same user friendly design of the single -port unit, the EVSE-RS Dual and Quad systems can simplify the installation and reduce costs by consolidating wiring runs and mounting locations. The attractive, weather -resistant housing provides a polished look that complements professionally maintained properties such as car dealerships, multi -dwelling units, shopping malls, corporate offices, and retail stores. EVSE-RS multiport systems are compatible with all SAE J1772 compliant electric vehicles (EVs) and plug-in hybrids (PHEVs). Each charge port complies with all features and specifications of the single -port EVSF.-RS, . and an optional module for Ethernet, WiFi, Zigbee, or cellular communication is availa CITY OF LA QUINTA BUILDING & SAFETY DEPT._ I FOR CONSTR CTION ITE & s@ C E C SITE PLAN IMPERIAL IRRIGATION DISTRICT J-71 BUILDING INSTALLATION OF ONE (1) DUAL PEDESTAL MOUNT ELECTRIC VEHICLE CHARGING STATION ❑ DD SCALE: NTS I CITY OF LAQUINTA BUILDING & SAFETY DEPT. APPR VED FOR CONST UCTION DATE 146 A - - I PROJECT LOCATION OPERATIONtYBUILDING 111111 IIIhf�� II EMPLOYEE PARKING 58th AVENUE ° lit. �cPRE T� - LOCATIO ,tk` ` i • 1 mil i.e at,a e r • IL fine B tIII cIII vole PUBLIC PARKING 1�P NpM• I; �' . 58th AVENUE ° lit. �cPRE T� - LOCATIO ,tk` ` i • 1 mil i.e at,a e r • IL 1�P NpM• I; �' . VICINITY MAP SCALE: NTS SCOPE OF WORK: IID TO INSTALL ONE (1) DUAL PEDESTAL MOUNT ELECTRIC VEHICLE CHARGING STATION PER ATTACHED SPECIFICATIONS. THE LEVEL II ELECTRIC VEHICLE CHARGING STATION WILL BE INSTALLED INSIDE OF IID FACILITY AT THE EMPLOYEES PARKING LOT AND THEIR USE SHALL BE FOR IID VEHICLES ONLY (NOT FOR PUBLIC USE). a 0 0 4 N I " EIVED Y YY 11i �1 N a SEP 15 2016 W CITY OF LA QUINTA COMMUNITY DEVELOPMENT SHEET __L_ OF_3 x E EXISTING 200 AMP, 3 0 a 120/208 PANEL 'T-. MAIN POWER I MEN KERS PANEL MEN NEW 1%" CONDUIT RUN; 4 - #8 AWG THHN COPPER, EXISTING 24" x 24" x 8" 1 - #10 AWG THHN COPPER PULL BOX IT ENTRY STORAGE HALLWAY CLERICAL '':SCHEDULER II TECH. Tryli SUPT. ENERGY C. & M. NEW 1Y4" CONDUIT RUN; I.T. DEPT. DISPATCH CENTER 4 - #8 AWG THHN COPPER, ELE DISTRIB 1 - #10 AWG THHN COPPER WOMEN CLERICAL OUTAGE COORD TECH. w CONSTRUCTION $ MAINTENANCE V p STORAGE ! FS SHIFT R ■ 0 SHIFT ROOM wssisr. suvuRRr. WT. RES. Q DISP. MTR. RK. BREAK TELE AND SCADA SUPT. GRAIL. CONFERENCE METER STORAGE CONSTR. MAINT. AREA SUPT. CONSTR. ROOM EQUIP. RM. BRG RM. JANITOR A C UNIT wl�' L0' MAINTENANCE � XEROX SCHEDULER H ■ F-.... USE NEW 12" x 12" x 4" ' PULL BOX • - VACANT LINE CONST, POWER STAND ■ FOREMAN BY SYSTEM STORAGE MEN WOME TRAINING ROOM NEW 1%4' CONDUIT RUN; 4 #8 AWG THHN COPPER, Z 1 - #10 AWG THHN COPPER ASSEMBLY AND TRAINING STORAGE ■ LOBBY STOR:. STOR. TROUBLE SHOOTERS METER SHOP OFFICE NEW 12" x 12" x 4" F M 1A6. PULL BOX METER TECH. VESTIBULE FOREMAN , ■ NEW 3/4" CONDUIT RUN; A ' 4 - #8 AWG THHN COPPER, / v 1 - #10 AWG THHN COPPER EXISTING COLUMN NEW DUAL PEDESTAL MOUNT ELECTRIC VEHICLE CHARGING STATION (LEVEL II) CITV BUILDING &SAFETY DEPT.' IMPEL FOR CONS UC T ION gl ELECTRICAL PLAN - LINE DIAGRAM B q f��6 8,600 SCALE: NTS -- -- oaran mE�mm1 5R� n aaE_ om®n aaE_ .. o 04[ o'er ,vnavua ISSUED FOR ave[ m a 0 ru N LLN Y m W w a a SHEET _? _ Of_ 3 NEW 1Y4" CONDUIT R 4 - #8 AWG THHN COPP 1 - #10 AWG THHN COPE EXISTING 24" x 24" x 8 PULL BO; NEW 12" x 12" x 4" NEW 12" x 12" x 4" PULL BOX PULL BOX 1 C�C."( OF LA QUINTA - DING'& SAFETY DEPT. APPROVED CONSTR CTION � f BY o.,, ... ! rsul NEW DUAL PEDESTAL MOUNT ELECTRIC VEHICLE CHARGING STATION (LEVEL II) U a SHEET _3_.OF_ 3