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BELC2016-001778-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: T'ht 4 lwQulxrw COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT BELC2016-0017 I VIII' VIII IIII IIII 54920 AVENIDA JUAREZ 37 774266009 INSPECTION OF EXISTING CHANGE OUT; 54920 AVENIDA JUAREZ Applicant: CURRENT ELECTRICAL 51-735 EISENHOWER DRIVE LA QUINTA, CA 92253 D Q 0 MAR 0 2 2016 CITY OF LA OUINTA 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 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: C30 ' License No.: 1000855'1 _ Date -C B-2_—IG . Contractor: C. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Lbw 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 7006) 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 Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/2/2016 Owner: MICHAEL TERRY Contractor: CURRENT ELECTRICAL 51-735 EISENHOWER DRIVE LA QUINTA, CA 92253 (760)285-4015 LIC. No.: 1000851 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. Date:�e_3_2^_ fL is`t/ Applicant: WARNING: FAILURE TO SECURE WORKERS' CO PENSATION 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%Q C. Signature (Applicant or Agen`6 DESCRIPTION FINANCIAL INFORMATION ACCOUNT QTY AMOUNT PAID PAID DATE * ^•SERVICES 101-0000-42403 0 $24.17 $24.17 3/2/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY CURRENT ELECTRICAL DEBIT R13499 .093619 TSA DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SERVICES PC 101-0000-42600 0 $12.09 $12.09 3/2/16 PAID BY METHOD RECEIPT # CHECK #• CLTD BY + CURRENT ELECTRICAL DEBIT R13499 093619 TSA 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 3/2/16 PAID BY METHOD RECEIPT .# CHECK # CLTD BY CURRENT ELECTRICAL DEBIT R13499 093619 TSA Total Paid for PERMIT ISSUANCE: $91.85 $91.85 TOTALS: $128.11 $128.11 Description: INSPECTION OF EXISTING CHANGE OUT; 54920 AVENIDA JUAREZ Type: ELECTRICAL Subtype: Status: UNDER REVIEW Applied: 3/2/2016 TSA Approved: Parcel No: 774266009 Site Address: 54920 AVENIDA JUAREZ LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 276 Lot: 16 Issued: UNIT 25 Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $0.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: PANEL CHANGE OUT. 2013 CALIFORNIA BUILDING CODE Printed: Wednesday, March 02, 2016 4:42:50 PM 1 of 2 IrIp'-------- ADDITIOI%AL SITES CHRONOLOGY CONDITIONS, CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT CURRENT ELECTRICAL 51-135 EISENHOWER LA QUINTA CA 92253 DRIVE CONTRACTOR CURRENT ELECTRICAL 51-735 EISENHOWER LA QUINTA CA 92253 DRIVE OWNER MICHAEL TERRY 3419 VIA LIDO STE 455 NEWPORT CA 92253 BEACH Printed: Wednesday, March 02, 2016 4:42:50 PM 1 of 2 IrIp'-------- DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY SERVICES PC 101-0000-42600 0 $12.09 $12.09 3/2/16 R13499 093619 DEBIT CURRENT ELECTRICAL TSA Total Paid for ELECTRICAL: $36.26 $36.26 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 3/2/16 1 R13499 1 093619 DEBIT CURRENT.ELECTRICAL I TSA Total Paid for PERMIT ISSUANCE: $91.85 $91.85 TOTALS: $128,11 $128.11 INSPECTIONS SEQIb INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES ELECTRICAL FINAL" AOR 3/3/2016 Printed: Wednesday, March 02, 2016 4:42:50 PM 2 of 2 _ Bin # City of La Quin to Building 8£ Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheen Permit # a�LC Z p1 lO _ Project Address: 'J - Z6 UreZ Owner's Name: I I C A. P. Number: Address: Legal Description: V City, ST, Zip: act r Co ntr o . CV ��-I c.J n Telephone: e. .... Address:_ a5 F %fin v We,� d� Project Description: I et� -41 City, ST, Zip: p,, 0,`n-�-- Gr,-- 53 Jrc e a Telephone: hone — 7� O V5 6 State Lic. # : 1060<551 City Lic #:1631.:::.:, Arch., Engr., Designer: Address: City, ST, Zip: Telephone: n TYPe: Construction �. . Occupancy:an cy:r 'C Irl State Lic. #- ne • NewAn A]ter Repair Demo Project ecthP (circle o Name of Contact Person:AtGOn �l'I-(Ci� Sq. Ft.: 0 0 # Stories: ! # Units: l Telephone # of Contact Person: 0 — �g 5 — I-10 t 5 Estimated Value of Projec 1 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rcc'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 Cales. Plans picked up Construction ' Flood plain plan Plans resubmitted Mechanical Grading plan 2p° Review, ready-for-corrections/issue _Electrical, Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3'! Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees, Total Permit Fees heck A License - License Detail - Contractors State License Board Page 1 of S 4 " Contractor's License Detail for License # 1000851 )ISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this nformation, you should be aware of the following limitations. CSLB complaint disclosure is restricted by law (B&P 7124.6) If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on the link or button to obtain complaint and/or legal action information. Per B&P 7071.17 , only construction related civil judgments reported to the CSLB are disclosed. Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. Due to workload, there may be relevant information that has not yet been entered onto the Board's license database. This license is current and active. All information below should be reviewed. 10 - ELECTRICAL Business Information CURRENT ELECTRICAL 51-735 EISENHOWER DRIVE LA QUINTA, CA 92253 Business Phone Number:(760) 285-4015 Entity Corporation Issue Date 02/06/2015 Reissue Date 10/09/2015 Expire Date 10/31/2017 License Status Classifications Bonding Information Contractor's Bond This license filed a Contractor's Bond with AMERICAN CONTRACTORS INDEMNITY COMPANY. Bond Number: 100287860 Bond Amount: $15,000 Effective Date: 01/01/2016 Contractor's Bond History Bond of Qualifying Individual Thte Responsible Managing Officer (RMO) HATRAK JASON CHRISTOPHER certified that he/she owns 10 percent or more of the oing stock/ equity of the corporation. A bond of qualifying individual is not required. Effective Date: 10/09/2015 Workers' Compensation This license is exempt from having workers compensation insurance; they certified that they have no employees at this time. Effective Date: 09/30/2015 Expire Date: None Workers' Compensation History tps://www2.cslb.ca.gov/OnlineServices/CheckLicenseIlILicenseDetail.aspx?LicNum=1000851 3/2/201 A-1 Cesspool Service, Inc. P.O. Box 580188, North Palm Springs, CA. 92258 JOB INVOICE `Since 1959, (760) 329-6875 Fax (760) 251-3405 State Lie. #265214 www.alcesspool.com BILL TO ADDRESS CITY JOB ADDR SERVICE ❑ PUMP SEPTIC TANK HAS SEPTIC TANK BEEN DUG UP? ❑ Yes ❑ No ❑ PMT. ON SITE REQUESTED ❑ PUMP SEEPAGE PIT AT ITS RISER ❑ OFFICE BILLFNG OUANT. DES C IPTION OF PRICE AMOUNT Pumping Fee per 1000 Gallons (or fraction) Waste Discharge Fee per 1000 Gallons Locating and Opening Fee (Ihr. Min.) Out of Area Fee ❑ THE LEACiTING SYSTEM HAS FAILED ❑ THERE IS AN OBSTRUCTION "UPSTREAM" OF THE SEPTIC TANK It will he necessary to contact a line cleaning company. ❑ WE RECOMMEND MAINTENANCE PUMPING OF THE SEPTIC TANK EVERY ❑ YEAR OTHER YEAR ❑ 2-3 YEARS To remove built up solids. This will increase the life ofyour ladling system ❑ THIS PUMPING WILL PROVIDE ONLY TEMPORARY RELIEF AND NOT SOLVE CUSTOMERS SEPTIC PROBLEM BECAUSE OF THE ABOVE. ❑ CUSTOMER HAS BEEN GIVEN AN "EXPLAINATION"PACKET. A SERVICE CHARGE OF $22 WILL BE DUE ON ALL RETRUNED CHECKS. A FINANCE CHARGE OF ] 312% PER MONTH,18%a PER YEAR, WILL BE - CHARGED ON PAST DUE ACCOUNTS OVER 30 DAYS. 1F PAYMENT IS BY CHECK DRIVERS LTC. # STATE I hereby acknowledge the satisfactory completion of the above described work SIGNATURE u` i Tutal Due