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BELC2015-0016a 78-495 CALL A PICO LA QUINTA, CALIFORNIA 92253 c&'s 4 44" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BELC2015-0016 Property Address: 51370 AVENIDA BERMUDAS APN: 770152011 Application Description: LUXE/INSTALLING (1) 2P 40 AMP BREAKER. Property Zoning: Application Valuation: $2,500.00 Applicant: FV�� %n� n HARTMAN ELECTRIC INC,-GREG (r-� 77849 CALLE ARROBA LA QUINTA, CA 92253 � (� 6 20 44 - FLAQUINTA 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: _ -License No.::LIC-0105320 / Date: K Contractor: 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 Divisio 3 of the Business and Professions Code) or that he or she is exempt therefrom and th basis for the alleged exemption. Any violation of Section 7031.5 by any applicant f 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.). (_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 Name: Lender's VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/6/2015 Owner: LUXE VACATION HOMES 51370 AVENIDA BERMUDAS LA QUINTA, CA 92253 Contractor: HARTMAN ELECTRIC INC, GREG 77849 CALLE ARROBA LA QUINTA, CA 92253 (760)831-0660 Llc. No.::LIC-0105320 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 trissued. 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 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith gomply with those pr visions. /Date 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 e5eriTppn the above - mentioned property for inspection purposes. Date Signature (Applicant or Agent) t r FIN, . • , • Esc., gg 4..b+ L� k'e[riw W >4�f. � xs 4P. PAID,DATE;. rDESCRIPTION,; kACCOUNT�. ,f QTY xx >AMOUNTa a,:aPAID. :>_ BSAS SB1473'FEE 101-0000-20306 0 $1.00 . .$0.00 Ffi a --r-'�.?" z Y PAID BY `+: !k-^: x,'x;Yv w .=y es < METHOD { 4i::#F�s. .,.ar FN-RECEIPTS#f w�p: •4 '•s;.:t; ?ge ° _tip CHECK # � �,� ': .y f CLTD BY p , 40 M W' Total'Paid for BUILDING STANDARDS'ADMINISTRATION BSA $1.00 . $0.00 W. DESCRIPTION<.x, . ACCOUNT 4TY £. Y `bx +=,AMOUNT�fr PAID, PAID DATE; P- • -�� V. ..�'.:..'..*F iI.E > $_.' ? _".2:eYY.C"�iE'f: i'G ..�i'G?$�,. '2i ;t_t..., �i.:-..+.S .w.XiY3: cf..:^: id.v L ..a"n .F 90, ��X.✓� $v'.$` i' �eR. L-.n :.�.}1M�i. "+52 ..,Phx, a F, :S'4i m ..�7.'v. d. ^c POWER APPARATUS 101=0000-42403 0 . $24.17 $0.00 :-,.s.,,..-� -.174, Nii' IE'F,'a.. p> P,AID' � � Y.".."KNI'?v1: ':� i'o:LAW,�"�f. g ;y9' "'.S.+Y.'$";3L�.a-`5,.;a�Y ' S RECEIPT # :F '.F? # s: CLTD BYE:, BY ` s ..... s cakg ' � .y�f... ,Y %i.F>,^�-:fie. METHOD rY �, xe. ab,r,,9CHECK _ "t.DESCRIPTION' �« x Y ; ACGOIJNT E fl,'E QTY .�'"..�y�. AMOUNTS PAID PAVD'ATE Sd..-.,'_!u'zC,. Y ,,3 c POWER APPARATUS PC 101-0000-42600 '0 $24.17 $0.00 > PAID;.BY ,..r METHOD RECEIPTS#:;.:,` # mCLTD BY �° is p trt ._. x, 3s. .fCHECK i Total Paid for ELECTRICAL: • $48.34 $0.00 �� s a DESCRIPTION, r A NT "` CCOU- TM e�x _ g; AMOUNT h ks W PAID ti s PAID`DATE :Q PERMIT ISSUANCE. 101-0000-42404 0 $91:85 $0.00 -Fi.• P 4 iM' 4s r° �f y PAID BY { 4 A" Y �" )' a rc 3ilvk,&xZ METHOD ff ti� REIPT# EC # CLTD BY ��.�..r� g fit.., .T' 4 _ >s" rCHECK Total Paid forPERMIT ISSUANCE: $91.8S $0:00 • •• • 4 Description: LUXE/INSTALLING (1) 2P 40 AMP BREAKER. Type: ELECTRICAL Subtype: Status: UNDER REVIEW Applied: 3/6/2015 PJU Approved: Parcel No: 770152011 Site Address: 51370 AVENIDA BERMUDAS LA QUINTA,CA 92253 Subdivision: DESERT CLUB TR UNIT 1 Block: 7 Lot: 1 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $2,500.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: INSTALLING (1) 2P40 AMP BREAKER FOR A CHARGING STATION. EXISTING 100 AMP METER MAIN WITH (1) 2P50 & (5) ONE SINGLEFOLD 20AMP. 2013CEC APPROVED PER JJ. ADDITIONAL SITES Printed: Friday, March 06, 2015 2:38:36 PM 1 of 2 112717 SYSTEMS DESCRIPTION ACCOUNT- QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # ' METHOD PAID BY CLTD BY POWER APPARATUS 101-0000-42403 0 $24.17 $0.00 POWER APPARATUS PC 101-0000-42600 0 $24.17 $0.00 Total Paid forELECTRICAL: $48.34 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:0• Printed: Friday, March 06, 2015 2:38:36 PM 2 of 2 CmS YSTEti1S Description: LUXE/INSTALLING (1) 2P 40 AMP BREAKER. Type: ELECTRICAL Subtype: Status: UNDER REVIEW Applied: 3/6/2015 PJU Approved: Parcel No: 770152011 Site Address: 51370 AVENIDA BERMUDAS LA QUINTA,CA 92253 Subdivision: DESERT CLUB TR UNIT 1 Block: 7 Lot: 1 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $2,500.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: INSTALLING (1) 2P40 AMP BREAKER FOR A CHARGING STATION. EXISTING 100 AMP METER MAIN WITH (1) 2P50 & (5) ONE SINGLEFOLD 20AMP. 2013CEC APPROVED PER JJ. ADDITIONAL SITES' CHRONOLOGY CONDITIONS Printed: Friday, March 06, 2015 2:38:36 PM . 1 of 2 CR SYS7EiNS DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE RECEIPT # CHECK # :. METHOD PAID BY CLTD BY POWER APPARATUS 101-0000-42403 0 $24.17 $0.00 POWER APPARATUS PC 101-0000-42600 0 $24.17 $0.00 Total Paid for ELECTRICAL: $48.34 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:00 Printed: Friday, March 06, 2015 2:38:36 PM 2 of 2 CR sysrrMs Bin #city 6f .Ld Quinta. Building 4 Safety Division P.O. Box 1504, 78-495 Calle Tampico . La Quirita, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Addr.'css:. �/ 3 p %�A. Owner's Name: L„(> A. P. Number: Address: 513 7q v{n rda 161w1 vpq, Legal Description: City; ST,Zip: 2�x Contractor: Address: �% !(Z Project Description: City, ST, Zip:4A.11 f 2 ZK i .. TGG 4 6 0. 2 s a.: p State Lic. #1 : q /. S S city`Lic. #�a� �} �0�.► / t� Arch., Engr., Designer: A \ Address:JL City, •ST, Zip: . , Construction Type: Occupancy Pro ect type circle one New . Add n Alter Repair Demo .. Telephone: State L•ic. #: ,`�Ly:4i:hi::: Ln}:•}}:$tiijnry,:.:.y.};:•:iv}iYi Lvdv:q: : , ;= :: Name of Contact Person: -Sq.-FL: #Stories: #Units: Telephone, #,of'Contact Person: .� 3. Esiimatcd:Value of Project:. %�s-oo PIN-01 APPLICANT :DO'NOT WRITE BELQW THIS LINE # Submittal Rcq'd : Rec'd TRACKING _ ?'ERMIT.FEFS. Plan Sets Plan Check submitted' I.tem Amount Structural Cates. Reviewed, ready. for corrections Plan Chc& Deposit, Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction ''• Flood plain play Plans resulimittcd Mechanical Grading plan 2"" Review, ready for corrcctions/issue. Electrical Subcontactor.List 'Callcd-Contact Person Plumbing Grant Deed ' r..lans picked up S:NLI.' H.0.4. Approval Plans resubmitted Grading IN IiOUSE:T r '"! Rcyiew, eady.for eorrectionsfissue .. Dvdoper-impact Fee c Plaoing, pproval, Called ConOct.Person ,- A:I.P P . Pali. Wks: App,r Datc.of permit issue School.Fccs TotalTermit Fccs l_vkc- l,�- Q .y..4CK,- 4zZY �