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 2014
- 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
b -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 should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
omply with those pr isions.
Date Applicant:
WARNING: FAILURE TO -SECURE WORKERS' COMPENSATION ERAGE 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)
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PAID,DATE;.
rDESCRIPTIONvNA,; kACCOUNT�. ,f QTY xx >AMOUNTa a,:aPAID.
� :>_ . r.,.:
BSAS SB1473'FEE 101-0000-20306
0
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FN-RECEIPTS#f ° _tib CHECK # � CLTD BY
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Total'Paid for BUILDING STAN DARDS'ADMINISTRATION BSA '$1.00. $0.00
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AMOUNTS
PAID
PAID'D'ATE
Y
Pg,„3
c
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-3 .int
POWER APPARATUS PC
101-0000-42600
'0
$24.17
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Total Paid for ELECTRICAL: • $48.34 $0.00
a DESCRIPTION, s
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AMOUNT
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PAID
ti s
PAID`DATE
:Q
.-'nu:.
PERMIT ISSUANCE.
10(1-0000-42404
0
$91-.85-
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Total Paid forPERMIT ISSUANCE: $91.8S $0:00
• ••
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
HARTMAN ELECTRIC INC, GREG 77849 CALLE ARROBA
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
NAME TYPE `
NAME . ADDRESSI
CONTACTS
CITY
STATE
ZIP,
PHONE
FAX
EMAIL
APPLICANT
HARTMAN ELECTRIC INC, GREG 77849 CALLE ARROBA
LA QUINTA
CA
92253
(760)462-5893
CONTRACTOR
HARTMAN ELECTRIC INC, GREG 77849 CALLE ARROBA
LA QUINTA
CA
92253
(760)462-5893
OWNER
LUXE VACATION HOMES 51370 AVENIDA
BERMUDAS
LA QUINTA
CA
92253
(760)462-5893
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•
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED [COMPLETED
DATE DATE
RESULT REMARKS NOTES
ELECTRICAL FINAL"
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) 2PS0 & (5) ONE
SINGLEFOLD 20AMP. 2013CEC APPROVED PER JJ.
Printed: Friday, March 06, 2015 2:38:36 PM . 1 of 2 CR
SYS7EiNS
CHRONOLOGY
CONDITIONS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE FAX• EMAIL
APPLICANT
HARTMAN ELECTRIC INC, GREG
77849 CALLE ARROBA
LA QUINTA
CA
92253
(760)462-5893
CONTRACTOR
HARTMAN ELECTRIC INC, GREG
77849 CALLE ARROBA
LA QUINTA
CA
92253
(760)462-5893
OWNER
LUXE VACATION HOMES
51370 AVENIDA
LA QUINTA
CA
92253
(760)462-5893
BERMUDAS
FINANCIAL
•
•
DESCRIPTION
ACCOUNT QTY AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK # METHOD PAID BY CLTD
BY
BSAS SB1473 FEE
101-0000-20306
0 $1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00
$0.00
BSA:
Printed: Friday, March 06, 2015 2:38:36 PM . 1 of 2 CR
SYS7EiNS
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 for ELECTRICAL: $48.34 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE. DATE
RESULT REMARKS NOTES
ELECTRICAL FINAL**
Printed: Friday, March 06, 2015 2:38:36 PM 2 of 2 CR
sysrrMs
Bin #city
Of LJ QUrnta.
Building 4 Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
Permit #
La Quirita, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Addr.'ess:. �/ 3 � p �A. Owner's Name: L„(>
A. P. Number: Address: 5137ol4veniolp 161w1 vpq,
Legal Description:City; ST, Zip: �,�, ! Zx
Contractor:
Address: !(Z Project Description:
City, ST, Zip:4A.11 f 2 ZK i .. 5 TGG 4 6 0. 2
Telep}ionc:
sc................a.:
State Lic. #1 : q /. J S city`Lic. #�a� �} ! O�+ / t�
Arch., Engr., Designer: A \
Address:JL
City, •ST, Zip: .S iR 'LO Y
.. ,`�Ly:4i:hi::: Ln}:•}}:$tiijnry,:.:.y.};:•:iv}iYi Lvdv:q: . ,
Telephone: : , ;= :: Construction Type: 1 Occupancy
State L•ic. #: Pro ect c circle one New . Add'n Alter Repair Demo
Name of Contact Person: FL: #Stories: #Units:
Telephone, #,of'Contact Person:.� Esiimatcd:Value of Project:. PIN-01 3.
AP -!C :DO 'NOT WRITE BELbW THIS LINE
# Submittal Rcq'd : Recd TRACICii`IG _ ?'ERMIT.FEFS.
Plan Sets
Ptan Check submitted'
I.tem
Amount
Structural Cala.
Reviewed, ready -for corrections
Plan Chc& Deposit,
Truss Calcs.
G11ed Contact Person
Plan Check Balance
Title 24 Gla.Ptans
picked up
Construction
Flood plain play
Plaris resulimittcd
Mechanical
Grading plan
2"" Review, ready for corrcctions/issue.
Electrical
Subcontactor.List
Callcd-Contact Person
Plumbing
Grant Deed'
r..lans picked up
S.M.I.'
H.0.4. Approval
Pians resubmitted
Grading
IN IiOUSEi=
'"! Rcyiew, ready.for corrections fissue ..
Dcvd66er-3mpact Fee
PlanningAPProval,
Called Contact.Person ,-
A:LP P .
Pali. Wks: App,r
Datc.of permit issue
School.Fccs
Total.Pcrmit Fccs