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BELC2015-0055Applicant: a Contractor: ARWIN ELECTRIC INC D ARWIN ELECTRIC, INC. 73048 EL CENTRO WAY OUTSIDE CITY LIMITS THOUSAND PALMS, CA 92276 JUL 2 LA QUINTA, CA 92253 CFIY OF Lr10UINTA (760)251-9740 C0P3R1UNITyDEVELOP I^rNTD� �PART_'_'�^1T LIC. No.::LIC 0105126 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.::LIC-0�105�12�y%: Z ate: J Contractors ► i� Ile, IrNOWNER-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 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 permit subjects the applicant to a civil penalty of not more than five hundred dolla ($500).: (-11, 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.). ( )1, 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 I 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 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:_ Polity 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,'f I should become subject to the workers' compensation provisions of Section 3 0 o0 of the Labor Code, I shall forthwith comply with those pr visions. Date: G. 0T Applica 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 i o ene. mentioned/gC/��ope for inspection purposes. v gate: r [. I ignature (Applicant or Age ): TA Qumro VOICE (760) 777-7125Tit,, 78-495 CALLE TAMPICO D FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 7/21/2015 Application Number: BELC2015-0055 Owner: Property Address: 52731 AVENIDA BERMUDAS LOPEZ ELEUTERIO P ESTATE OF APN: 773305024 Property Zoning: Application Valuation: $850.00 Applicant: a Contractor: ARWIN ELECTRIC INC D ARWIN ELECTRIC, INC. 73048 EL CENTRO WAY OUTSIDE CITY LIMITS THOUSAND PALMS, CA 92276 JUL 2 LA QUINTA, CA 92253 CFIY OF Lr10UINTA (760)251-9740 C0P3R1UNITyDEVELOP I^rNTD� �PART_'_'�^1T LIC. No.::LIC 0105126 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.::LIC-0�105�12�y%: Z ate: J Contractors ► i� Ile, IrNOWNER-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 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 permit subjects the applicant to a civil penalty of not more than five hundred dolla ($500).: (-11, 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.). ( )1, 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 I 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 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:_ Polity 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,'f I should become subject to the workers' compensation provisions of Section 3 0 o0 of the Labor Code, I shall forthwith comply with those pr visions. Date: G. 0T Applica 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 i o ene. mentioned/gC/��ope for inspection purposes. v gate: r [. I ignature (Applicant or Age ): FINANCIAL 1 • DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 7/21/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY ARWIN ELECTRIC INC DEBIT MR203 PJU Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $i.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE POWER APPARATUS 101-0000-42403 0 $24.17 $24.17 7/21/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY ARWIN ELECTRIC INC DEBIT MR203 PJU •DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE POWER APPARATUS PC 101-0000-42600 0 $24.17 $24.17 7/21/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY ARWIN ELECTRIC INC DEBIT MR203 PJU Total Paid for ELECTRICAL: $48.34 $48.34 DESCRIPTION ACCOUNT QTY - AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 7/21/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY ARWIN ELECTRIC INC DEBIT MR203 PJU Total Paid for PERMIT ISSUANCE: $91.85 $91.85 TOTALS: $141.19 $141.19 • ` Permit Details PERMIT NUMBER • BELC2015-0055 ,T City of La Quinta,:: Description: REPLACE ELECTRICAL 100 SAME FOR SAME CONDITIONS Type: ELECTRICAL Subtype: Status: UNDER REVIEW Applied: 7/21/2015 PJU Approved: Parcel No: 773305024 Site Address: 52731 AVENIDA BERMUDAS LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 140 Lot: it Issued: UNIT 15 NAME TYPE NAME Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $850.00 _ Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 ARWIN ELECTRIC INC Details: REPLACE EXISTING 100 AMP PANEL SAME FOR SAME 2013 CALIFORNIA ELECTRICAL CODE THOUSAND PALMS CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT ARWIN ELECTRIC INC 73048 EL CENTRO WAY THOUSAND PALMS CA 92276 CONTRACTOR ARWIN ELECTRIC, INC. OUTSIDE CITY LIMITS LA QUINTA CA 92253 OWNER LOPEZ ELEUTERIO P ESTATE OF 49608 ESCALANTE ST INDIO CA 92253 Printed: Tuesday, July 21, 2015 12:48:51 PM 1 of 2 cg? I" SYSTEMS DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK -#- METHOD PAID BY 11 CLTD BY POWER APPARATUS 101-0000-42403 0 $24.17 $24.17 7/21/15 MR203 DEBIT ARWIN ELECTRIC INC PJU POWER APPARATUS PC 101-0000-42600 0 $24.17 $24.17 7/21/15 MR203 DEBIT ARWIN ELECTRIC INC PJU Total Paid for ELECTRICAL: $48.34 $48.34 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 7/21/15 MR203 DEBIT ARWIN ELECTRIC INC PJU Total Paid forPERMIT ISSUANCE: $91.85 $91.85 TOTALS: Printed: Tuesday, July 21, 2015 12:48:51 PM 2 of 2 SYSTEMS INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES ELECTRICAL FINAL*" BLD Printed: Tuesday, July 21, 2015 12:48:51 PM 2 of 2 SYSTEMS Bin # City of La Quinta Building &' Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012. Building Permit Application and Tracking Sheet Permit # Pro ect Address: J 527-3 a n e Owner's Name: A. P. Number: Address: 1JC— n4Cf Legal Description: City, ST, Zip: (a L� CA . Contractor: UJ C T ele h n P 0 Address: • 3 d� CeA >� lig Project Description: e CLC C� City, ST, Zip: c)— daC.C.C� ( � i�d �� Telephone: g 76(/ 5 � aUeL State Lic. City Lic. Arch., Engr., Designer: Address: City, ST, Zip: Telephone: hone: .................... ............................. Con tr c • n TYPe: Occupancy: cY State Lic. # 0 Project (circle one): : NewAdd'nAlter Repair.air Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Reed TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance. Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan tad 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 ROUSE:- Jrd 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 r�