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BELC2015-003978-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: BELC2015-0039 T4tr 4XfvQ"ttrw COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Property Address: •79125 BIG HORN TR APN: 776030010 Application Description: ANDERSON/50A CIRCUIT FOR VEHICLE CHARGER Property Zoning: Application Valuation: $1,300.00 Applicant: HEGGE ELECTRICAL CONTRACTORS I D 83852 AVE 45 MAY 1.9 215 INDIO, CA 92201 1V' �UIMA CiN OF �Q,.�.rT nEP1F— 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. Z,I!se Class: C10 License No.: 748171 : f.� Contractor: L e U 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 Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the 4 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).: U 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.). (1 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 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: 5/19/2015 Owner: ROBERT ANDERSON 79125 BIG HORN TR LA QUINTA, CA 92253 Contractor: HEGGE ELECTRICAL -CONTRACTORS 1 83852 AVE 45 INDIO, CA 92201 (760)775-4855 Llc. No.: 748171 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' compensate n, asprovided for by Section 3700 of the Labor Code, for the performance of th, which this permit is issued. I have and will maintain workers' compensation insurance, as required by S 700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance.carner 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 co ply with thos provisions. at 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 enter upon the above- 6tioned pr C,p'erty for inspection purposes. Date: / Signature (Applicant or Agent • DESCRIPTION FINANCIAL INFORMATION 'ACCOUNT QTY AMOUNT PAID` PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 5/19/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY HEGGE ELECTRICAL CONTRACTORS 1 CHECK R6207 30302 AOR Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00' $1.00 DESCRIPTION. ACCOUNT QTY AMOUNT PAID PAID DATE APPLIANCES, RES 101�99,,Q,0 42403,- - _ r 0 $12.09 $12.09 5/19/15 PAID BY IMETHOD ° ,t RECEIPT # CHECK # CLTD BY HEGGE ELECTRICAL CONTRACTORS 1 i :.CHECK i R6267 30302 AOR DESCRIPTION I ACCOUNT ` QTY 7AMOUNT PAID PAID DATE APPLIANCES, RES PC 101-000042600 --� _• _ 0l$12.0 $12.09 5/19/15 PAID BY _ (VIETIiOD� j� �4 RECEIPT # CHECK # CLTD BY HEGGE ELECTRICAL CONTRACTORS I CHECK ~`"�� a1'!J1-W,11R6207 30302 AOR Total Paid for ELECTRICAL: $24.18 $24.18 DESCRIPTION ACCOUNT QTY' AMOUNT • PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 5/19/15 PAID BY METHOD, RECEIPT # CHECK # CLTD BY HEGGE ELECTRICAL CONTRACTORS I CHECK' R6207 30302• AOR Total Paid for PERMIT ISSUANCE: $91.85 $91.85 Bin # Permit # -�01s- °A39 Project Address: Qty of La Quin to . "Building 8t; Safety Division P.O. Box 1504, 78-495 Calle Tampico . " La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Owner's Name: POYf'� A. P. Number: Address:72 Legal Description: City, ST, Zip: Contractor: Telephone ' :'>>t>:a ..........:. Address: S- Project Descripf n: z av City, ST, Zip: � (b C4 9 2 2_0 Tele hone: _ l/yam— P 7�U 77S T93 >:>�,>:4z•>.«;:;:v�:<:��a':�" >;:<' ; ,:::::.,•:. SEEN= Lel ZL C f Ll "T•' ► '� State Lie. # : 1 City Lie. Arch., Engr., Designer: V.r Address: City., ST, Zip: ' - Telephone: State Lie. # •:i�}:w`: i:��:!i::;i.�:>y:Y,.i: Zvi: �tiiy< :;:<;; i:},v,�:i ::<:s::<:; ""' a::;Y>"` -``'<' ? >` Construction Type: Occupancy: Pro'eci type (circle one): Now Add'n Alter Repair Demo Name of Contact Person:,�� Sq. Ft.: #Stories: #Units: Telephone #,of Contact Person: 7 -� �— Estimated Value of Project: o 0 e _— APPLICANT- DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Cala.. Called Contact Person Plan Check Balance. Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 21' Review, ready for corrections/issue Electrical Subcontactor List Called Contact Pcrson Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN ROUSE:- 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 Tota] Permit Fees Description: ANDERSON/50A CIRCUIT FOR VEHICLE CHARGER Type: ELECTRICAL Subtype: Status: ISSUED Applied: 5/19/2015 AOR Approved: 5/19/2015 AOR Parcel No: 776030010 Site Address: 79125 BIG HORN TR LA QUINTA,CA 92253 Subdivision: TR 25429 Block: Lot: 18 Issued: 5/19/2015 AOR Lot Sq Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $1,300.00 Occupancy Type: Construction Type: Expired: 11/15/2015 AOR No. Buildings: 0 No. Stories: 0 No. Unites: 0 ZIP PHONE FAX EMAIL Details: 50A CIRCUIT FOR VEHICLE CHARGER LOCATED IN GARAGE. 2013 CALIFORNIA ELECTRICAL CODE. HEGGE ELECTRICAL CONTRACTORS 1 Printed: Tuesday, May 19, 2015 7:55:44 AM 1 of 2 CR�SYS7EM5 CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT HEGGE ELECTRICAL CONTRACTORS 1 83852 AVE 45 INDIO CA 92201 CONTRACTOR HEGGE ELECTRICAL CONTRACTORS 1 83852 AVE 45 INDIO CA 92201 OWNER ROBERT ANDERSON 79125 BIG HORN TR LA QUINTA CA 92253 Printed: Tuesday, May 19, 2015 7:55:44 AM 1 of 2 CR�SYS7EM5 PARENT PROJECTS BOND INFORMATION Printed: Tuesday, May 19, 2015 7:55:44 AM 2 of 2 RWY57EM5 CLT - DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY APPLIANCES, RES 101-0000-42403 0 $12.09 $12.09 5/19/15 R6207. 30302 CHECK HEGGE ELECTRICAL AOR CONTRACTORSI APPLIANCES, RES PC 101-0000-42600 0 $12.09 $12.09 5/19/15 R6207 30302 CHECK HEGGE ELECTRICAL AOR CONTRACTORSI Total Paid for ELECTRICAL: $24.18 $24.18 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 5/19/15 R6207 30302 CHECK HEGGE ELECTRICAL AOR CONTRACTORS Total Paid forPERMIT ISSUANCE: $91.85 $91.85. TOTALS: $117.03 $117.03 PARENT PROJECTS BOND INFORMATION Printed: Tuesday, May 19, 2015 7:55:44 AM 2 of 2 RWY57EM5