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14-0687 (ELEC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number:14-00000687__�_ Property Address: 50570 BREVA APN: 776 -330 -011 - Application description: ELECTRICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 100 Tiht 4 XP Q" Applicant: Architect or Engineer: PIP BUILDING & SAFETY DEPARTMENT BUILDING PERMIT --------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury hat I am licensed oder provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Bu i ass and Profes ' all de, and my License is in full force and effect. License CI s: iB i nse No.:- 717431 r /ate: O s ontractor: OWNE -B DER DECLARATION I hereby4 affirm under penalty of perjury that I am exe pt fr m the Contractor's State License Law for the following reason ISec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct,l 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 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).: (_ 1 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 _ 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.). (_ 1 I am exempt under Sec. , BAP.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY 1 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: LQPERMIT Owner: RMB CITRUS LLC. 18 PEPPERTREE ALISO VIEJO, CA 92656 (949)351-4200 Contractor: RAFFERTY, MICHAEL 18 PEPPERTREE ALISO VIEJO, CA 92656 (949)351-4200 Lic. No.: 717431 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/23/14 --------------- - - - 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 STATE FUND Policy Number 909887414 I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any man9r,��r so as to beco subject to the workers' compensation laws of California, and agree that, ifd'hould become b t the workers' compensation provisions of Section 700 of the Labor e, I s all f h amply with those provisions. /Date:pplicant: WARNING: FAILURE TO SECURE WORKERS' C M NATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENA IE 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 Director of Building and Safety 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 above informs 'on is correct. I agree to comply with all city and co my ordinances and state laws relating to b din(, ccoonnS,struct' nd hereby authorize representatives of �ftis co ty Y o enter upon.tlie above-mentioned prop fof vpact oses. Date:ignature (Applicant or Agent): Application Number . . . . . 14-00000687 Permit . . . ELECTRICAL 2013 Additional desc . . Permit Fee . . . . 23.83 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 11/19/14 Qty Unit Charge Per Extension 1.00 23.8300 EA ELEC TEMP POWER POLES 23.83 ---------------------------------------------------------------------------- Special Notes and Comments ELECTRICAL - TEMP POWER POLE. 2013 CALIFORNIA BUILDING CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . PLAN CHECK, ELECTRICAL 16.68 PERMIT ISSUANCE M/P/E 90.57 Fee summary Charged Permit Fee Total 23.83 Plan Check Total .00 Other Fee Total 107.25 Grand Total 131.08 LQrERMrr Paid Credited Due .00 .00 23.83 .00 .00 .00 .00 .00 107.25 .00 .00 131.08 Bin # City of La Quinta Building 8I' Safety Division P.O. Box 1504, 78-495 Calle Tampico . La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: -400; 50,570 ? VA Owner's Name: ir�v c` ► jt� ri- A. P. Number: ��-��-��0_G�/ -� Address 6Upll Legal Description: Contractor: � A 6 City, ST, Zip: X661 V Zrb 1 f f w telephone: one: 5/— L €< Address: `0 6 p � Project Description: ��y yti 70 f�/�, City, ST, Zip: ff Le '� hti7U6L Telephone: P i ................................................ Lic. # : City Lic. #: -20 J5- SArchState ., Engr., Designer: Arch., Address: City., ST, Zip: Telephone: Construction Type: Occupancy: State Lic. Project (circle e one • New Addt n Alter Repairair 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 Recd 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 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2". 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:- '"' 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 HEARTHSIDE C 0 M 'i I " IT I CS _JJ rt c: 0 TI 000-- Z LTi LOT 7 50690 APN: 776-330-007-7 LOT 8 50660 APN: 776-330-008-8 II LOT 9 50630 APN: 776-330-009-9 LOT 11 50570 APN: 776-330-011-0 LOT 12 50540 APN: 776-330-012-1 CLUB HOUSE 4 THE CONTENTS OF THIS EXHIBIT ARE INTENDED INFORMATION 110. -SES ONLY AND Altdi an HALL NOT BE CONSIDERED FINAL. HEARTHSIDE COMMUNITIES (Developer) RMB CITRUS LLC (Owner) NOH1 0.25.13 THE RESERVE AT THE CITRUS Bassenian I Lagoni LA QUINTA, CA 713. 13093 _JJ rt c: 0 TI 000-- Z LTi 1 � � �