BELC2014-1017781495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
TAt!t 4 4� QuiKr(v
COMMUNITY DEVELOPMENT DEPARTMENT
Application Number:
BELC2014-1017
Property Address:
44060 CAMINO AZUL
APN:
604180011
Application Description:
CHANGE OUT 200 AMP MAIN BREAKER
Property Zoning:
Application Valuation:
$500.00
Applicant:
COLLINS ELECTRICAL SERVICES
PO BOX 10925
PALM DESERT, CA 92255
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/3/2014
SEP2 2014 U Owner:
MELISSA KENDALL
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: C10 License
No.: 788945
ate:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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
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).:
(_) 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.).
(_) 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:
ViLl
Contractor:
COLLINS ELECTRICAL SERVICES
' 1 PO BOX 10925
PALM DESERT, CA 92255
(760)341-8764
Llc. No.: 788945
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: 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
comply with those provisions.
/I e: 4pp
icant:
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-
mentio d property for inspection purposes.
Dat . Signature (Applicant or Age ):
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT CITY
AMOUNT
PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306 0
$1.00
$0.00
PAID BY
METHOD RECEIPT #
CHECK #
CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$90.57
$0.00
PAID BY
METHOD.
RECEIPT #
CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $90.57 $0.00
TOTALS:00
Bin #
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=�
Permit #
Project Address:
City Of La Quin td
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
La Quints, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name:
A. P. Number:
Address: K--61-00 ` Az—,Ai-
uLegal
LegalDescription:
City, ST, Zip: L k(' VL+C, CL, ZZ�
Contractor: ;KS Cleo
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'Telephone:
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Address: ��' Y S Z L u �'S tQe
Project Description:
City, ST, Zip: P bee(' C-c.
2,00 A adak 0-60 e p(k-* •
ne: - o
Telephone: C tf
P o �S
? 7 8 3
State Lic. # : -78 89 qS
City Lie. #;
Arch., Engr., Designer,.
Address:
City., ST, Zip:
Telephone:
Occupancy:
PaneY•nstructionYP C
45 VvLk � S-
tYPa (circle one): Project : New Add'n Alter Repair Demo
State Lic. #:
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: 500
# Submittal Req'd
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rec'd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Cluck Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance.
Title 24 Cala.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'" Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S•rif•I•
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionstiissue
Developer Impact Fee
Planning Approval
Called Contact Person
. A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Description: CHANGE OUT 200 AMP MAIN BREAKER
Type: ELECTRICAL
Subtype: Status: APPROVED
Applied: 9/3/2014 SKH
Approved: 9/3/2014 SKH
Parcel No: 604180011 Site Address: 44060 CAMINO AZUL LA QUINTA,CA 92253
Subdivision: TR 24517
Block: Lot: 26
Issued:
Lot Scl Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $500.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
Details: MAIN BREAKER CHANGE OUT 200 AMPS PER 2013 CALIFORNIA BUILDING CODES
- ADDITIONAL SITES
Printed: Wednesday, September 03, 2014 2:28:53 PM 1 of 2
SYSTEMS
Printed: Wednesday, September 03, 2014 2:28:53 PM 2 of 2
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