BELC2014-100378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
RUDY G REYES
736 PALM AVENUE
COACHELLA, CA 92236
T4t�p 4 4 Q"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
BELC2014-1003 Owner:
50550 CALLE QUITO �` JOSE GARZA
770092001 50550 CALLE QUITO
upgrade panel 100a to 200a `i LA QUINTA, CA 52253
$1,500.00
Contractor:
(( RUDYS ELECTRIC
736 PALM AVE
(
COACH ELLA, CA 92236
(760)275-0307
LIc. No.: AEC122
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 oft a Business and Professions Code, and
my License is in full force and effect.
License CI ss: License No.: AEC122
J� 'date: Contractor:
G v 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 basis for the alleg�
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 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
Date: 7/9/2014
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one o<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 performancea ork for whish this permit is issued, I
shall not employ any person in any manner ass to ecome subject to the workers'
compensation laws of California, and agre that, if should ecome subject to the
workers' compensation provisions of Secti n 370 of the L b Code, I shall forthwith
comply with those provisions.
ate: f 1 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 t1he Building Official for a permit subject to
the conditions and restrictions set forth on th s application.
1. Each person upon whose behalf this appl cation is made, each person at whose
request and for whose benefit work is perforned 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 rhe work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this applkation 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 cancellaticn.
I certify that I have read this application andmate that t ve information is correct.
I agree to comply with all city and county ordnances a d stap laws rung to building
construction, and hereby authorize representatives of his to ente Yon the above-
mentioned property for inspection purposes. A
Signature (Applicant•or
FINANCIAL INFORMATION
- • 4 DESCRIPTION J eY { ACCOUNTa rapt
QTY'r ��+��AMOUNT �'� ` PAID
rPAID DATE
r
1.7
BSAS SB1473 FEE
101-0000-20306
0 $1.00
$0.00
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METHOD
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RE.CEIPtS# .t t� f x° �9
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Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
= `_i
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fit,", ACCOUNTy`
QTY',,
k AMOUNT'
PAID DATE
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,, ��r`
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- r ��PAID�;
SERVICES
101-0000-42403
0
$23.83
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uPAID DATE
;DESCRIPTION G a .,
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SERVICES PC
101-0000-42403
0
$11.92
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Total Paid for ELECTRICAL: $35.75 $0.00
Lxt� a DESCRIPTION'' �`
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QTY.::,
AMOUNT =
;" `{
PAID DATE
t
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PERMIT ISSUANCE
101-0000-42404
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$90.57
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Total Paid forPERMIT ISSUANCE: $90.57 $0.00
I
'n #
City of La Quinta
-Building 81: Safety Division
P.O. Box 1504, 78-495 Calle Tampico.
La Quints,CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
Permit #
Project Address:
Owner's Name: —J -(-)e cc rL q
A. P. Number:
Address: So SS(% Ca 11 e Q (.t_ ( {
Legal Description:
City, ST, Zip: . (�
Contractor: ?_td O(t S
Telephone: I (00Sit - 2 06 yl
Address: 73(o Pa_a_� A.L�e
Project Description:Wfi e. Lecf. seg �i
City, ST, Zip: Goa -G" cA q 22-3 6
(00 A, . t 2 xj A
Telephone:
!<->::::::><:::;::.;': M•!,......fzr%.
. , .....:::::....,..
...........
State Lic. # : (p (aj
City Lic. C
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupalcy:
State Lic..#:
Project type circle one): New Add'n Ater Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:.
# Units:
Telephone # of Contact Person:
Estimated Value of Project: 60
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKNG
PEZMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
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 correctiousfissue
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 Impac� Fee
Planning Approval
Called .Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fee.:
a
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561473 FEE 101-0000-20306 0 $1.00 $0.00
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Total.Paid forBUILDING STANDARDS ADMINISTRATION BSAc $1.00 $0.00
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� � D.ESCRIPTIOW, m �� E A,..: ACCOUNt 5 4 r ....
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SERVICES 101-0000-42403 0 $23.83 $0.00
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ktis �DESCRIPTION{f:.bA000�UNT �'QTaYw�AMOUNT�rPAID #PQID�DATE
„ve:..ss.a�5�sz'a_<
' SERVICES PC',.. 101-0000-42403 0 $11.92 $0.00
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Total Paid for ELECTRICAL: $35:75' $0.00'
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DESCR'IP<TION€ ACCOUNT'a� nTYs �nAMOUNT- D RAID DATE:
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ti PERMIT ISSUANCE, ° ,101-0000-42404 0$90.57 $0.00
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Total Paid for PERMIT ISSUANCE: $90.57 $0.00
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