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BELC2016-0085t♦ 78-495 CALLE TAMPICO D• VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 10/4/2016 Application Number: BELC2016-0085 Owner: Property Address: 78940 CABRILLO WAY STANLEY MORRISON APN: 646410006 Property Zoning: o Application Valuation: $1,500.00 0 Applicant: Pp _n O o41 n Contractor. BRADLEY ELECTRIC INC ;� BRADLEY ELECTRIC INC 42215 WASHINGTON STREET 42215 WASHINGTON STREET SUITE A381 SUITE A381 ro err rV PALM DESERT, CA 92211 PALM DESERT, CA 92211 ! O 44 Uc. No.: 275466 -, 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 Cod and my License is in full force and effect. License Class: C10 )% License No.: 275466 Date: Jv /Sv Contractor.. - 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 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 am exempt under Sec. B.&P.C. for this reason Date: Owner: r 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 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 COMPENSATION INSURANCE FUND Policy Number: 9084693 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 sub'e to the workers' compensation provisions of Section 3700 of the La 1 r -Code, I shat forthwith comply wit tho a provisions. Date: © Ap n WARNING: F LURE TO SEC E WORKERS' COMPENS IONCO ERV AGE IS UNLAWFUL, AND SHALL SUBJECT AN EMP T 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 theabove i ormation is I agree to comply with all city and county ordinances and state laws lating to construction, and hereby authorize representatives of this it nt r �onth above m do ed property for inspection pos . pl c Oate: SignKreAp icant or Agent): 4 Date: 10/4/2016 Application Number: BELC2016-0085 Owner: Property Address: 78940 CABRILLO WAY STANLEY MORRISON APN: 646410006 Property Zoning: Application Valuation: $1,500.00 Applicant: Contractor: BRADLEY ELECTRIC INC BRADLEY ELECTRIC INC _ 42215 WASHINGTON STREET 42215 WASHINGTON STREET SUITE A381 SUITE A381 PALM DESERT, CA 92211 PALM DESERT, CA 92211 (760)360-0944 Llc. No.: 275466 Detail: ELECTRICAL - CHANGE OUT (1) 200AMP MAIN SERVICE. 2013 CALIFORNIA BUILDING CODES. 4 FINANCIAL ••. DESCRIPTION ACCOUNT CITY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT CITY AMOUNT SERVICES 101-0000-42403 0 $25.33 DESCRIPTION . ACCOUNT CITY AMOUNT SERVICES PC 101-0000-42600 0 $12.67 Total Paid for ELECTRICAL: $38.00 DESCRIPTION ACCOUNT CITY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $96.27 Total Paid for PERMIT ISSUANCE: $96.27 DESCRIPTION ACCOUNT CITY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 Bin 1`i Permit `Project Address: — Qty of 1a Quinta Building 8r Safety Division 78-495 Caffe Tampico La Quinta, CA 92253 - (760) 777-70 L2 Building Permit Applicatidn and Tracking Sheet LL(j Owner's Name: A. P. Number: ' Address:-70 _q TV Legal Description:City, I ST, Zip: Ply 7'x/1 L , ,'Cotitractor: ' Telephone: hone: \~ `Address: .�-.' ( W'- Project Description: Cqm& ity, ST, Zip . T �U U -)o , Te one• leP h 60 ti State Lic. # :GCd �o � 8City Lic. #; r r �c Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Ph o e. - t C on tru t' s c ton Type: O ecu ane Y: P P State ,. Lic- L # ' Pr Ject tYPc (circle one)• New Add'n Alter Repair Demo o Name of Contact Person: Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: r Estimated Value of Protect: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rcc'd TRACKING . PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. 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 d CalleContact Person Plumbing Grant Deed Plans picked up S.M.T. H.O.A. Approval Plans resubmitted Grading IN ROUSE:- 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