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BELC2014-1045Applicant: MARTINEZ ELECTRIC 31040 AVENIDA LA GAVIOTA CATHEDRAL CITY, CA 92234 Nov 13 2014 QUINTA COMMUNITY DEVELOPMENT DEI LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that l'am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of"the Business a d Professio ode, and License is in full force and effee License Class: C10 license N 866958 / Date: T— 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 permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_) 1, 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,)'. 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 Contractor: MARTINEZ ELECTRIC 31040 AVENIDAiLA GAVIOTA CATHEDRAL CITY; CA 92234 (760)834-5570 Llc. No.: 866958 WORKER'S COMPENSATION DECLARATION I hereby affirm:underpenalty 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 _o!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'•cdmpen sation insurance carrier and policy number are: Carrier: _`` ;Policy Number: I cert fy'that,in•the performance of the work for, which this permit is issued, I shall not employ any `pe.rson in any manner so as to become subject to the workers' compensation"laws of California; and agree that, if.1 should become subject to the workers''compensation provisions of Section 3700 of the Labor de, I shall forthwith comply with those provis ions. Dater _�� / f Applic t: :;Ln WARNING: F.AILURE`TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO'CRIMINAL PENALTIES AND CIVIL FINES UP TO ONEHUNDRED 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'restri6ons set forth on this application. 1. Eacli 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.6vner, 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 followingissuance of this;permit.. 2. Any permit issue&as;a4re sult 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 i80 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 a tate laws r lating building construction, and hereby authorise representatives ; this city to ente p the above mentioned property for inspeciion.pu poses. Date: "" f7/4 Signature (Applicant oAgent): VOICE (760) 777-7125 78-495 CALLE TAMPICO U FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 . COMMUNITY DEVELOPMENT b049TMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 11/13/2014 Application Number: BELC2014-1045 Owner: Property Address: 78785 SANITA DR RU.BEN RODRIGUEZ APN: 604162017 78785 SANITA DRIVE Application Description: 100 AMP TO 200 AMP PANEL -LA*QUINTA, CA:92253 Property Zoning: Application Valuation: $1,400.00 Applicant: MARTINEZ ELECTRIC 31040 AVENIDA LA GAVIOTA CATHEDRAL CITY, CA 92234 Nov 13 2014 QUINTA COMMUNITY DEVELOPMENT DEI LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that l'am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of"the Business a d Professio ode, and License is in full force and effee License Class: C10 license N 866958 / Date: T— 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 permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_) 1, 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,)'. 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 Contractor: MARTINEZ ELECTRIC 31040 AVENIDAiLA GAVIOTA CATHEDRAL CITY; CA 92234 (760)834-5570 Llc. No.: 866958 WORKER'S COMPENSATION DECLARATION I hereby affirm:underpenalty 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 _o!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'•cdmpen sation insurance carrier and policy number are: Carrier: _`` ;Policy Number: I cert fy'that,in•the performance of the work for, which this permit is issued, I shall not employ any `pe.rson in any manner so as to become subject to the workers' compensation"laws of California; and agree that, if.1 should become subject to the workers''compensation provisions of Section 3700 of the Labor de, I shall forthwith comply with those provis ions. Dater _�� / f Applic t: :;Ln WARNING: F.AILURE`TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO'CRIMINAL PENALTIES AND CIVIL FINES UP TO ONEHUNDRED 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'restri6ons set forth on this application. 1. Eacli 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.6vner, 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 followingissuance of this;permit.. 2. Any permit issue&as;a4re sult 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 i80 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 a tate laws r lating building construction, and hereby authorise representatives ; this city to ente p the above mentioned property for inspeciion.pu poses. Date: "" f7/4 Signature (Applicant oAgent): 1 1 . • 1 '. }, s h.;:'. me 2' ue"✓A,.iG"y:tii4".S:vC^�fi"4.'le •..M1:. '4.�'t .57 "� rc4r '5,, moi. ts.•p Ytie�,,•'Y» d' r,,;i'•{• y. 3�'�C °�`. ,, 'tyt°d� ' v'DESCRIPfTsION , ',}:ACCOUNT ' , icClTY NAM,OUNTa $. PAID.: " PAIDiDQTiE �'*>.Y"�.'. ryj• �1c'A-.=�7.64G7'��YdG+W?AKkY.h.!iYf9!4iN`M..iYL3 .,:'.n�rM:4Lki`:§�i.-•331:,dL.Sft:lfkN'.Ib�'.^!.R:ia1V.s,Yaw'k!Sfi..1`.%4.t7:l:RS:1SZrti;.`r3tli?t�tt�:b ' BSAS 561473, FEE • 101 0000' 20306 . ' '' ' ' 0 "..; $1"00 $0.00 �roro r -11r PAID � rMETMOD. �Ei1�StR+*..,.J-'K;Hi^�✓Y,1 uy5,�:.. E HEC Al 7•�y,1.161f Tri <a. BY a <', l ; RECE T #wk-� , Y�. sc �. Total Paid for BUILDINGSTANDARDS ADMINISTRATION M`.jp. yia. C A:,F y{h.. -�'U�� = `'.�:��! + .. itY6`d. �lYswUtiYrt' vtr'i 'VaG C, yC f 'M: A000.UNT `�;' �y',5 • Y6 Z Y li". "� ',y AMOUNT.jv. "'�d..k, �'^3eM {7j�kav?3::!ir16e -.. `y�, PAID,. t.S�.aSS3i.:#.:1:4:RilSkro' y,'•:UESCRIPiTION`{�:y , i^`i�f'.o-.�Y:$lYis'a!&75WN:ulY§WfY},.u..!1xk'r.�•.� Y>�f ?. N.�''..�n'•.�'J: {I.W�i'i.M .k±linY.tsu.:.YriA:2C �'1C!}i�li. •.< ,Fy�.:`),C1TY% <_lT.t+w'e,3(MK: ,b a-i";iY:>1.: "..5�x^.7±C:tr1,tRT+�k;. .i�-"FPy�AI�WDATE fd�:4ktx.s'$usN0.Y .i�.uYi,fMtial'.N%iE;1R5F•'� SERVICES 101000U-42403. ' 0 $2f4:17 $0:00 a OR, '{i aS3 ,.1„�'.-.At: :rDRSs#. �, ,64� ya 16,46IBY ! �.. d{�t",q$„ NaA�+ N@�fi3f•C y 1 �r METHOD 4'x;' " r PT �s +.'k• !,r?3:E'H ru, ,j., 6 � ,, RECEIPT°�¢ mak` ' ! 3" 'i6:?" NEAR (rte CMECK?# y a �u''.ik x.. " CLTD BY 'r a::. a •..Kb , 6S•...i�a6ri u:Y+*Fnrtr�a,: i.9 U-:.ri.6t.,. z„�r .`�.''�ti�rar„xW�X.- .rk r.;.•&, r. 1 14n,bd4Na r; 7i� .., '{;;�i- q `^ SaS7i;rhtk3rRuae.Ms r :.- .lM,x nafi++, nvhYnr.... vtii.3 1 Lv .x�l 1}XMubY _:laf''7�'., .. �AIVIOUNT - ,�.i ° Pm `C;sEt;:yw�. PAID DATE { DESCRIPTION ^ ACCOUNT. QTY* .W R} AID SERVICES PC 101 0000=42403.. 0 $12.09 a. $0.00. A..V`� ,.3.d�•. ' �*'"� �fi^ ... t g' All .; PAI,D BY ...wt i;& ri+r 5.'&iSF,' ii j u-%� -.. :e d r..� � METHOD '", -+ ' t %Sa.€ .rRM.+h,: Ott ty t,' 4i&;Eb'ad ' RECEIPT # IM s C 1�ia4'$4a kVJ.. ds;wnµRn.L! �„:#. .a`ei4R'3 .fix �� a6. Total PA for ELECTRICAL $36.26'; :x$0:00 si'F{ %L`".2M 1Qyd•'.lY.t;1:" nZ:7i,7iiai:ElrTt,Sx'�!F' ' � �Y. %� , �fi7+ �^5 5 r �<Nvxe�liiSy' ..fp';";i f` if }� ;%S.iCr3" ,� [ "R•AL PY. ysr. n !'�' A �u �14r '_Vv'.7�SSt$ PKAIDLLDATEa Ix t DESCRPTIQN. ACCOIINT�CZAMO; NT���Pf�AID� Y6MLJIt.S'3. s"c:.IFL;A '-i'"'.$.Y.i'ri� PERMIT ISSUANCE 101 0000;42404 ; .0 $91:85 , $0.00 K;3'I w ;�4 '� 1 o, �y C�I'PAIDBY;> OWN Will �v4."a tri ,?'t`.. .,'a.U'?•31a+F ^Y7" `V.3 �.� '°yak` „ .. �s '�.1W, 7:Y.E,` .: ..'•-x^w44p R aim aTotal.Paid forPERMITSISSUANCE0.00%, • x �� Bin.# 0tf ;1.Ci Qli%n Building 8r Safety Division P.O. Box 1504,"78-495- Calle T'ampfco b.Quinta, CA 92253 -:(760) 777-7012 Building Pennit'Application and Tracking Sheet Permit # ProjectAddress: ..qdh Owner's Name:. A. P. Number. Address: Legal Description: Contractor. City, ST, Zip: M. Telephone: ' ,.,y. > max.: . Project Description: Address: Q City, ST, Zip:. r 223 Lf" Telephone: ;sY �� r'Y - i State Lic. # : City Lic Arch., Engr., Designer ©� . Address: City., ST,.ZiP: Telephone: State Lie. MnProject Name of Contact Person: Construction Type:'. Occupancy: type (circle one): New Add'Alter Repair Demo Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW. THIS LINE p Submittal Req'd Recd TRACICi1VG PERMCP FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit. . Truss Cates. Called Contact Person Plan Check Balance Title 24 Calci. Pians picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2sd Review, ready for correctionsfissue Electrical 0. Subeontactor Ust Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resabmitted Grading IN HOUSE:- '"' Review; ready for eorreetionsfissue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr ' Date of permit Issue School Fees Total Permit Fees Description: 100 AMP TO 200 AMP PANEL Type: ELECTRICAL Subtype: Status: SUBMITTED Applied: 11/13/2014 PJU Approved: Parcel No: 604162017 Site Address: 78785 SANITA DR LA QUINTA,CA 92253 Subdivision: TR 23269 Block: Lot: 89 Issued: Lot Sq Ft' 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $1,400.00 Occupancy Type: Construction Type: Expired: No. -Buildings: 0 No. Stories: 0 No. Unites: 0 CA Details: MAIN PANEL CHANGE OUT 100 AMP TO 200 AMP.2013 CALIFORNIA ELECTRICAL CODES CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES s FINANCIAL INFORMATION Printed: Thursday, November 13, 2014 1:09:55 PM 1 of 2 SYSTEMS ADDITIONAL CHRONOLOGY CONDITIONS CONTACTS +ss?.. ;xrs .,� .._- •:R..-: .•:.�.- moria. ._ - r. ti, .: �;m• - : -r> ..n.a.� a•.;:,: r i '. -t. . .. �,_T:. NAME -TYPES "'''' 'NAME,^�' .,.#r*• :ADDRESSI, P. «�✓ � , �.k rx� "'v.1,#:. -, '"�.!s.e�'+. RL. .r�.a'#?..:nE`.'c�t. .:.J �y,:...� ^e +ri.•.Q .t.....^a .. ..mss:.:. a.. ..�...,. - ... �. -.- ...;,.,M y: �.. ..,..ice *EMAIL sia. S=N-:: e�'v: 5d.-1 .it.. i.?...,s . K*. FAQ �,^..� f.."Y'%R:L 'X". APPLICANT MARTINEZ ELECTRIC 31040 AVENIDA LA GAVIOTA CATHEDRAL CITY CA ''92234 (760)413-9452 ; CONTRACTOR MARTINEZ ELECTRIC 31040 AVENIDA LA z GAVIOTA-•*r' CATHEDRAL CITY: CA -•92234• (760)413-9452' , .. . OWNER RUBEN RODRIGUEZ 78785 SANITA DRIVE LA QUINTA CA , .92253 ' (760)413=9452 it.1 FINANCIAL INFORMATION Printed: Thursday, November 13, 2014 1:09:55 PM 1 of 2 SYSTEMS . e A* 'DESCRI PAI ATE�J-RECEII CKJ ' n PAI BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: SERVICES 101-0000-42403 0 $24.17 $0.00 SERVICES PC 101-0000-42403 0 $12.09 $0.00 Total Paid for ELECTRICAL: $36.26 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.8.5 -$0.00 .Total Pa.id for PERMIT ISSUANCE: $91.85 $0.00 TOTALS: $129.11 $0.00 Printed: Thursday, November 13, 2014 1:09:55 PM 2 of 2 CB?W.,YSTEMS