14-0616 (ELEC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
14-00000616
Property Address:
55964 PGA BLVD
APN:
775 -220 -021 -
Application description:
ELECTRICAL
Property Zoning:
TOURIST COMMERCIAL
Application valuation:
1200
App lic Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING. PERMIT
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 Professionals Cod j, and my License is in full. force and effect..
-icenseClass: C10 D31 Lice No.: 980589
bate: S a 1,4 Contractor:
O
- WNER-BUILDER' DECLARATION
- I hereby affirm under penalty ofperju th I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Bus.. and Professions Code: Anycity 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).:
( 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 forsale. 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 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. , 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:
LQPERMIT
Owner:
CAL WEST COMM
5927 PRIESTLY
LA QUINTA, CA
(760)918-6768
DRIVE
92253
Contractor: <
POWER PLUS
1210 REDGUM
ANAHEIM, CA 80
(714)765-7551
Lic. No.: 980589
--------------------
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/13/14
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 far which this permit is issued. My workers' compensation
insurance carrier and policy number are: -
Carrier XL. -SPECIALTY Policy Number CWG7409307.
_ I cenify'that, in the performance of the work for which thispermit is issued,,l 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 rkers' compensation provisions of Section
�J,-Q.,///,'37700 of the Labor Code, I hall o hwith com ith those provisions. -
-Date: _ 1 Applicant:
WARNING: FAILURE TO SECUR O ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO C IMI L PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 1N ADD T N,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 Ouinta, 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 suchpermit, 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 constr tion, and he
,^ authorize representatives
of this county to enter upon the above-mentioned pr for ins tion purpo
Date-sk.—?k Signature (Applicant or Agenfl:
Application Number . . . . . 14-00000616
Permit. . .
ELECTRICAL
2013
Additional desc .
Permit Fee . . . .
23.83
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . .
11/09/14
Qty Unit Charge
Per
Extension
1.00 23.8300
----------------------------------------------------------------------------
EA ELEC
TEMP POWER POLES
23.83
Other Fees . . . . .
. . . .
BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, ELECTRICAL
16.68
PERMIT ISSUANCE M/P/E
90.57
Fee summary Charged
-----------------
Paid Credited
Due
----------
Permit Fee Total
23.83
------------------------------
.00 .00
23.83
Plan Check Total
.00
.00 .00
.00
Other Fee Total
108.25
.00 .00
1'08.25
Grand Total
132.08
.00 .00
132.08
LQPERMIT
Bin #
City of La Quinta
Building 8r 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: V
Owner's Name:
A. P. Number:
Address: �- �jrj Q S% �`f. 564e = It D
Legal Description: eni px/u, e"3hxlivetti l
.City, ST; Zip: r ,5 q ,2008.
Contractor: O S
Telephone:
Address: 210 Al • F QOC ~ S4-,
Project Description:
City, ST, Zip:Avia-
Telephone: f •� 5 • 5
State Lie. # Wo,S
City Lie. #;
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
T. •:;;.;:.;:••::�;:.::.::i;;;:.
.Con tructi n TYPe: 4 P eweccu ancY:
State Lie. #:N<::;>;::;::::;>:>:`':%>>"»
Pro'a circle one : bw Add'n Alter Repair Demo
Ject h'P P
Name of Contact Person: �d %t (moi ,({ �,,�
Sq. Ft.:
# Stories:
# Units:
Telephone #.of Contact Person:
Estimated Value of Project: a20'p
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
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
2p° 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 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