BELC2014-1047y
f Y
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING, PERMIT
Application Number:
BELC2014-1047
Property -Address:
56162 PGA BLVD
APN:
775220020: .
Application Description:
400A ELECTRICAL SERVICE FOR
Property Zoning:
Application Valuation:
$75,000.00
Applicant:
CALIFORNIA WEST CONSTRUCTION
OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/20/2014
Owner:
LQR GOLF.
1 BUSH ST STE 1100
JAICK SHA, SAN FRANCISCO, CA 0
IJ h�V 2 2014
Contractor:
CITY OF LA QUINTA CALIFORN IA-WEST.CONSTRUCTION
COMMUNITY DEVELOPMENTDEPARTMENT OUTSIDE CITY LIMITS
LA-QUINTA, CA 92253
(760)918-6770
Llc. No.: :LIC -0101491
-----------------------------=--------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION ,' WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of,perjuryahat I am licensed.under pr inions of Chapter I I hereby affirm under penalty�of perjury one'of the following declarations
9 (commencing with Section 7000) of Division 3 of the Business an Professions Code, I have and willmaintain a certificate of consent to self -insure for workers'
and my Licen a is in II force and effect:' compensation, as provided, for by Section` 3700.of the Labor Code, for the performance
License Cl as : License No.::LIC-01014 1 of. the'workfor.which this•permit is issued.
I have and Will maintain workers' compensation insurance, as required by
Date: j.� Contractor: 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:
OWNER=BUILDER DECLA ION' Carrier:: Polity Number: J {
I hereby affirm under penalty of perjury that.[ am exe' pt from the Contr or's State I certify that in the performance of the work for which thi permit is issued, I
License Law for the following reason (Sec. 7031.5, Bu'si ess'and Professi s Code: Any shall not employ any person in any manner so; as to become subje o the workers'
city orcounty that requires a permit td construct, alter, prove, de ish, or repair compensation laws of California; and agree that, if, I should beco subject to the
any structure, prior to its issuance, also requires the applic a permit to file a workers' co ensationprovisions of Section 3 0 of the L r de, I shall forthwith
signed statement that he or she.is licensed pursuant to the provisions of the ; comply. wit hose ovisions:. j
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, Date: Applicant:
basis for the alleged exemption. Any violation'of Section 7031:Sby any applicant for a�' z '
permit subjects the applicant to a civil penalty of not more than five hundred dollars WARNING: FAILURE TO,SECURE WORKERS COMPENSAT N JANDIL
E IS UNLAWFUL,
($500).: AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES FINES UP TO
(_) I, as owner of the property, or my employees with wages as their sole 'ONE HUNDRED THOUSAND, DOLLARS ($100,000). 'IN `ADDITION TO THE COST OF
compensation, will do the work, and the structure is not•intended.or offered for sale. •,... COMPENSATION, DAMAGES AS PROVIDEDTOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not INTEREST, AND ATTORNEY'S FEES.
apply to an owner of property who builds or.improves thereon, and who does thework
himself or herself through his or her own employees,, provided that the improvements' APPLICANT ACKNOWLEDGEMENT
are not intended or offered -for sale. If, however, the building or improvement is sold IMPORTANT: Application is hereby'made to the Building Official -for a permit subject.to
within one year of completion, the owner -builder will have the burden of proving that , the conditions'and restrictions set.forth on this,application.
he or she did not build or improve for the purpose of sale.). '•1. Each,person upon whose behalf this,application is made, each person at whose
(_) I, as owner of the property, am exclusively contracting with licensed contractors request and or whose benOit,work is performed.under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: T'he Contractors' issued as a result of this„application , the owner ;;arid the applicant, each agrees to, and
StateLicense Law does not apply to an owner of property who builds or improves, shall 'defend indemnify and'hold harmless the.City ofLa Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractors licensed pursuant to '' em to ees'for an -act or`oniiss on related to'1he work bein
p � O p p y,. y g performed under or
the Contractors' State License Lawf following` issuance of this.permit.'
(_) I am exempt under Sec. B.&P.C. for this reason ' 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•subjecY•permit to cancellation.
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:
I certify thafl have,read this application and state.that the above information is correct.
I agree to com ',with all city and countyortlinances and stat relatin to building
construction, a• hereby authorize represen ves this ty to enter upo above
mentioned pro erty fo inspection purpose :
Date: f L Signature (Applicant or.A nt):
I
Description 400A ELECTRICAL'SERVICE FOR SNACK SHACK
Type: ELECTRICAL' Subtype: Status: APPROVED
Applied: 11/19/2014 AOR
Approved:
Parcel. No: 775220020 Site Address: 56162 PGA BLVD LA'QUINTA�CA 92253
Subdiv-ision:.PM,20,426,...`,. .. :Block::.. Lot: 7,•;,. _. . .... •.
Issued:.•.:..,.,:'::.
Lot. Sq Ft: BuildirigSq Ft:.O' Zoning'
Finaled
Va.luatiom $75,000.00Occupancy Type: Construction TV pe:
1
Expired:
No: Buildings 0 No:;Stones: 0 No Unites 0
�.. i ti
Details 400A ELECTRICAL SERVICE FOR SNACK SHACK INCLUDING CONDUCTOR�RUNS 1AlITH 25KVA TRANSFORMER TO EXISTING SUBPANEL.
SIGNAGE SHALLBE PROVIDED. AT BOTH`SNACK SHACK AND SERVICE LOCATIONS DETAILING..
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,o�
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NAME TYPENAME ADDRE551 HI CITY �T�ATE- ZIP PHONE. FAX _ JOE
-.>
„R.-r�.._, N�•U a..•.. ... , -y �..
APP..LICANT CAL'IFORNIA•WEST CONSTRUCTION °OUTSIDE CITY LIMITS." LA QUINTA : CA, 92353.
.:.....
CONTRACTOR ` CALIF.,ORNIA WEST CONSTRUCTION OUTSIDE CITt1f LIMITS LA QUINTA,: CA 92253
n - N
OWNER :
-COR GOLF 1 BUSH ST STE"1100' SAN FRANCISCO CA 0 =
• DESCRIPTION: "ACCOUNT QTrY AMOUNT PAID PAID DATE RECEIPT # CHEGK# METHOD PAIDnBY
.a4a7 r A- Blf
BSAS.SB1473'FEE 101-0000-20306 0`, $100 0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION $3.00 $0.00
BSA:
Printed: Thursday, November 20, 2014 8:41:58 AM 1 of:2'
CRWIYSTEMS
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Thursday, November 20, 2014 8:41:58 AM 2 of 2 CRWYSTEMS
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT#
CHECK #
METHOD
PAID BY
.
}
OTHER ELECTRICAL
101-0000-42403
0
$24.17
$0.00
EQUIPMENT
OTHER ELECTRICAL
101-0000-42600
0
$24.17
$0.00
EQUIPMENT PC
SERVICES
101-0000-42403
0
$24.17
$0.00
SERVICES PC
101-0000-42403
0
$12.09
$0.00
Total Paid for ELECTRICAL: $84.60 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:• ••
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Thursday, November 20, 2014 8:41:58 AM 2 of 2 CRWYSTEMS
B►° #
City of La Quints
BulkGog at Safety Division
P.O. Box 1504,78-495 Cali* Tampico
La.Quinta, CA 92253 -:(760) 7777012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 56-162 PGA Blvd
Q 's Name:. CalWest Communities
A. P. Number. 775-220-020
Address:5927 Priestly Drive, Suite 110
Legal Description: Lot 1 of MB 297/054, TR 29421
City, ST, zip: Carlsbad, CA 92008
Contractor. CalWest Communities •
Telephone: 760-918-6768
ProjecxDescription:
Address: Same as above
City, ST, Zip:
Telephone: electrical service with step
MciLia
State Lic. #: #; On File ..
oWn transformer, ,000 on
Archy EW., Designer
duat and wore the seive
Address: Primary Contact: Liz Belloso
City, ST, Zip: Cell: 760-710-9912
Telephone: Construction Type:. Occupancy:
State Lia #: Project type (circle one): New Add'n Alter Repair Demo
Name of ContactPerson:fAjt: Ulrich-2Saue�b ey Sq. Ft:#Stories: #Units:
Telephone # of Contact Person: 760:6t0 941`01
Estimated value of Project: $75,000
APPLICANT: DO NOT WRITE BELOW THIS UNE
# Submittal Req'd Recd TRACIMG PERM r FEES
Plan Sets
Pian Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Coles.
Called Contact Person
Plan Check Balance
Tide 24 Calci6
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Giadiug plan
2'` Review, ready for correctiomTLaue
Electrical
Subcontaetor List
Called CoatectPerson
Plumbing
Grant Deed
Plana picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE.-
''" Review, ready for correc)Developer
Impact Fee
Planning Approval
Called Contact Person
A.LP.P. "
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees