BELC2017-0016178-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
DESIGN & DEVELOP
BUILDING P
Application Number:
BELC2017-0016
Property Address:
77670 CALLE SINALOA
APN:
773133023
Application Description:
LOPEZ RESIDENCE / ELECTRICAL
Property Zoning:
Application Valuation:
$1,790.00
Applicant:
WEST BOUND ELECTRICAL CONTRACTING AND SE
74170HWYIll STE3
PALM DESERT, CA 92260
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 Code,
and my License is in full force and effect.
License Class: C10 License No.: 786678
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. 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).:
(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 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.).
(_J.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:
VOICE (760) 777-7125
a FAX (760) 777-7011
JT D MENf I CTIONS (760) 777-7153
FEB 2 2 2017 Date: 2/22/2017
Cin QPan er•
.DESIGN AND DEVEtr9RPEz
F 1
• LA QUINTA, CA 922 922
Contractor:.
WEST BOUND ELECTRICAL CONTRACTING AND SE
74170 HWY 111 STE 3
PALM DESERT, CA 92260
(760)776-8314
Llc. No.: 786678
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 for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
Carrier: MID-CENTURY INSURANCE COMPANY Policy Number: 809472744
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 subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Daie~: fApplicant:
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 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 the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to ter upon the
above-mentioned property for inspection purposes.
Date:' 2 Z Signature (ApplicantorAgent):
Date: 2/22/2017
Application Number:
BELC2017-0016
Owner: -
Property Address:
17670 CALLE SINALOA
CRISTOBAL LOPEZ `
APN:
773133023
77670 CALLE SINALOA
Application Description:
LOPEZ RESIDENCE / ELECTRICAL
LA QUINTA, CA 92253.
Property Zoning:
Application Valuation:.
$1,790.00
Applicant:
Contractor:
WEST BOUND ELECTRICAL CONTRACTING. AND SE
WEST BOUND ELECTRICAL'CONTRACTING AND SE
74170 HWY 111 STE 3
74170 HWY 111 STE 3
PALM DESERT, CA 92260,
PALM DESERT, CA 92260 .
(760)776-8314
LIC. No.: 786678
Detail: REPLACE MAIN PANEL 125 AMP. PER 2016 CALIFORNIA BUILDING CODE
i
r
FIF%Ar1CIAL%%F0Wrrrr.
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
_ ACCOUNT
QTY
AMOUNT
SERVICES
101-0000-42403
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SERVICES PC
101-0000-42600
0
$12.67
Total Paid for ELECTRICAL: $38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $S.00
1
Bin /i
Permit
CPro'ect-Address: •-� D
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City of La Quinta
Buifdina tat Safety Division
78-495 Calle.Tanipico
U Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking Sheet
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Address:
Legal Description:
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State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone.
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Occupancy:
Co tructi n Type: cY=
StateLic- 9:
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Project nP �circle one): New Add'n Alter Repair-ai o
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Sq. Ft.:
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#Units:
(Tele`pho`ne #'of Contact Person:
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Estimated Value of -Project:
APPLICANT: DO. NOT WRITE BELOW THIS LINE.
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Submittal
Req'd
Rcc'd
T'RACKrNG
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
2°" Review, ready for corrections/issue
Electrical
Subeontact'or 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 Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees.
Total Permit Fees