BELC2014-103778-495 CALLE TAMPICO T 0 U
LA QUINTA, CALIFORNIA 92253' COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BELC2014-1037
Property Address:
78300 TALKING ROCK TURN
APN:
770260026
Application Description:
REPLACE 200 AMP PEDESTAL
Property Zoning:
Application Valuation:.
$1,700.00
Applicant:
LONG ELECTRIC, INC.
0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
OCT 14 2014
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
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: _ License No.: :LIC -0000559
'Date: tic k Contractor: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 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:
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
Lender's Add
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/14/2014
Owner:
TRADITION GOLF CLUB
78505 OLD'AVENUE 52
LA QUINTA, CA 0
Contractor:
LONG ELECTRIC, INC.
0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
(760)568-4750
Llc. No.: :LIC -0000559
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 performanee
of the wgr or,which this permit is issued.
t/ 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: _ Policy Number:
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.
Date: l/ —�� —�/ Applicant:
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 ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above•
mentioned property for inspection purposes.
Date: AGI l Signature (Applicant or Agent):
FINANCIAL INFORMATIM
`.DESCRIPTION' `Y ° ; ,� �'3r'"ACCOUNT' QTY" '"AMOUNT,; PAID nx$ PAID DATE
j
BSAS SB1473 FEE
101-0000-20306 0 $1.00 ,$1.00 10/14/14
;PAID BYz {`
°4' ;"'`t' METHOD ', -ij - ?RECEIPT# CHECK # " " CLTD}BY;a:'
,
= :.
LONG ELECTRIC, INC.
CHECK -112037 5222 MFA
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00
`6 DESCRIPTION"i'
{
QTY
*AMOUNT '
'}'f as PAID f r
PAID DATE".
,;,ACCOUNT E
, s
;w�`
SERVICES
101-0000-42403
0
$24.17
$24.17
10/14/14
PAID BY c
w ' METHOD * V, �,.
_ ;,RECEIPT # � K
�e. ;CHECK # s
`;CLTD BY
;
Y <,'
LONG ELECTRIC, INC.
CHECK
R2037
5222
MFA
DESCRIPTIONS, `r;,
•A00OUNT� x
xQTY
AMOUNT`
PAID DATE
�4�'PAIDx
SERVICES PC
101-0000-42403
0
$12.09
$12.09
,10/14/14
a PAID BY � �., a, # .
`
METHOD , ,_ , �r
RECEIPT #
�
�'' hCNECK #iGLTD
BY k
+
E�
LONG ELECTRIC, INC.
CHECK
112037
5222
MFA
Total Paid for ELECTRICAL: $36.26 $36:26
Y.. .. ... .<- '.
"i3 -41', '"e DSC
ERIPTION ` �j, i
,o ACCOUNT
QTY
AMOUNT.:
PAID a 'k
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
10/14/14
' PAID 6Y
�t METHOD
;"
CHECK #r,
.'RECEIPT#:f'-;�
,gypI;CLTD'BY'.
LONG ELECTRIC, INC. r
CHECK
R2037
5222
MFA
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
TOTALS: $129.11
s
rCITY OF LA QUINTA r
COMMUNITY DEVELOPMENT DEPARTMENT
PROJECT FORM
CASE NUMBER FEE I DATE RECEIVED IRELATED APPS SA ❑�
t $00.00, 10/13/20141 SDP ❑
SA 2014-1050 ` 2
LOGGED IN BY , PROJECT PLANNER DATE ASSIGNED (EA ❑
MARY FASANO ; { 1 TPM ❑
APPLICANT SIGN-A-RAM. - BILL SIGURDSEN IPM ❑
MAILING ADDRESS 41945 BOARDWALK, SUITE L
LLP` ❑
CITY PALM DESERT I STATE CA ZIP 92211MM�� W SP
PHONE -770PDSIAAMAO
+7606-997 FAX BILL@GNR.CMi
_...._..._ ...w_ .__ _ .. _ __.._ _ .__. _. Q El
• PROPERTY OWNER JIMARK A. HAYDEN
TUP ❑
❑
PO MAILING ADDRESS 1545 FARADRY
PO CITY CARL�SBAD, CA PO STATE 97008 , VUP ❑
I.._._.._.._.............,. _..._�.� CUP _ ❑ � '
PO PHONE 760-827-6025 4 IPO FAX HAYDEN@CAPSTONEADVISORS.COM (
❑
PROJECT LOCATION THE CENTRE AT LA QUINTA. SOUTH OF HIGHWAY.111 BETWEEN ADAMS STREET i
AND DUNE PALMS ROAD. 79255 HIGHWAY 111 4 AMD ❑
' � I EXT ❑
- - � GPA - ❑ 1 •
PROPOSED USE ROOSTERS FRIED CHICKEN & SPIRITS. PERMANENT WALL SIGN __ MUP ❑ .
{ ZCA ❑
PR ❑
GPC ❑
LEGAL ! ,
DESCRIPTION I SEARCH FORS.,
_ _
DEVELOPMENT ❑ENVIRONMENTAL~ ❑ ENVIRONMENTAL'
PLANS y INFORMATION FORM ^�W INFORMATION FEE $0.00
PUBLIC HEARING t 1:1 SITE DEVELOPMENT ❑SIGNATURE OF SIGNATURE OF ,:PRINT THIS:,`
NOTIFICATION PERMIT FILING FEE . ' APPLICANT PROPERTY RECORD ONLY
PACKAGE OWNERS,
REQUEST ROOSTERS FRIED CHICKEN & SPIRITS. PERMANENT WALL SIGN AT-79255 HIGHWAY
111 LOCATED AT THE CENTRE AT LA QUINTA. SOUTH OF HIGHWAY_ 111 BETWEEN
ADAMS STREET AND DUNE PALMS ROAD. I
ARCH LAND HIST PRES PLANN��
REV COMM - _ w ; COMM n _ _� COMM' COUNCIL.
r ,
• CITY OF LA QUINTA ' ,
COMMUNITY DEVELOPMENT DEPARTMENT
.PROJECT FORM. t
CASE NUMBER ' FEE DATE RECEIVED RELATED APSA '; ❑�
LOGGEDSA IN 0 $200.00 10/13/20141 - � }SDP E]" PROJECT PLANNER DATE ASSIGNED r } EA ❑' "
MARY FASANO I #TPM ❑
.a......
APPLICANT'S SIGN-A-RAMA - BILL SIGURDSEN ❑
MAILING ADDRESS 41945 BOARDWALK, SUITE L _ i Lam` ' ❑
" � COAPP ❑
CITY PALM DESERT �M STATE CA � � M192 • }
PHONE 760-776-9907 FAX + BILL@PDSIGNARAMA.COM'
El
PROPERTY OWNER MARK A. HAYDEN .'r
TUP El
PO MAILING ADDRESS F54,1 FARADRY ,
ZC ❑
PO CITY CARLSBAD, CA ^� PO STATE ^97008 µf }
PO PHONE 760-827-6025_ �ij PO FAX HAYDEN@CAPSTONEADVISORS.COM CUP ❑
k:,._ ,.L....,..,.�....J �..-..._._...,..:-._._.,�-...,_.::_.,._....:_..-c,_,.-;_.__M....._.,� SNC • ❑ .
u
PROJECT LOCATION THE CENTRE AT LA QUINTA. SOUTH OF HIGHWAY 111 BETWEEN ADAMS STREET '
' AND DUNE PALMS ROAD. 79255 HIGHWAY,111 AMD ❑ 1
❑ .
' � ,E GPA ❑ � '
PROPOSED USE ROOSTERS FRIED CHICKEN & SPIRITS. PERMANENT WALL SIGN MUP ❑
- K E ZCA r ❑
i PR
GPC ❑
LEGAL
DESCRIPTION r FSEARCHFoW
RECORD
DEVELOPMENT ❑ ENVIRONMENTAL ❑ ENVIRONMENTAL $0.00 i..
PLANS INFORMATION FORM JINFORMATION FEE
PUBLIC HEARING ❑ SITE DEVELOPMENT ❑SIGNATURE OF SIGNATURE OF INT THIS` Y'
NOTIFICATION PERMIT FILING FEE APPLICANT PROPERTY' RECORD ONLY'
PACKAGE " OWNERS ,
REQUEST ROOSTERS FRIED CHICKEN & SPIRITS. PERMANENT WALL SIGN AT 79255 HIGHWAY.
111 LOCATED AT THE CENTRE'AT LA QUINTA. SOUTH OF HIGHWAY 111 BETWEEN
ADAMS STREET AND DUNE PALMS ROAD. `
ARCH LAND_ `> HIST PRES �� PLANN CITY•
REV COMM _ i, COMM Y i COMM COUNCIL
Description: REPLACE 200 AMP PEDESTAL'
°,"ACCOUNT:
CH,RONOLOGY.,
Type: ELECTRICAL
Subtype:
Status: SUBMITTED
Applied: 10/14/2014 MFA
Approved:
Parcel No: 770260026 Site Address: 78300 TALKING ROCK TURN LA QUINTA,CA 92253
Subdivision: TR 28611
Block:
Lot: 35
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0'
Zoning:
Finaled:
Valuation: $1,700.00
-Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0
No. Unites: 0
92253
Details:
TRADITION GOLF CLUB
78505 OLD AVENUE 52
LA QUINTA
ADDITIONAL !I I LS
DESCRIPTION.
°,"ACCOUNT:
CH,RONOLOGY.,
CONDITIONS
PA�IDBa ;CLTD
RECEPT#4CHE(METHOD
PAID:DATE #„
..NAMEiTYPE
NAME' -
;. ADDRESSI: •
CONTACTS
* ' CITY °'`'
.STATE
ZIP PHONE , .FAX EMAIL
e ..
APPLICANT
LONG ELECTRIC, INC.
0 OUTSIDE CITY LIMITS
LA QUINTA
CA
92253
CONTRACTOR
LONG ELECTRIC, INC.
0 OUTSIDE CITY LIMITS
LA QUINTA
CA
92253
OWNER
TRADITION GOLF CLUB
78505 OLD AVENUE 52
LA QUINTA
CA
0
DESCRIPTION.
°,"ACCOUNT:
AMOUNT4
PAID
PA�IDBa ;CLTD
RECEPT#4CHE(METHOD
PAID:DATE #„
BSAS SB1473 FEE
101-0000-20306 0
$1.00
$1.00
10/14/14 R2037 5222 CHECK
-LONG ELECTRIC, INC.
MFA
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00
$1.00
BSA:
_
Printed: Tuesday, October 14, 2014 1:35:58 PM 1 of 2 ........
DESCRIPTION!
D
ACCOUNT. _,
CIfY
AMOUNT
y
PAID
PAID DATE-
;RECEIPT #
CHECK #
METHOD ;
PAID BY
L-TD
-
• ,:,
a
rBY
SERVICES
101-0000-42403
0
$24.17
$24.17
10/14/14
R2037
5222
CHECK
LONG ELECTRIC, INC.
MFA
SERVICES PC
101-0000-42403
0
$12.09
$12.09
10/14/14
R2037
5222
CHECK
LONG ELECTRIC, INC.
MFA
Total Paid for ELECTRICAL: $36.26 $36.26
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
10/14/14
R2037
5222
CHECK
LONG ELECTRIC, INC.
FMFA
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
:W 'TI['.
SEQID INSPECTION TYPE —INSPECTOR SCHEDULED I COMPLETED RESULT REMARKS NOTES `
,DATE - DATE _
ELECTRICAL FINAL**
- PARENT PROJECTS
f i
Printed: Tuesday, October 14,2014 1:35:58 PM 2 of 2
Bin # City of La Quinta
?� Building 81: Safety Division
Permit # 1 P.O. Box 1504, 78-495 Calle Tampico.
La Quln6, CA 92253 - (760) 777 -7012 -
Building Permit Application and Tracking Sheet
Project Address: '79— Owner's Namege C
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: S t—
(moi Cjr- �� C', C, �-J�
Telephone:
!'s><`<'s`: =s:
:. ;:•::::•;:z:v::;:.:
Address: " Ro ctQ L% �i P
Project.Description:
City, ST, Zip: L u 1 N-7-0 Q (i�
L �� -► i � i v"U
nn
State Lie. # :t�C
City Lie.
Arch., Engr., Designer:
Address:
City, ST, Zip.
Telephone:
P
>>
'
`'?<:'•!> ??
Construction Type: Occupancy:
Ste e Lic" #:
oject type (circle one): New Add n
Alter Repair Demo
Name of Contact Person:
Sq. Ft :.
# Stories:
#Units:
Telephone # of Contact Person:Estimated
Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Rcq'd Recd TRACKING PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
7 I
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance.
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical.
Grading plan
2" 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 IiOUSE:-
'"' Review, ready for corrcctionslissue
Developer Impact Fee '
Planning Approval
Called Contact Person
A.I.r.P.
Pub. Wks. Appr
Date of permit issue
Sclwol Fees
Total Permit Fees