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BELC2015-003678-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 ' T-i&t 4 4 Quiltro COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BELC2015-0036 Property Address: 56104 PLATINUM WY APN: 775220021 Application Description: SIGNATURE / TIME WATNER CABLE / (1) 100 AMP METER PEDESTAL Property Zoning: Application Valuation: $1,200.00 Applicant: COCHRAN COMMUNICATION CONSTRUC 36630 CATHEDRAL CANYON DRIVE CATHEDRAL CITY, CA 92234 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: C-7 License No.: 478543 I r Date S Contractor: 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).: ( 11, 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 Ccde: 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.). (1 I, as ownerbf 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 protects with a contractor(s) licensed pursuant to the Contractors' State License Law.). I I 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 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 n -fi Owner: RREF II CWC LAQ LLC z _, 5927 PRIESTLY DR STE 110 CARLSBAD, CA 92008 M O m� Contractor: y D (.T1 COCHRAN COMMUNICATION CONSTRUCT 36630 CATHEDRAL CANYON DRIVE CATHEDRAL CITY, CA 92234 (760)328-6778 Llc. No.: 478543 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. r At Shave 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: ?/� Applicant: Qr/� 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: S _ – Signature (Applicant or Agent): Z v FINANCIAL INFORMATION DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE POWER APPARATUS 101-0000-42403 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE POWER APPARATUS PC 101-0000-42600 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL: $48.34 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PERMIT ISSUANCE „ 101-0000-42404 0 $91.85 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:i0 Permit Details PERMIT NUMBER � BELC2015-0036 City of La Quinta�Jr-�j Description: SIGNATURE / TIME WATNER CABLE / (1) 100 AMP METER PEDESTAL Type: ELECTRICAL Subtype: Status: UNDER REVIEW Applied: 5/6/2015 SKH Approved: Parcel No: 775220021 Site Address: 56104 PLATINUM WY LA QUINTA,CA 92253 Subdivision: PM 20426 Block: Lot: 7 Issued: Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $1,200.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: ELECTRICAL - (1) 100 AMP METER PEDESTAL FOR TIME WARNER. 2013 CALIFORNIA BUILDING CODES. ADDITIONAL CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT COCHRAN COMMUNICATION 36630 CATHEDRAL CATHEDRAL CA 92234 CONSTRUC CANYON DRIVE CITY CONTRACTOR COCHRAN COMMUNICATION 36630 CATHEDRAL CATHEDRAL CA 92234 CONSTRUC CANYON DRIVE CITY OWNER RREF 11 CWC LAQ LLC 5927 PRIESTLY DR STE CARLSBAD CA 92008 110 FINANCIAL INFORMATION Printed: Wednesday, May 06, 2015 9:23:35 AM 1 of 2 CRW.IYSTEMS DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: POWER APPARATUS 101-0000-42403 0 $24.17 $0.00 POWER APPARATUS PC 101-0000-42600 0 $24.17 $0.00 Total Paid for ELECTRICAL: $48.34 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:• 00 INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES DATE DATE ELECTRICAL FINAL" BLD PARENT PROJECTS REVIEWS REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUSmm7 REMARKS NOTES DATE BOND INFORMATION ME ATTACHMENTS Printed: Wednesday, May 06, 2015 9:23:35 AM 2 of 2 CRUW SYSTEMS r •� 4r a. a�It s w . 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