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BELC2015-005078-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&tw 44Qumrw COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BELC2015-0050 Property Address: 53045 AVENIDA DIAZ APN: 774041015 Application Description: CHILDRES RESIDENCE PANEL UPGRADE Property Zoning: Application Valuation: $1,500.00 Applicant: d COULTER ELECTRIC INC 78078 COUNTRY CLUB #202 � L / BERMUDA DUNES, CA 92203 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.: 957021 Date: %—Z — S Contracto . 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 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.). ( ) 1, 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 Name: Lender's VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 7/2/2015 Owner: �\ CHERYL CHILDERS 53045 AVENIDA DIAZ 4� LA QUINTA, CA 92253 O tO N �t a Q Ci W v Contractor: V o COULTER ELECTRI.Q LVJ z 78078 COUNTRY CLU fl3� BERMUDA DUNES, CA 92203 c� (760)660-2838 Llc. No.: 957021 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:_ 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 oft Labor Code, I shall forthwith comply with those provisions. Date: S Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSA ION 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 toeryer upon flys rmentioned• property for inspection purposes. I �) Dater /--.4 I L/ — I LI/ — I L Signature (Applicant or Agent) No °'n # City: of La Quinta Building 8i Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012. Building Permit Application and Tracking Sheet Permit # gCLC, 20 1150o50 Project Address: -5 De �t olZ Owner's Name: G' ►t er l �' vi j 1 u t e 5 S A. P. Number: Address: Legal Description: City, ST, Zip: CA7 A Xf;,�> n t Co frac or . �Telephone:-1 � Address: /� (�'% r VO Project Description: City, ST, Zip: f i vt Z ( C, 0L A ne• Telephone: 6U3,0 � as �� a c State Lic. # :11114 76 ll City Lic. #. Arch., Engr., Designer: Address: City,, ST, Zip: Telephone: hone: ancY• n Type: Occupancy: Constructi P Lie. # DemoState New Add'n Aletr Repairait Project tYPe�c (circle one)•Ne Name of Contact Person: }� vJf Q S#Stories: # Units: Telephone # of Contact Person: % Estimated Value of Project;: SO'D APPLICANT: DOOW 'THIS # Submittal Req'd Recd 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 Cales. 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 HOUSE:- 3' 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 Description: CHILDRES RESIDENCE PANEL UPGRADE Type: ELECTRICAL Subtype: Status: APPROVED Applied: 7/2/2015 EVA Approved: 7/2/2015 EVA Parcel No: 774041015 Site Address: 53045 AVENIDA DIAZ LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 178 Lot: 3 Issued: UNIT 18 Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $1,500.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 NAME TYPE Details: CHANGE MAIN ELECTRICAL PANEL FROM 14AMP TO 200 AMP, LOACTED TOWARDS THE REAR OF THE HOME _j Applied to Approved Printed: Thursday, July 02, 2015 1:07:42 PM 1 of 2 CPW sysreMs CHkONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP ......____. PHONE FAX EMAIL APPLICANT COULTER ELECTRIC INC 78078 COUNTRY CLUB BERMUDA CA 92203 ( Printed: Thursday, July 02, 2015 1:07:42 PM 1 of 2 CPW sysreMs 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 BSA: $1.00 $0.00 SERVICES 101-0000-42403 0 $24.17 $0.00 SERVICES PC 101-0000-42403 0 $12.09 $0.00 Total Paid forELECTRICAL: $36.26 $0.00 PERMIT ISSUANCE 101-0000-42404 1 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:• 0• INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES ELECTRICAL FINAL" BLD PARENT PROJECTS Printed: Thursday, July 02, 2015 1:07:42 PM 2 of 2 orpw. SYSTEMS DESCRIPTION: ACCOUNT QTY ` AMOUNT . PAID : PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 w PAID BY .: METHOD .: _......: RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 DESCRIPTION ACCOUNT QTY "AMOUNT.: PAID PAID DATE SERVICES 101-0000-42403 0 $24.17 $0.00 PAID BY "METHOD:,RECEIPT.# ' CHECK # CLTD BY DESCRIPTION ACCOUNT::.„; . QTY; . AMOUNT PAID PAID DATE SERVICES PC 101-0000-42403 0 $12.09 $0.00 PAID BY. METHOD RECEIPT #• CHECK # CLTD BY Total Paid for ELECTRICAL: $36.26 $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 r