Loading...
BELC2014-102778-495 CAL.LE TAMNICO� LA QUINTA, CALIFORNIA-yzz53 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: .• BELC2014-1027 Property Address: 50921 WASHINGTON ST ST APN: 770020019 Application Description: INSTALL (2) 30 AMP 240 V CIRCU Property Zoning: , Application Valuation: $500.00 - Applicant: DOUBLE J ELECTRIC OUT OF CITY LIMITS Q SEP 18 2014 CITY OF LA QUINTA COMMUNITY OEVELOWENT 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-762313 Date: f O +� y Contract � V ,. OWNER -BUILDER ARATION 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 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).: - s (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure isnot 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 Name Lender's VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/18/2014 Owner: LQ INV 17165 NEWHOPE ST FOUNTAIN VALLEY, CA 92253 Contractor: DOUBLE J ELECTRIC OUT OF CITY LIMITS Llc. No.: :LIC -762313 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 of the Labor Code, I shall forthwith comply with those provisions. &`1 v 1 Applican/t:/ �10 d/ 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 ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application , the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is . not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. - I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city enter upo the above. mentioned property for inspection purposes. Date:/ —' " Signature (Applicant orAgent ): L FINANCIAL INFORMATION, 7:7,UNT`&''�§� T1(x e z AMOUNT$ PAID j' 9 PAID DATE' x';{DESCRIPTION, 4A000 juaf a. .-4i.'.�.A .,': �:',T:.oX: x� �. .�L':,: .ii+ •?.3.4 £`59 F,T:.� 4 BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 9/18/14 PAID BY HECK �;C. r. LTD Bwa.Ya.. REC,r.E,µI>.-„--U T.,6,RP M« ET.r>H r ew' "'�sy.n is r.ei�e � i � o, 3 a. � e°�� a r ...:; Y.r• as ,. k A _.aO:r rD.F a��..sea _ .3wE .. a rH ` DOUBLE J ELECTRIC DEBIT R1317 MFA Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $1.00 ACCOUNT �` QTY AMOUNT `� PAID �;:0' PAID DATE` DEVICES, FIRST 20 - . 101-0000-42403 0, $24.17 $24.17 9/18/14 .Y METHOD�€�� 4;.PD :. ..Yy _ f ">.•,RECEIP.T # S CHECK #J�¢CLTD t BYE gEx DOUBLE J ELECTRIC DEBIT R1317 - MFA a * DESCRIPTION € '€ice, Y ACCOUNT`P�s� QTY4z : 'AINIOUNT` PAID` +�*a PAID DATE ..ua u... e_x+X.'..Z. 6.x.:S a.e:s .. & .. ..:P A. . �".nw:. M YM, :.., 3" [ .iAt x'.. t'- iee�nhP't.-. .'i.'zF'::Me_ -,S :u k_. a ..,i d.::?°L &&*A� .f. !^2 DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $24.17 9/18/14 PAID BY4 £METHOD RECEIPT # '' # BY „�, ';: €c r :Kk Uy #` .. ,, r�a4fCHECK E..,k� x pCLTD DOUBLE J ELECTRIC DEBIT R1317 MFA Total Paid for ELECTRICAL: $48.34 $48.34 DESCRIPTION =ACCOUNT'$$ "QTY �b� AMOUNT P� r:�4� PAID ' PAID DATE] �x _ +:..r•m ..... ..r. ca w.. ..$� • ,a, _? z.• a c� PERMIT ISSUANCE 101-0000-42404 0 $91:85 $91.85 9/18/14 i07V PAIDY ' �rs.r.e-, CLTDB Y,.'k :.,.' E`T`.xr �v y'+eSM c. ..�• nF..-. a-. »., Gw-e. s, e , r ",XC > .« .F DOUBLE ELECTRIC DEBIT t'R1317 MFA Total Paid for PERMIT ISSUANCE: $91.85 $91.85 TOTALS: Description: INSTALL (2) 30 AMP 240 V CIRCUIT Type: ELECTRICAL Subtype: Status: SUBMITTED Applied: 9/18/2014 MFA Approved: Parcel No: 770020019 Site Address: 50921 WASHINGTON ST ST LA QUINTA,CA 92253 Subdivision: PM 27984 Block: Lot: 5 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $500.00 Occupancy Type: Construction Type: Expired: No. Buildings: -O No. Stories: 0 No. Unites: 0 Details: INSTALL (2) 30 AMP 240 V CIRCUITS RECEPTACLES CONDITIONS Printed: Thursday, September 18, 2014 1:49:22 PM 1 of 2 7777-7��� A--' D ESCRIPTIOW U N P, COP 04 r "� I T; "Byl� DEVICES, FIRST 20 101-0000-42403 0 $24.17 $24.17 9/18/14 R1317 DEBIT DOUBLE J ELECTRIC MFA DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 9/18/14 R1317 DEBIT DOUBLE J.ELECTRIC MFA Total Paid forELECTRICAL: $48.34 $48.34 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 9/18/14 R1317. DEBIT DOUBLE J ELECTRIC MFA Total Paid fotPERMIT ISSUANCE: 1$91.95 $91.85 ... ....... . . . ..... TOTALS: $141.19 Bln.# City Of i s QU1ntd Building 8L Safety Division P.Q. Box 1504,78-495 Calle Tampico i a.Quinta, CA 92253 - (760) 777-7012 Building Pennit Application and Tracking Sheet Permit # ) �(, '" % a 5 Owner's Name:. ENumber Adder: n: Contractor. D0 4 61 e a,7, L City, ST, Zip. Telephone: Address: J-6 e ectDescription: City, ST, Zip: -0 h k Ol•4 I C. C Telephone:oU s1D3 9, ` State Lie. #: CLie #;ty Arch., Engr., Designer Address: City., ST, Zip: Telephone: State Lie. #: — Name of Contact Person: jrM aL. `J Q �/ Construction Type:. Occupancy: Project type (circle one): New Add'a Alter Repair Demo Sq. Ft : # Stories: # u tS: Telephone # of Contact Person: Z0 j 5-j( qq6t I Estimated value of Project: S d . c) APPLICANT: DO NOT WRITE BELOW THIS LIME # Submittal ReWd Recd TRACKIPIG PERbWFEES Plan Sets Plan Check submitted Ytem Amount Structural Calls. Reviewed, ready for corrections Plan Check Deposit. . Truss Calls. Called Contact Person Pian Check Balance Title 24 Calci. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2'a Review, ready for correctionsfimue Electrical Subcoatactor List Called Contact Person Plumbing Grant Deed Pians picked up SALL H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 'i° Review; ready for correstionsAssue Developer Impact Fee Planning Approval Called Contact Person A I.P.P. Pub. Wks. Appr " Date of permit Issue School Fees Total Permit Fees �a�