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BELC2014-1029apply 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.). (__).l 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: 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 apcilicationis made, each person at whose request and for whose benefit work is perfumed 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 tie City of La Quinta; its officers, agents, and employees for any act or omissiori'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 Df issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application anc state that the above information is correct. I agree to comply with all city and county o dinances and state laws relating to building construction, and hereby authorize representative f this city to enter upon the abo e. mentioned property for ins ction purpose Date: �47--"/'/ Signature(Applicant Ag Llc. No.: 34769. ----------------------------------------------------------------------------------------------- > LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I hereby affirm under penalty of perjury one of the following declarations: 9 (commencing with Section 7000) of Division 3 of the Business and.Professions Code, _ I have and will maintain a certifiote of consent to self -insure for workers' and my License is in full force and effect. compensation, as provided for by Section 3:00 of the Labor Code, for the performance 4 � a -- - VOICE (760) 777-7125 8-4 I 78-495 CALLE TAM 9 PCO 1%Iave and will maintain workers'compensation insurance, as required by Date: _Contractor: - (�� Ci - , FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 - COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 I hereby affirm under penalty of perjury that I am exempt from the Contractor's State BUILDING PERMIT License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any �BELC2014-1029 - city or county that requires a permit to construct, alter, improve, demolish, or repair Date:9/29/2014 Application Number: Owner: 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 Property Address: 53305 AVE NIDA VILLA MARLENE BRIBYEES �J APN: 774093015. 24365 EL TOR FD B permit subjects the applicant to a civil penalty of not more than five hundred dollars Application Description: REPLACE 2001AMP PANEL LAGUNA, CA 92637 �- Property Zoning: ONE HUNDRED THOUSAND DOLLARS ($100,700). IN ADDITION TO THE COST OF o N Application Valuation: $2,200.00 f LU Sa LL OO Applicant: - Contractor: ca( a- W EAGLE CONSTRUCTION EAGLE CONSTRJCTION v cWi� 31855 DATE PALM DRIVE 31855 DATE PALM DRIVE SUITE 3-500 (SUITE 3-500 CATHEDRAL CITY, CA 92234 CATHEDRAL CITY, CA 92234 (760)285-4959 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.). (__).l 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: 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 apcilicationis made, each person at whose request and for whose benefit work is perfumed 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 tie City of La Quinta; its officers, agents, and employees for any act or omissiori'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 Df issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application anc state that the above information is correct. I agree to comply with all city and county o dinances and state laws relating to building construction, and hereby authorize representative f this city to enter upon the abo e. mentioned property for ins ction purpose Date: �47--"/'/ Signature(Applicant Ag Llc. No.: 34769. ----------------------------------------------------------------------------------------------- > LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I hereby affirm under penalty of perjury one of the following declarations: 9 (commencing with Section 7000) of Division 3 of the Business and.Professions Code, _ I have and will maintain a certifiote of consent to self -insure for workers' and my License is in full force and effect. compensation, as provided for by Section 3:00 of the Labor Code, for the performance License Classi B License No.: 347697A f thew rkfor which this permit is issued. (—� �/ection 1%Iave and will maintain workers'compensation insurance, as required by Date: _Contractor: - (�� Ci 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: OWNER -BUILDER DECLARATION Carrier: _ Policy Number: _ I hereby affirm under penalty of perjury that I am exempt from the Contractor's State Icertify that in the performance :)f the work for which this permit is issued, I License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner :o as to become subject to the workers' - city or county that requires a permit to construct, alter, improve, demolish, or repair compensation laws of California, and agree .hat, if I should become subject to the any structure, prior to its issuance, also.requires the applicant for the permit to file a workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith 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 comply with those provisions. Ln of the Business and Professions Code) or that he or she is exempt therefrom and the Date:' C Applicant: 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ($500).: AND SHALL SUBJECT AN EMPLOYER TO.CRIMINAL PENALTIES AND CIVIL FINES UP TO (1 I, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS ($100,700). IN ADDITION TO THE COST OF compensation, will do the work, and the structure is not intended or offered for sale. COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not INTEREST, AND ATTORNEY'S FEES. 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.). (__).l 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: 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 apcilicationis made, each person at whose request and for whose benefit work is perfumed 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 tie City of La Quinta; its officers, agents, and employees for any act or omissiori'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 Df issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application anc state that the above information is correct. I agree to comply with all city and county o dinances and state laws relating to building construction, and hereby authorize representative f this city to enter upon the abo e. mentioned property for ins ction purpose Date: �47--"/'/ Signature(Applicant Ag FINANCIAL `"DESCRIP.TION . �+ "*� • rr=? A000UNT'PAID' c, 'PAID DATE. i , BSAS SB1473 FEE 101-0000-20306 0 1$1.00 $0.00 t ' s T PAID BY �r ,^Yr '; �� iMETHOD, a r, �zr Yar t • RECEIPT # r ** w CLTD BY. . ^ ,` d �, r , •CHECK# 'Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 e r�sf)ESCRIPTION r. :'.. -:"x .T`A000UNT ti }� QTY '''AMOUNT . r:'., PAID,PAID�DATE SERVICES 101-0000-42403 0$24.17 $0.00 �. �L PAID BY," :. mac.. METHOD r'. �. , �r RECEIPT# +'rte ..- CHECK#.+, "' ` .CLTD BY r `z aDESCRIP710N PAID, ;: PAID DATE axw ' SERVICES PC 101-0000-42403' 0 $12.09 $0.00 P PAID;BY " ' * ;' c -; ' METHOD 4i_ RECEIPT # CHECK # S``' CLTD BY .6'• .r[ _ :i r .a. Total Paid for ELECTRICAL: $36.26 $0.00 DESCRIPTION `'_ V.:'...T '� ;ACUNT CO 1QTY AMOUNT., j PAID ' F' PAID:DATE _fir; PERMIT ISSUANCE 101-0000-42404 , 0 '. $91.85 $0.00 i PAID, BY �� "f K r=METHOD ;. RECEIPT# vi r` CHECK#`r". 16TDBY • Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:00 Description: REPLACE 200 AMP PANEL Type: ELECTRICAL Subtype: 'Status: APPROVED Applied: 9/29/2014 SKH Approved: 9/29/2014 SKH Parcel No: 774093015 Site Address: 53305 AVENIDA VILLA LA QUINTA,CA 92253. Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 213 Lot: 3 - — Issued: - UNIT 20 r Lot Sq Ft: 0 •Building Sq Ft: 0 Zoning: Finaled: r - Valuation: $2,200.00 Occupancy Type: , Construction Type: Expired: No. Buildings: 0 — No. Stories: 0 z No. Unites: 0 , Details: ELECTRICAL -REPLACE (1) 200 AMP PANEL. 2013 CALIFORNIA BUILDING CODES. K ADDITIONAL CHRONOLOGY CONDITIONS ^0' ` CONTACTS t �.^s' -:.� "".._ `-,NAME-TYPE < . a . » :.NAME f)` a a •" ADDRESS1 ? Cl , - STATE "ZIPS PHONE'S r FAX } r;EMAIL - APPLICANT EAGLE CONSTRUCTION 31855 DATE PALM CATHEDRAL CA 92234 = DRIVE CITY • CONTRACTOR EAGLE rnNtTRi,irrinN 31855 DATF, PALM CATHEDRAL - CA,. 92234 ` r DRIVE CITY OWNER MARLENE BRIBYEES 24365 EL TOR RD B LAGUNA'- CA 92637 FINANCIAL INFORMATION rZT-' ++.ill «- y "- . r .. - • r (� - Printed': Monday, September 29, 2014 8:36:59 AM' 1 of 2 0TWYSTEMS OF DESCRIPTION: ACCOUNT'. -,QTY,� AMOUNT INFORMATION PAID DATE, RkEIP�f'#`, Ck -CHECK #,, METHOD, 17' PAID BY �CILTD rp 1,1&� BYBSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: SERVICES 101-0000-42403 0 $24.17 $0.00 SERVICES PC 101-0000-42403 0 $12.09 $0.00 Total Paid for ELECTRICAL: $36.26 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 T_ $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS: $129.11 $0.00 I iNqpFrTlf)Nc% :SEQID INSPECTION -TYPE -INSPECTOR -SCHEDULED COMPLETED I -,RESULT REMARKS,.-.,-. NOTES IF DATE .1 , I , -. I DATE ELECTRICAL FINAL" PARENT PROJECTS REVIEWS NOTES DATE' -,STATUS a. RETURNED,, - � ., r -, ,4 F�4 51e � - [i� ' REMARKS, REVIEW TYPEREVIEWEli. SENT -DATE DUE DATE ­ L , :: Printed: Monday, September 29, 2014 8:36:59 AM f 2 of 2 c ARWSYSTEMS BOND INFORMATION a "M ATTACHMENTS Printed: Monday, September 29, 2014 8:36:59 AM f 2 of 2 c ARWSYSTEMS APPLICANT: DO NOT WRITE BELOW THIS LINE if Submittal Bin # City of La Quinta Building 8r Safety Division 1a P.O. Box 1504,78-495 Calle Tampico . La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking -Sheet Permit # PERMIT FEES. Project Address: 3t%`J UC% ,l Owner's Namc: y� Y� w4a /� pf / Qp2� A. P. Number: Address: 17 Legal Description:City, ST, Zip: Contractor 7/1 !� Telephone: > ...........:. Address: V � - ,p n a., Project Description: City, ST, Zip: ✓ / l s�i G��N�Y ::::,1(0D TeleP hon Called Contact Person State Lic. # : -- 3.el76 City L,ie. M. /013 7b , Arch., Engr., Designer: Title 24 Gla. Address: Plans picked up City., ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: 0 PU ),e A Sq. Ft.: # Stories: - # Units: r . Telephone .# of Contact Person: 6 - % Estimated Value of Project: p� 00• Electrical APPLICANT: DO NOT WRITE BELOW THIS LINE if Submittal Rcq'd Rcc'd TRACKNG PERMIT FEES. Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Dcoosit Truss Cala. Called Contact Person Plan'Check MC.ance _ Title 24 Gla. 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 Decd 5. Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '`d Review, ready for eorrcctions(ssue Developer Imlact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees - Total Permit Res