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BELC2017-002578-495 CALLE TAMPICO �r 4.a& Q9&& LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT. BUILDING PERMIT Application Number: BELC2017-0025 Property Address: 52253 AVENIDA VILLA APN: 773273011 Application Description: CHACON / UPGRADE PANEL 100 TO 125 Property Zoning: Application Valuation: $3,000.00 Applicant: ENERGY REMODELING INC 22120 CLARENDON STREET STE 200 WOODLAND HILLS, CA 91367 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: B. C10 License No.: 968844 Date ^a —) Contractors OW UILDER 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 Name: e _Lender's Address: k' VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: EDMUNDO CHACON 52253 AVENIDA VILLA LA QUINTA, CA 9=253 Contractor: ENERGY REMODE_ING INC 22120 CLARENDOIN STREET STE WOODLAND HILLS, CA 91367 (877.)245-4672 Llc. No.: 968844 Date: 3/22/2017 WORKER'S COMPENSAT©N 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' compensatio provided for by Section 3700 of the Labor Code, for the performance of the.yr ; 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: STATE COMPENSATION INSURANCE FUND Polity Number: 9057028 I certify that in the performance of tEne 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 3770 of the Labor Code, I shall forthwith comply with those provisions. Date: J APpli t WARNING: FAILURE TO SEC fIORKERV COIy-. NSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT APqrAPLOYER 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 applicaton 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 cancellw ion. I certify that I have read this application and stata 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 representative- s of this city to enter upon the above-mentioned property for inspection purposes. -22- 7 _ Date: Signature (Applicant or Agent• / Date: :3/22/2017 Application Number:..._ BELC2017-0025 Owner: Property Address: 52253 AVENIDA VILLA EDMUNDO CHAGON APN: 773273011 52253 AVENIDA VILLA Application Description: CHACON / UPGRADE PANEL 100 TO 125 LA QUINTA, CA 92253 Property Zoning: Application Valuation: $3,000.00 Applicant: Contractor: ENERGY REMODELING INC ENERGY REMODELING INC 22120 CLARENDON STREET STE 200 22120 CLARENDCN STREET STE 200 WOODLAND HILLS, CA 91367 WOODLAND HILLS, CA 91367 (877)245-4672 Llc. No.: 968844 Detail: ELECTRICAL - UPGRADE PANEL FROM 100 TO 125 PANEL. 2016 CALIFORNIA BUILDING CODES. 1 FINANCIAL •• • DESCRIPTION ACCOUNT', CO AMOUNT BSAS SB1473 FEE 101-0000-20306'-.0 $1.00 J Total Paid.for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT SERVICES 101-0000-42403 0 $25.33 DESCRIPTION ACCOUNT QTY AMOUNT •SERVICES PC 101-0000-42600 0 $12.67 Total Paid for ELECTRICAL: $38.00 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $96.27 ' Total Paid for PERMIT ISSUANCE: $96.27 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 lr Bin #i : .City of La Quin to Building &r Safety Division . Permit #; 78-495 Calle Tampico La Quinta; CA 92253.- (760) 777-701,2 - Building Permit Application and Tracking Sheet [ rPr'oje`cf Address: ` 2 .2 S fl `/ �;�� pot �/� 1 IOL pwner's Name: �'vj U✓7 O C . a. oe A. P. Number; 3Address: V/ 114 - 14Legal Legal Description- 4[ xCity QST, Zip: `1..A- .0"U"') r Contractor: o Y1 Q p_ / CiO�c 11�i J�l� �Tefephone: 7tj :,.. a?Address: O. c! �% U� , R �O r^/I e L Project Descripti on: V f AC rity_ ST, Zip: '�at7 D . d C-6 qq. a 3 loo . %:o ..1. S Tele ne . 5 �a P o h ' 1St1te Lic. # :f=iGity tic. #.: Arch.,`Engr., Designer: Address: City, ST, Zip: 3ncY Occupancy: :n ction Pe:TelePh0ne: Castu Ty P E fate ic. #- S L Pa cir 1e ne • New Add'n Alter Repair 0ProJect •ty Demo --N--a,-Me of Contact Person: ���5 �A 4Yl qqrede N n9 # Stories: # Units: :.�.Te1` ep e # of Contact Person: 6 - Je G l J� ` Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE tl Submittal Req'd Rcc'd 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 Balarce. Title 24 Calcs. Plans picked up Construction ' Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person i Plumbing Grant Deed Plans picked up S.M.I. II.O.A. Approval Plans resubmitted Grading IN If OUSE:- ''d Review, ready for corrections/issue Developer ImpactTee Planning Approval Called Contact Person 'A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees.. Total Permit Fees