BELC2017-006778-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4'yl 4 -4 QabA-'
DESIGN & DEVELOPMENT DEPARTMENT
Application Number: BELC2017-0067
Property Address: 52660 AVENIDA VILLA
APN: 773304007
Application Description: ELECTRICAL PANEL CHANGE OUT
Property Zoning:
Application Valuation: $1,800.00
Applicant:
POSITIVE CONNECTION
52-155 AVENIDA.OBREGON
LA QUINTA, CA 92253
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/24/2017
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NHEIM
VENIDAVILLA
TA, CA 92253
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CITY OF
OW
ND DFV � OP�IE�1S DEP Contractor:
DESIGN A POSITIVE CONNECTION
52-155 AVENIDA OBREGON
LA QUINTA, CA.32253
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000} of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Clas: C10 License No.: 900283`•
Date: . JAL Cont:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that.I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair
any structure, prior to its issuance, also requires the applicant for the permit to file a
signed statement that he or she is licensed pursuant to the provisions of the
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
3 of the Business and Professions Code) or that he or she is exempt therefrom and thea
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($Sb0).: '
(_) 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 intendedor 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
(760)771-9566
Llc. No.: 90028=
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one :)f the following declarations:
_ I have and will maintain a certificrte of consent to self -insure for workers'
compensation, as provided for by Section 37]0 of the Labor Code, for the performance
of the work for which this permit is issued.
I have and will maintain workers' =ompensation insurance, as required by
bion 3700 of the Labor Code, for the per(c rmance of the work for which this permit
is issued. My workers' compensation insurar ce carrier and policy number are:
Carrier: STATE COMPENSATION INSURANCE GUND Policy Number: 9076036
I certify that in the performance cif 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 tiat, if I should become subject to the
workers' compensation provisions of Section3700 of the Labor Code, I shall forthwith
comply with those rovisions.
00,001Date: 1 �.rApplicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMI NAL 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 -:he Building Official for a permit subject to
the conditions and restrictions set forth on tF is application.
1. Each person upon whose behalf this apdication 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 tothe work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this app'.ication becomes null and void if work is
not commenced within 180 days from date d issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation..
1
I certify that I have read this application and .:tate that the above information is correct.
I agree to comply with all city and county ordinances and state la ting to building
construction, and hereby authorize represen-:atives of this ci enter up he
above-men�nedroperty for inspection pu-poses.
i
pate: Slg^ure ('Appy 'Heart o Agent):
Date: ' .7/24/2017
Application Number:
BELC2017-0067.
Owner:
Property Address:
52660 AVENIDA VILLA'
ZVI GREENHEIV
APN:
773304007
52660 AVENIDA VILLA
Application Description:
ELECTRICAL PANEL CHANGE OUT
LA QUINTA, CA 32253
Property Zoning:
Application Valuation:
$1,800.00
. Applicant:
Contractor:
POSITIVE CONNECTION
POSITIVE CONNECTION
52-155 AVENIDA OBREGON
52-155 AVENIDA OBREGON
LA QUINTA; CA 92253
LA,QUINTA, CA 32253
(760)771-9566
LIc. No.: 900283.
Detail: ELECTRICAL PANEL CHANGE OUT. 125 AMP. PER 2016 CALIFORNIA BUILDING CODE
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FINANCIAL
DESCRIPTION ACCOUNT CITY AMOUNT
BSAS.SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for.BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
POWER APPARATUS
.101-0000-42403
0
$25.33
DESCRIPTION I
ACCOUNT
CITY
AMOUNT
POWER APPARATUS PC
101-0000-42600
0
$25.33
Total Paid for ELECTRICAL: $50.66
DESCRIPTION
ACCOUNT,
I CITY
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
$S.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
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Bin #
City. of La Quinta
Building & Safety Division
78-495 Calle Tampico.
La .Quinta, CA 92253.- (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:SCI -. 6� o `
Owner's Name: v ^ Q
A. P. Number:
Address: J
Legal Description:
City, ST, Zip: ,� v
Contractor:
Tele h n -
P 0
Address:
Project Description: r a
ti
-t....!
City, ST, Zip:_,
TeleP h one:
o .
State Lic. # City Lic- #;
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
:::::::.;:.:•.:..::.;:-;.;r:> ::......::......
Construction Type: Occupancy:
State Lic_ #:
Project P a circle one): New Add'n Alter Repair Demo
type �)
Name of Contact Person:b®
_�
Sq. Ft:
#Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO- NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Chcck Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"" Review, ready for correctionslssue
Electric:.)
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A: Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' 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