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BELC2015-003478-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BELC2015-0034 Property Address:- _--__ _._..__.. -._8t-•)S5 C�IR_OtAo Wy• APN: 767780005 Application Description: LENNAR/TEMPORARY POLE Property Zoning: Application Valuation: $2,000.00 a p Q Applicant: S R BRAY LLC DBA POWER PLUS 1 1210 N RED GUM STREET MAY ®12015 ANAHEIM, CA 92806 clrr u� LA 014TR COMMUNITY ? ELOPMtNTDEPARTMENT 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. CSO. D31 / License No.: 980589 ,,o Date? �fContractor: 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 theme 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.). ( 11, 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 Address: rl VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/1/2015 Owner: IOTA GRIFFIN 4675 MACARTHUR.CT NO 1550 NEWPORT BEACH, CA 0 Contractor: S R BRAY LLC DBA POWER PLUS 1210 N RED GUM STREET ANAHEIM, CA 92806 (714)507-1881 LIc. No.: 980589 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. Dat�Cr 15- Applicant: 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 1 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 to enter upon the above- mentioned property for inspection purposes. r Date :+'S' igeture (Applicant or Agent): v NAN ci CINFORMATION AR ESCRIPTIONi.-�-,��l:,..,-",�,�:.I!iS'', ACCOUNT, ID PAID DATE 'A , y BSAS SB1473 FEE101-0000-20306 $1.00 $0.00 R 'M1O,t R EIP.7ME� " ' 41 k':-. "'Q , 'gU�NPAIMBY ECKWjq,:g- CLTDBY '.: 1 Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 W01,14 MESCRIOION;'i' IN Kul) ACCOUNT fip�j - ",'RAID:DAT& FN� RM PAID"kN'4,��,Tj TEMP POWER SERVICE 101-0000-42403 0 '$24A7 $0.00 40 KR' i 2. a'x.CHEC V�j�'-� XLTD,BY! Q, R.RECEIP-T& f',� Kx ff4 , _x "0 RI !".m' ESC PTII� W 4 R W."p, U NT�w PAID RV QTYAM�OUNT� z DATEt TEMP POWER SERVICE PC 101-0000-42403 0 $16.92 $0.00 a ,BY METHOD ,7. R" M41 O RRECEIAf� "P:ID sRAO't kCK`#i Ol 1% ,PWN!iW7�l 6' =1 . tw Total Paid for ELECTRICAL:. $41'.00' $0.00 ISBN .3 %4OUNT_ -PAIDMATE, PERMIT ISSUANCEiOl -0000-42404 0. -$91.85 -$0.00 ffi UAW - AW, gg iR"l gm� qi F'MET -ARECEIPT, DU CHECK 4 "Tia OA - MY, Total Paid,forPERMIT ISSUANCE: $91.85 $0.00 •$133 .94 $0.00 Description: LENNAR / TEMPORARY POLE CONDITIONS Type: ELECTRICAL Subtype: Status: APPROVED Applied: 5/1/2015 SKH Approved: 5/1/2015 KHE Parcel No: 767780005 Site Address: 54395 ALYSHEBA DR LA QUINTA,CA 92253 Subdivision: TR 32879 Block: Lot: 53 Issued: Lot Scl Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $2,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 ANAHEIM Details: ELECTRICAL - TEMPORARY POWER POLE. 2013 CALIFORNIA BUILDING CODES. 92806 __t Applied to Approved CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT S R BRAY LLC DBA POWER PLUS 1210 N RED GUM STREET ANAHEIM CA 92806 CONTRACTOR S R BRAY LLC DBA POWER PLUS 1210 N RED GUM STREET ANAHEIM CA 92806 OWNER IOTA GRIFFIN 4675 MACARTHUR CT NO 1550 I NEWPORT BEACH CA 0 Printed: Friday, May 01, 2015 10:13:08 AM 1 of 2 0rP SYS7C'ti1S T' PERMIT NUMBER Permit Details City of La Quinta BELC"20150034 BOND' INFORMATION Printed: Friday, May 01, 2015 10:13:08 AM 2 of 2 UATIffsysrEMs CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS S81473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: TEMP POWER SERVICE 101-0000-42403 0 $24.17 $0.00 TEMP POWER SERVICE 101-0000-42403 0 $16.92 $0.00 PC Total Paid for ELECTRICAL: $41.09 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:•4 $0.00 BOND' INFORMATION Printed: Friday, May 01, 2015 10:13:08 AM 2 of 2 UATIffsysrEMs .w..:.r.rti.•.- ,Mw..e!• ....rw.....uGnr• ... w. .:: ,.....�..k-... ,..,-•:rte r J,r �:� ✓' .,,,.gra,. «w • ., .. «..�',................. ..., ......."" .<. "` 00 _. ,. . w...,.. �..s.. +� + , «.. .. ".yr�wr.;,,py.v... • .s...•.•vwu taw....•.. wa.. ro.r .aMVW'. ..n MW•um.•. lea. t..MN+r. 7 Y Y 1 r .,k.ww....•. ..µ,v . r % r ........T :.:...:. Y,rb»✓•"Y.•�"� .41 Vii[". .� s r �,. 1zr. w..M.T'Is�I+•x••�r,.N1srW� •v....tnl�n+Rr•N ...+cw•i•'M .wtlr.:h-�Wf..w .�•wMs'4'�w ...N ell N..w+rW.q.•rM'.!•-•w.�ism•MV:4•r rW,•WM'p� N•W, l.eN.�aV#•P �...N}'«�� W.��,�� .(�/yygyJAy�yM.��y,i4MM1M.nMn�.I.f.1wNWM01ll+/•�M�.��'".��•� ,A,.,i•rv..+auvV•._�_ -"w�•� �Mr. w�- .M' Mfr. L Mg 14 v �WIN""ir I . 00 � .,k.ww....•. ..µ,v . r % r ........T :.:...:. Y,rb»✓•"Y.•�"� .41 Vii[". .� s Mg 14 v �WIN""ir 00 � 31tk: Bin # City of La Quinta Building 8T Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012. Building Permit Application and Tracking Sheet Permit # Project Address: ?j �� /q'I S Gl ��n Owner's Name: L 2n o CL r R O M e— A. P. Number: Address: Legal Description: pelkM.or-4- Pr V-1" 1 � �p City, ST, Zip: Dn q CO`t" Contractor: PO Pr Pk Telephone: hone: Address: -2--157D 0,� . P--�r;.S IrSL ow4 Prrooject Description: loo X " 1 �v 2,4D4 City, ST, Zip: '�?e r r i S C* ��.�, V r1.212 p— e -r b l hone: RJI- 37- q3I, "Lic. oTele p� w r Y U q� G State Lic. # City Arch., Engr., Designer: Address: City., ST, Zip: hone: .Tele COccupancy:u on uct on TYPe: cY State Lie. #:Alter'. Dem Demo (circle Add'n Name of Contact Person: =01f.1 Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: f,LC.iJa APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cates. 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:- '"' 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 . Ltal Permit Fees