BELC2015-003878-495 CALLE TAMPICO D 4v J VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT FAX
(760) 777-7153
BUILDING PERMIT
Date: 5/15/2015
Application Number: BELC2015-0038 Owner:
Property Address: 78023 CALLE ESTADO VILLAGE PUP
APN: 770152001 78023 CALLE ESTADO
Application Description: VILLAGE PUP INSTALL POWER FOR FOUNTAIN AND LED FIXTURES LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $1,500.00
Applicant: n L,E Contractor:
GRAYCO ELECTRIC GRAYCO ELECTRIC INC
P0BOX 13311 PO BOX 13311
PALM DESERT, CA 55 MAY 15 Z015 PALM DESERT, CA 92255
CITY OF LA QUINTA (760)250-0467
_. __... nniar►tr nPPARTMENT Llc. No.: 977951
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 Divisio23of e Businessand Professions Code,'
and my License is in full force and effect.
License Class: C10 License No.: 97795
Date? Contractor
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 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.).
(_) 1, 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
Lender's Address:
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 W01for 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. y workers' compens ion insurance carrier and policy number are:
Barri Policy Number:
I*
that in the pe rmance of the work for which this permit is issued, I
shall no employ any person in any manner so as to be me subject to the workers'
compensation laws of California, and agree that, if I Id become subject to the
workers' compensation provisions of Section 3700 f e Labor Code, I shall forthwith
comply with those provisions, i
Date:' > Applicant:
r ,4-
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 inf ation is correct.
I agree to comply with all city and county ordinances and state la r ating to building
construction, and hereby authorize representatives of this city en r upon the a ve-
mentioned property for ins ection purposes.
D�ate: Signature (Applicant or Agent):
1j
CIALINFQRM��T!!p
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DESCRIPTIL , CCO :.: .. Q _4 r T x fPAID� r F,.. RAIDyDATEr
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METHOD r RECEIPT#'�° CIiECK # - 4
CLTD BY
Total Paid for.BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
k D SCRIPTION
s ACCOU � :
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AMOUNT
RR -T D '
AI
PAID DATE`
DEVICES, FIRST 20
.101-0000-42403
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DEVICES, FIRST 20 PC
101-0000-42600
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CLTD BY.,-.
Total -Paid for ELECTRICAL: $48.34 $0.00
��sDESCRIPTi�N
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$ AMOUN�
PAID DATES
PERMIT ISSUANCE
101-0000-42404
0
$91.85
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RECEIPT # W—
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CLTD BYL
Total Paid -for PERMIT ISSUANCE:$91.85 $0.00
e ��
Permit Details PERMIT NUMBER
City of La Quinta BEL24�15003I'
Description: VILLAGE PUP INSTALL POWER FOR FOUNTAIN AND LED FIXTURES
Type: ELECTRICAL Subtype: Status: APPROVED
Applied: 5/15/2015 AZA
Approved: 5/15/2015 AZA
Parcel No: 770152001 Site Address: 78023 CALLE ESTADO LA QUINTA,CA 92253
Subdivision: DESERT CLUB TR UNIT 1 Block: 9 Lot: 1
Issued:
Lot Scl Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $1,500.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: INSTALL (3) THREE 18 WATT LED FLOOD FIXTURES ON TIMER, INSTALL POWER FOR FOUNTAIN & CONVENIENCE POWER (GFCI)
PROTECTED AT FENCE LED FIXTURES TO BE PLACED ON EAST WALL 15FT. OFF OF GROUND. 2013 CALIFORNIA BUILDING CODES.
Applied to Approved
Printed: Friday, May 15, 2015 4:44:18 PM 1 of 2
CHRONOLOGY
CONDITIONS
............. ............. .................. . ..,.
NAME TYPE
NAME
ADDRESSI
CONTACTS
CITY
STATE
ZIP PHONE FAX EMAIL
APPLICANT
GRAYCO ELECTRIC INC
P O BOX 13311
PALM DESERT
CA
92255
CONTRACTOR
GRAYCO ELECTRIC INC
P O BOX 13311
PALM DESERT
CA
92255
OWNER
VILLAGE PUP
78023 CALLE ESTADO
LA QUINTA
CA
92253
Printed: Friday, May 15, 2015 4:44:18 PM 1 of 2
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY
DEVICES, FIRST 20
101-0000-42403
0
$24.17
$0.00
DEVICES, FIRST 20 PC.
101-0000-42600
0
$24.17
$0.00
Total Paid for ELECTRICAL: $48.34 $0.00
PERMIT ISSUANCE
101-0000-42404
1 0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
11111111 1: 1111161 IIIIIIIIIIIIIIIIIIIIIlli�!'Ill I
Printed: Friday, May 15, 2015 4:44:18 PM 2 of 2 Ic_.....
LOW
I
TED
SEQID INSPECTION.TYPE INSPECTOR SCHEDULED CO7DATE
DATE
RESULT REMARKS NOTES
ELECTRICAL FINAL" BLD
Printed: Friday, May 15, 2015 4:44:18 PM 2 of 2 Ic_.....
Bin #
..City of La Quinta
Building 8z 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:
Owner's Name: v
A. P. Number:
Address: s
Legal Description:
City, ST, Zip: Z4 L111M ZZ 2 7-5 -S
Contractor: r f� C
Te n
le ho e.
P
Address: %� .('x' .A `,
.1 j ctDescription:
City, ST, Zip: h L,
L D R�C e5 ave
T ele h 0 11
P o�
..City
State Lic. # : 9% %� ��
Li,. #.
V&PULP
Arch., Engr., Designer:
Address:
"Lis J14ex--Icll i
City., ST, Zip:
Telephone:
Construction Type: ccu an cY
State Lic. #:
Project hP circle one): New Add'n Alter RepairDemo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: ,5wo
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 Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21' 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:-
'rd 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