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BELC2015-009278-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4tr4 lw4" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT 11111111111111111111 40 VOICE (760) 777-7125 FAX (760) 777-7011 `rC,9yNFO INSPECTIONS (760) 777-7153 Date: 10/7/2015 Application Number: BELC201S-0092 Owner: Property Address: 80262 Champions Wy RREF II CWC LAQ LLC APN: 775220021 5927. PRIESTLY DR STE 110 Application Description: ESTATES / TEMP POWER 200 AMP CARLSBAD, CA 92008 Property Zoning: Application Valuation: $500.00 moi' o 5z Applicant: Contractor: a g o S R BRAY LLC DBA POWER PLUS S R BRAY LLC DBA POWER PLUS�rit - 1210 N RED GUM STREET ANAHEIM, CA 92806 1210 N RED GUM STREET ANAHEIM, CA 92806 v (714)507-1881. . Llc. No.: 980589 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. D31 License No.: 980589 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 ) 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 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 N Lender's Add 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 wo or 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 worke s' pensation insurance carrier and policy number are: Carrier �P+`�64 I mber. 7Y&F3 a`75I 3 h / //& 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. Date: /0� �� 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 I 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. G Date: /V 7'�r Signature (Applicant or Agent): FINANCIAL • ai DESCRIPTION ', ACCOUNT , :. QTY - AMOUNT.' PAID' PAID DATE`. BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD ;'. RECEIPT # CHECK # CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1:00 $0.00. DESCRIPTION:.: ` ACCOUNT,_ AMOUNT:: PAID PAID DATE TEMP POWER SERVICE 101-0000-42403 0 $24.17 $0.00 PAID BY : METHOD RECEIPT #, CHECK # CLTD BY DESCRIPTION ACCOUNT QTY; AMOUNT PAID ,' PAID GATE: TEMP POWER SERVICE PC 101-0000-42600 0 $16.92 $0.00 PAID BY ', METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL: $41.09 $0.00 DESCRIPTION . r; ACCOUNT . QTY_ '• AMOUNT.:, PAID PAID DATE< PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD,BY, Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:00 Description: ESTATES / TEMP POWER 200 AMP CONDITIONS Type: ELECTRICAL Subtype: Status: UNDER REVIEW Applied: 10/7/2615 SKH Approved: Parcel No: 775220021 Site Address: 80262 Champions Wy LA QUINTA,CA 92253 Subdivision: PM 20426 Block: Lot: 61 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $500.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 PHONE ' Details: ELECTRICAL -TEMPORARY POWER POLE 200 AMP. 2013 CALIFORNIA BUILDING CODES. EMAIL. ` 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 ANAHEIM CA 92806 (714)507-1881 STREET CONTRACTOR S R BRAY LLC DBA POWER PLUS 1210 N RED GUM ANAHEIM CA 92806 (714)507-1881 STREET OWNER RREF II CWC LAQ LLC 1. 5927 PRIESTLY DR STE CARLSBAD CA 92008 (714)507-1881 L 110 j j j FINANCIAL INFORMATION Printed: Wednesday, October 07, 2015 11:09:22 AM 1 of 2 SYSTEMS Permit Details PERMIT NUMBER . City of La Quinta BELC�201�50092 ti `. ` PARENT PROJECTS Printed: Wednesday, October 07, 2015 11:09:22 AM 2 of 2 CM SYSTEMS CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: TEMP POWER SERVICE 101-0000-42403 0 $24.17 $0.00 TEMP POWER SERVICE 101-0000-42600 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 PARENT PROJECTS Printed: Wednesday, October 07, 2015 11:09:22 AM 2 of 2 CM SYSTEMS Din 11 .� Permit // ProjectAddress: . City of La Quinta Building a Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Owner's Name: lAL A. P. Number: Address: S5 2 404-7L51 `/bo Legal Description: City, ST, Zip: CA Z,426� Contractor: . s�Ki�cc � eP�s� Telephone: e: 7� ��— 7 Address: AZA N. AA Project Description: /NST c o/-�E 2-0b ova G(/ City, ST, Zip: �jy�y�i�/� Z�(J(o —.G L1 PD -60 E %CS AV166 Tel eP h n — o e: 7 %S % S y s ... MMMM P ��7�NExi MA - LE 7cT AAAE State Lic. # :s city Lic.# M01t CnION . Arch., Engr., Designer: Address: . City, ST, Zip: Telephone: _ ane Con tructi n T e•146,0 Occupancy: Construction YP P Y• State L ic. #. o Project bPa (circlele one : e Add'n Alter Repairair Demo Name of Contact Person: A ce6 Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: .� s/ — Z 7 7 `/13 Estimated Value of Project: S00 . Gb APPLICANT: DO NOT WRITE BELOW THIS LINE t/ Submittal Req'd Rcc'd TRACKING PERMIT FEES Plan Sels Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan . Plans resubmitted Mechanical Grading plan 2nd Review, ready for corrections/issue Electrical Subcontact'orList Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. II.O.A. Approval Plans resubmitted Grading IN ROUSE:- '"' 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 .2.CQ2- a vo(h p` un U Lo-r u t Pham �Y O' a { 4,� �� u,9--e, t- Sa 0J 9 sA zx �3lV VINMO d-1 o DNI NOLLXIN ISNOD lsaa A VINHOJI"IVD > 0 " rlol L Ol-t 6 L _ 8S -SS '£i -ll 9 9 tS-ls 'Sl -ti L - 9 0S -6t '61-91 9 9 9t-94 'ZZ -OZ S 9 St -it '9Z -fl t 9 £Y It '6Z LZ £ S 9.... Ot-6£ _Z£-0£ 6f-ff - Z Z £9-Z9 S1300N 1Y101 S838Nf1N 101 3SYHd N\N ivim 9 Of liLZl iL-£L '99-99 ZL-19 •• •"" tl Ol 9 9Zl-tZI 'LL -SL 6 L IWSA t S Zll-lz1 't9 -Z9 L S Olt -911 '99-99 9 S 9 Lll '06-19 911-tll '£6-I6 S t 9 Oli 901 '001-86 z L LOl lol 1Y101 S839NI1N 101 t 3SYHd IfS CIN310YH 3H1 L OOIA-96A 'l6A-O6A El L ZZA-OZA '/A -IA Zl L IWSA t 9 9ZA-£ZA Ol 8 61A-ZlA-._...6 L 9£A-6ZA 9 9 _ LOA -99A '99A -99A L L SLA -69A 9 9 18A-9LA S 01 8A-L8A 't8A-Z9A 'W -NA t 9 £►M1-9fA £ L 09A -29A LtA-YYA Z 01 LSA 91A -__l_.. T/101 SMIW im 3SYHd m vnlA 3H1 swaal joluag 6C069Z Rol'