BELC2016-000178-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Titr444uiltrw
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BELC2016-0001
Property Address:
53300 DEL GATO DR
APN:
770350015
Application Description:
TRADITION / KRORETZ / REPLACE MAIN BREAKER
Property Zoning:
Application Valuation:
$300.00
Applicant:
BRADLEY ELECTRIC INC
42335 WASHINGTON STREET
SUITE F #381
PALM DESERT, CA 92211
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: C10 License No.: 275466
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.).
(� 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 Na
Lender's Address:
1111 1111IIII
62
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
RICHARD KORETZ
53300 DEL GATO
LA QUINTA, CA 92253
Contractor:
BRADLEY ELECTRIC INC
42335 WASHINGTON STREET
SUITE F #381
PALM DESERT, CA 92211
(760)360-0944
Llc. No.: 275466
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
t e k for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
e 700 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 ermit is issued, I
shall not employ any person in any manner so as to become subject tie workers'
compensation laws of California, and agree that, if I should bec me subi }ct to the
workers' compensation provisions of Section 3700 ohth`e Labor Co shall forthwifh
comply witl)thpse provisions.
Date:
WARNING: FAILURE TO SECURE RKERS' COMPEN5T N COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYE TO LTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ( 00 00). 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 abov informati is correct.
I agree to comply with all city and county ordinances and state ws relating o bui
construction, and hereby authorize representatt'i ,es this city t on
e
above (n Toned property for inspection pu%oses.
Date: \ Signature pplicant or Age .'
V- Nzz-
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U fiJIMIiQNaAMOUNT, -5" 'E.-
BSAS.SB1473 FEE' 101-0000-20306,
0 $1.00 $1.00 1/11/16
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BRADLEY ELECTRIC INC CHECK
R12029 40656 SKH
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA::. $1.00 $1.00
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ACCOUNZg
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PAID ,.-DATE;
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SERVICES
101-0000-42403
0
$24.17
$24.17
1/11/16
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BRADLEY ELECTRIC INC
CHECK
R12029
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SKH
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P
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SERVICES PC
101-0000-42600
.0
$12.09
$12.09
1/11/16 -
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BRADLEY ELECTRIC INC
CHECK
R120.29
40656
SKH
Total Paid for ELECTRICAL: $36.26 $36.26
)ESCRIPTIOW, W "A
MOUNT
rPA1D DATE
XPAID
PERMIT ISSUANCE
0 $91.85
$91.85
1/11/16
PAID
M M ET H 0 I
91�'- MR,
BRADLEY ELECTRIC INC
CHECK
R120,29
40656,
SKH
Total Paid for PERMIT ISSUANCE: $91.85 $91.8S''
TOTALS:
' Permit Details PERMIT NUMBER
City of La Quinta BELC101611111
Description: TRADITION / KRORETZ / REPLACE MAIN BREAKER
Type: ELECTRICAL
Subtype: Status: UNDER REVIEW
Applied: 1/11/2016 SKH
Approved:
Parcel No: 770350015 Site Address: 53300 DEL GATO DR LA QUINTA,CA 92253
Subdivision: TR 28867
Block: Lot: 93
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $300.00
Occupancy Type: Construction'Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
Details: REPLACE MAIN BREAKER. 2013 CALIFORNIA BUILDING CODES.
CONTRACTOR
CHRONOLOGY
CONDIT IONS
NAME TYPE
NAME
ADDRESSI
CONTACTS
CITY
STATE
ZIP
PHONE
FAX EMAIL
APPLICANT
BRADLEY ELECTRIC INC
42335 WASHINGTON
STREET
PALM DESERT
CA
92211
CONTRACTOR
BRADLEY ELECTRIC INC
42335 WASHINGTON
STREET
PALM DESERT
CA
92211
OWNER
RICHARD KORETZ
53300 DEL GATO
LA QUINTA
CA j
92253
Printed: Monday, January 11, 2016 11:49:48 AM 1 of 2
SYSTEMS
Permit Details PERMIT NUMBER
�. City of La Quinta
B E LC201r6'=0001
INSPECTIONS
PARENT PROJECTS
Printed: Monday, January 11, 2016 11:49:48 AM 2 of 2 Cff?
SYSTEMS
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT.
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
.
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$1.00
1/11/16
R12029
40656
CHECK
BRADLEY ECLECTRIC
SKH
IN
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00
BSA:
SERVICES
101-0000-42403
0
$24.17
$24.17
1/11/16
R12029
40656
CHECK
BRADL 'NECLECTRIC
SKH
SERVICES PC
101-0000-42600
0
$12.09
$12.09
1/11/16
R12029
40656
CHECK
BRADLENECLECTRIC
SKH
Total Paid for ELECTRICAL: $36.26 $36.26
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
1/11/16
R12029
40656
CHECK
BRADLEY ELECTRIC
SKH
INC
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
TOTALS: $129.11 $129.11
INSPECTIONS
PARENT PROJECTS
Printed: Monday, January 11, 2016 11:49:48 AM 2 of 2 Cff?
SYSTEMS
Bin #
City of La Quinta
Building 8T: Safety Division
. . 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
((p--
Project Address:
Owner's Name:
A. P. Number:
Address: 3332SO
Legal Description:
City, ST, Zip:
Contractor: r:
Telephone:
Address: f`
Project Description:
City, ST,'go
T le hon
G P !%IJ' C
:City
WE. # :
Lie.
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Pane
n TYe• Occupancy:
Construction P Y•
State Lic.
Project type (circle ne • New Ad d'n Alter Repairair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: d
Sri
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
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 Cates.
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 Dced
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN IIOUSE:-
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