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BELC2016-009778-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4ty, 4 4v Qubtz- DESIGN & DEVELOPMENT DEPARTMENT Application Number: BELC2016-0097 Property Address: 49447 AVD VISTA BONITA APN: 773350041 Application Description: HSIN RESIDENCE/ ELECTRICAL Property Zoning: Application Valuation: $2,000.00 Applicant: WEST VALLEY ELECTRIC 30300 LIVE OAK CANYON ROAD REDLANDS, CA 92373 BUILDING PERMIT P NOV 2 2 2016 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: RICKY & MELISSA HSIN 16 WILDFLOWER LN LACENTIA, CA 92870 CITY OF LA QUINTA contractor: WEST VALLEY I—, DESIGN AND DEVELOPMENT DEPARTMEN10300 LIVE OAh CANYION ROAD REDLANDS, CA 92373 Date: 11/22/2016 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: CSO License No.: 576818 � Date: l _ - Contractor. OWNER -BUILDER DEC TION 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).: ( ) 1, 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 Name: Lender's (909)792-0684 Llc. No.: 57681E WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury oneof 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 perf3rmance of the work for which this permit is issued. My workers' compensation insurance carrier and polity number are: Carrier: SENTINEL INSURANCE COMPANY LTO Policy Number: 76WEGZJ5138 I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner !o as to become subject to the workers' compensation laws of California, and agree Mat, if I should become subject to the workers' compensation provisions of Sectior 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: FAILURE TO SECURE WORKERS' C PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,-)00). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FDR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNDWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on tris application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is perfo-med under or pursuant to any permit issued as a result of this application , the ovvier, and the applicant, each agrees to, and shall defend, indemnify and hold harmless t&e City of La Quinta, its officers, agents, and employees for any act or omission related tc 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 represertatives of this city to enter u n the above -mention d property for inspection purposes. Date: /6 Signature (Applicant or Agent). Date: 11/22/2016 Application Number: BELC2016-0097 Owner: Property Address: 49447 AVD VISTA BONITA RICKY & MELISSA HSIN APN: 773350041 416 WILDFLOWER LN Application Description: HSIN RESIDENCE / ELECTRICAL PLACENTIA, CA 92870 Property Zoning: Application Valuation: $2,000.00 Applicant: Contractor: WEST VALLEY ELECTRIC WEST VALLEY ELECTRIC 30300 LIVE OAK CANYON ROAD 30300 LIVE OAK CANYON ROAD REDLANDS; CA 92373 REDLANDS, CA 92373 (909)792-0684 Llc. No.: 576818 Detail: INSTALLING (6) LED RECESSED LIGHTS, (1) FAN OUTLET ON BACK PATIO, (1) OUTLET AND (1) SWITCH FOR SEASONAL LIGHTS ON FRONT PATIO. PER 2013 CALIFORNIA BUILDING CODE FINANCIAL •• • DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1:00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT Credit Card Fee 101-0000-43505 0 $2.66 . Total Paid for Credit Card Fee: $2.66 DESCRIPTION ACCOUNT. QTY AMOUNT DEVICES, FIRST 20 101-0000-42403 0 $25.33 DESCRIPTION -ACCOUNT QTY AMOUNT DEVICES, FIRST 20 PC 101-0000-42600 0 $25.33 Total Paid for ELECTRICAL: $50.66 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $96.27• Total Paid for PERMIT ISSUANCE: $96.27 Bin # ,. Permit u Project Address: 1-°19'-11-{7 Qty of La Qui pis Building &r Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-701,2 - Building Permit Application and Tracking Sheet Avin,t7A `%.cTA to�,Yp. Owner's Name: �ICK� •i- MIz616,5A 4Sm . A. P. Number: Address: I (7 w 1 h �L� u✓r ( yN Legal Description: City, ST, Zip:92 g 7 O LAce N-I 14 CA . n ra Cot ct r: o T � �r ' S l A L W V I y—Z 1 , t � !: r _o 9 71 I -3 -'S one: 4 43 Telephone: P Address: 30 3 0 O L„t Vii- ©pk C,goy. - fZpAd, Project Description: S� � 1-4 , n City` ST, Zip: Rid �o ti cis . CA. 9: 3 7 -3 G I tics . 1. r,-- o y-rL ETl - o ti b•o cK RAr & Telephone: 9 5 3 2 n Z- 1. 4 � � w ,T r . r D L a 1 �. S n I T State Lic. #:0- 10 57(., ( City Lic. 4-$ ow; A L .. [_ I k7rc' C) N T-, it a o Arch.,`Engr., Designer: Address: City, ST, Zip: Tele h ne: O ccu PaneYConstructi n Type: i� S Lic.#. - Project Add'n Repair c, le one : New Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 771 Estimated Value of Project: U v 6 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rcc'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. 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 corrcctions/issue Electrical SubcontactorLis( Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. II.O.A. Approval Plans resubmitted Grading .' IN IIOUSE:- Jrd. 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, Poo j 1151,12s,. l x� O PEN ?417m? e s`" M WAR UM fA r^ C C f GIS OF L \ QUINT `7 -BUILDING & SAFETY DEPT. FO ONSTRUCTIOIV I DATEI' �V • BY ( lj Dr