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BELC2015-010978-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Tuy 4 - 40" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BELC2015-0109 Property Address: 44415 LAS VISTAS DR APN: 604175008 Application Description: GRAFF / REPLACE 100 AMP SERVICE Property Zoning: Application Valuation: $1,000.00 Applicant: RON MARTINEZ ELECTRIC 38-455 BEL AIR CATHEDRAL CITY, CA 92234 D Q 0 LDE4 2015 CITY OF LA QUINTA COMMUNITY DEVELORMENT DEPARTMIENT 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: C3/0' License No.: 510541 Date: �r Contractor: OWNER-BUI ER DECLARATION I hereby affirm under penalty of perju 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 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 Lender's Address: 11111111111111111111 ,7 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/14/2015 Owner: NANCY GRAF 44415 VIA VISTAS LA QUINTA, CA 92253 Contractor: RON MARTINEZ ELECTRIC 38-455 BEL AIR CATHEpRAL CITY, CA 92234 (760)333-0974 Llc. No.: 510541 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 w rk for which this permit is issued. _—?L L_ ave 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 polity 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 oft r Code, I shall forthwith complywith those provisions. Date://L �r —,/• ' Applicant: WARNING: FAILURE TO SECURE WOR S' 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 relatin to building construction, and hereby authorize representatives of this city to enter h� above-mentioned property for inspection purposes. Date: / G� Signature (Applicant or Agent) FOR MATIO1 t -i.:"f;. ad rr .;;..ii.tr�- a vrV's` ;_- Ex $ n;''t�,i,�;1S. V�''}T', ,..awx ...,'_1�,iy- �' DESCRIPTION �ACCQUNTs ? TYAMOUNT" aPAID>DATEx ;.. r ;PAID:. ,:.:.x.1:sE.c.,`i+�...mi3 BSAS SB1473 FEE .101-0000-20306 0 $1.00 $1:00 12/14/15 .,.,vJ � .. •l � - 4`�'.4:'�-\-F .i' ""T 4 �: � TL'rie'F,vih � PAID BYE _ x METHOD > RECEIPT # rf3CHECK #CLTD BY -a k7f, 3,.._dW .fi".,'sk.' �z...,j.:� y RON MARTINEZ ELECTRIC DEBIT - MR248 SGU Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00 i�E? � � 'L^'kYP ��4:�n.§:( DESCRIPTION.. � .�., � $��: �y�. _��. ACCOUNT:<^ �, PAID:DATE:; s g..¥F V CITY 4�AMOUNT cPAID F SERVICES 101-0000-42403 0 $24.17 $24.17 12/14/15 PAIDBY METHOD` t �4.Iadv. : T'v Y.4 ,RECEI?T #� X'e 6 bn M x `CHECK #y 3C-TD'BY s . -Y n.� _ E��... RON MARTINEZ ELECTRIC DEBIT MR248 SGU DES 39 R , 'YO(" U.N'h l F '. D -A? T;�.Es:: +; PAT'vI.".D ,PA.I,W.:5\ R SERVICES PC 101-0000-42600 0 $12.09 $12.09 12/14/15, xIr k PAIWBY, ' g METHOD RECEIPTv>f. Y # st riC ECK� ROWMARTINEZ ELECTRIC DEBIT MR248 SGU Total Paid for ELECTRICAL: $36.26 $36.26 ...�.S.!.,S"➢.3.t.<5* s' --,DESCRIPTION < Y � s tis A000UNTi x� i s AMOUNT 6 PAID PAID DAT£ a..a�.....�, caan...,e`;v«,.4.+,: ,.vF,s5d3 a.. r` "REM k,QTY s t>`, rc_:? ,-.,. PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 12/14/15 PAID BY w" r.. a METHOD $�:: ,.. "D.tv', f 4[.*E� �i r� p�, t k e t ,,. _... 13..' 9 r < RECEIPT`#'r CHECK # CCTD BYh 'RON MARTINEZ ELECTRIC DEBIT MR248 SGU Total Paid for PERMIT ISSUANCE: $91.85 $91.85 ' Description: GRAFF / REPLACE 100 AMP SERVICE CbNbITIONS Type: ELECTRICAL Subtype: Status: APPROVED Applied: 12/14/2015 SGU Approved: 12/14/2015 SGU Parcel No: 604175008 Site Address: 44415 LAS VISTAS DR LA QUINTA,CA 92253 Subdivision: TR 23269 Block: Lot: 246 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $1,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 CATHEDRAL Details: REPLACING (1) 100 AMP SERVICE. 2013 CALIFORNIA BUILDING CODE 92234 CHRONOLOGY CbNbITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT RON MARTINEZ ELECTRIC 38-455 BEL AIR CATHEDRAL CA 92234 CITY CONTRACTOR RON MARTINEZ ELECTRIC 38-455 BEL AIR CATHEDRAL CA 92234 CITY OWNER NANCY GRAF .44415 VIA VISTAS LA QUINTA CA 92253 Printed: Monday, December 14, 2015 12:40:03 PM 1 of 2 1127127 SYSTEMS DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 12/14/15 MR248 DEBIT RON MARTINEZ SGU ELECTRIC Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: SERVICES 101-0000-42403 0 $24.17 $24.17 12/14/15 MR248 DEBIT RON MARTINEZ SGU ELECTRIC SERVICES PC 101-0000-42600 0 $12.09 $12.09 12/14/15 MR248 DEBIT RON MARTINEZ SGU ELECTRIC Total Paid for ELECTRICAL: $36.26 $36.26 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 12/14/15 MR248 DEBIT RON MARTINEZ SGU ELECTRIC Total Paid for PERMIT ISSUANCE:' $91.85 $91.85 TOTALS: $129.11 $129.11 INSPECTIONS PARENT PROJECTS REVIEWS REVIEW TYPE REVIEWER SENT DATE .DUE DATE RETURNED STATUS REMARKS.. DATENOTES ATTACHMENTS Printed: Monday, December 14, 2015 12:40:03 PM 2 of 2 C9?SYSTEti1S Bin # pity of La Q uin to Building 8t Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit ti � 9 G Project Address: fOwner's Name: _ A. P. Number: Address: Legal Description: City, ST, Zip: OV Contractor:Telephone: hG (/Al Address: ,0— z-�e Project Description: City, ST, Zip: �✓ G r%�� Telephone: L State Lic. # : S�dS`y City Lic. #. Arch., E ., Designer: Address: City, ST, Zip: o ne: Telephone:h State to L c. ....................................... Occupancy: Construction Type: . Project type (circle one): New Add'n Alter Repairair Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: G vUO t! Submittal Req'd APPLICANT: DO NOT WRITE BELOW THIS LINE Rcc'd TRACKING PERMIT PEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrections/issue Electrical Subeontactor List Called Contact Person Plumbing Grant'Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN ROUSE:- 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 Sc 1061 Fees, Total Permit Fees