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BELC2014-102578-495 CALLE TAMPICO Ct 0 D �i4tIlACl/ LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BELC2014-1025 Property Address: 52302 MERIWETHER WY ' APN: 767900014 Application Description: MADISON / 100 AMP PEDESTAL Property Zoning: Application Valuation: $35,000.00 Applicant: p DISCOVERY BUILDERS CALIFORNIA INC DBA DB 14605 N 73RD STREET SCOTTSDALE,. AZ 85260 LICENSED CONTRACTOR'S DECLARATION 15 VOICE (760) 77777125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 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 License No.: 915336 —&MV—� Date: —f 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).: (1 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 whodoes 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 contractors) licensed pursuant to the Contractors' State License Law.). (_J I am exempt under Sec. . B.&P.I . 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: (480)624-5200 Llc. No.: 915336 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty ofperjury 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 offor which this permit is issued. have and will maintain workers' compensation insurance, as required by Semlon37010 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 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: CZ—� Applicant: ` WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVE GE 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. Date. z - Signature (Applicant or Agent): Date: 12/7/2015 Owner: MADISON CLUB OWNERS ASSN P O BOX 1482 z p LA QUINTA, CA 0 -1 � n D on Z O Contractor: y DISCOVERY BUILDERS CALIFORNIAIQg D A DB ' 14605 N 73RD STREET z �—.—�� SCOTTSDALE, AZ 85260 ' 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 License No.: 915336 —&MV—� Date: —f 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).: (1 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 whodoes 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 contractors) licensed pursuant to the Contractors' State License Law.). (_J I am exempt under Sec. . B.&P.I . 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: (480)624-5200 Llc. No.: 915336 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty ofperjury 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 offor which this permit is issued. have and will maintain workers' compensation insurance, as required by Semlon37010 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 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: CZ—� Applicant: ` WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVE GE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER. TO. CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION,3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose. request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application., the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result•of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. Date. z - Signature (Applicant or Agent): NMI `,_r , YA:g.E.., tt, s" C .af.": S.s: d'`s �"` r<' •h .'.n" 5„ a" F .air .. f L ,�-TM T' xt3� a ,i..- := `A.000UNT :rai{Y �4Yt._. x...}f>)C.5'%.,.'$.1.1.F.�.S,i�,��P�i�(:.il�+.yW'iYCPM:. �:"�.��� i.0 T�`�+kct?�%F S:SSR�4:::,w.�44�i£',-.£WauFXS+u!<a'pv173Yv�i�:� �i><7+�i�(Aextr.:�.A3"QG�D•A�.h�z l^°4,514� f BSASSB1473FEE .101-00007 . 20306 .0 $2.00 $0.00• j F -e., 'ia 1 i'E-'-.;.... -•' . ,,..� METWOD,'t�!� ':.}�...�i:,�' Yl:wF .v si \�i:5 v_.;M xwFA..v<`,u.:..r xM�C�'a.�a.��+.�"v3d VS; .w -`f f,&'=�. ik c�:. +�_'+,;, ..,4.:.a,.i..-_. "iC .}'7e�FxK��`:C''.Y:. �k rYCs dit1;4;�, x,".,a:-...:...Xk��`iF?..."4`kM1. al Yr. i, MS.aaa,4usa"3�'�:.:$,X �;�::�:1;•3y..k� "�<iS\S_...�..`Y i?v:t.v'x.: Total Paid tot. BUILDING STANDARDS ADMINISTRATION. BSA:. , - $2.00. $0.00 1,',.',„'"'a;*_"�x`D..ESGR.IPTIONL,�i)<>• ,£a m;*i '.".C•'Y.:ts�.wt3..nY.ia01_,d4:di.�i.=k3Y H...&..�'"xl�i�".�w1T�t -Y.='ACCO.UNTxY;'' x' ki?n.`�R$•..FiFSSKI:�"..s..,.:..:.::..:lc i.,'�'i:.at,f'1.o': T"k�:?.:4`4.,.i:?l<.S .Rsu- Lia"Y35i�i. �PAID'��°rp'7,. tNr?i ._{g?�1"^Fv: }.PAIDYUATE' �iti:kxi','!.i"::.`�1 :^i'a'k`,iiavr. SERVICES :101-0000-42403 0 $24.17 $0.00 ejR;s PAID=6Y ; i u3 .�:� .L�-,%I<.fffYZ:.<'m.}1: 35. dfx�• W',�.:EYF_.:'A(5�.::...Y.:�'. METHOD Vis`', ;> RECEIPT#,,c y CHECK #E' �n�y ... CLTD`BYs ..; ,.•,e >�zs:- .x :'�.?.::^s :.�t�'. x,t G.<x:Ns.. ::r!:�z,.., x <,s,r-. 4:e �.. <.lit.' .?, ,:�.AMQUNT,d .+ -:?r,:�.Ni:r.tiis''�.C�?S.__.:4;. .. t-_,�%�a h,PAID ;k'��`5. RAIDDATE SERVICES PC 101-0000-42403 0 $12.09 $0.00 l h ��C• F' $ 'ti'S: �4.w'�,.=� <7^�i,`L.. N�:`Xn-.f..•X,z�4-0::dx '. §:: �!�.'•kx�"1Fry��,c�.<:-.5.e:k„�s+.n: motif.. �` c� s;-rhT4.k+�: T '. y.. 'i :<�ii!:+,i �:x;�.�s��h+:..et i _ii:E..„�:�i.. '.�rt'_?,rA"t Y� ..5: �.<. 1` _. f :� � s.#:�:h ii,'�.si'•d.".•s0t;._ c.::§s'. .'. .,.. �i 1....: x,Y a`•,k' L::. r_nFLi._ .,4 3 §•5r : ����4s:v�-i'.;�.m.,e�e�V:r:: ..Y,.4"�".".`<,; �' Lbw �v �':t`q .:-<�` +f��� Total Paid for ELECTRICAL: $36.26 $0.00 `t�lxiw.' ^73�::?'�,�t pyY . -, � e`x^mi 4tP'*.,t�ai ,'F.":”" _ -'t} .` � �%z.. ��,:.;._.,..,:�.re: :.meq :: :,:. ,sI' }•� �n000NT .,,4� � i t'' F 4 v#,� `C`� �"" 2;:'� 'G*� 1,' '�'rs �Y2``�• G.F :; 8 �G ��< ,E' , t,'� � �.:Y.�4t'-ro ,.:s..: sa. tis 't��s.. � ��''`=2' +ra.t`�j! xk:, r _.r.., PAIDzr°k ii`.�e' `?.e .,., s� �+ . ' PAID DAT£s PERMIT ISSUANCE 101-0000-42404.0 $91.85 $0.00 y,? �Y. :'i\K4'a"�y`�.. y•}Y. 5"Sxi�4Y. _,x'3!.. .�55.J�yT by A'� al"» .•S7 `�>f_, wn7x3_r.. Cu<s+:;:4"G€� 7>?, L..G.�:... .:'wt?�6:s:#---w "?. ��".. -.Y�?% i�'di'.�'.4 �f:s. .i�'u'i'� "c?3.Si�'���h. .-..f� �',C.±?sNS'.`.l'r.�i :Y3's%Z-kn�"4'kix. ,.,-}N"t no-':L3'�-i... .N '4.�>Sx'.s _. u�{'��ix tea: y:"r::.Y:.::.`�' .i.: 1.'I{;,.�E� X'. ✓�.�. �„{C�':i a�'�..?.E' .ti-��Y,a'�� :�r�:dl? Ya . :i"�'�Y�? ":Y. �.iti''F7�.':': �i �. 'ii�+J>,s'�Y: Total Paid for PERMIT ISSUANCE: $91.85 ' $0.00 j . I i - Description: MADISON / 100 AMP PEDESTAL ADDITIONAL Type: ELECTRICAL Subtype: Status: APPROVED Applied: 9/15/2014 KHE Approved: 9/23/2014 JJO Parcel No: 767900014 Site Address: 52302 MERIWETHER WY LA QUINTA,CA 92253 Subdivision: TR 33076-2 Block: Lot: G Issued: Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $35,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: ELEC. SERVICE ONLY Printed: Monday, December 07, 2015 10:31:45 AM 1 of 2 C SYS TEti1S ADDITIONAL CHRONOLOGY TYPE STAFF NAME ACTION DATE CHRONOLOGY COMPLETION DATE NOTES PLAN CHECK.SUBMITTAL KAY HENSEL 9/15/2014 9/15/2014 sCONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT DISCOVERY BUILDERS CALIFORNIA INC DBA DB 14605 N 73RD STREET SCOTTSDALE AZ 85260. SBIRDWELL@DISCOVE RYLANDCO.COM CONTRACTOR DISCOVERY BUILDERS CALIFORNIA INC DBA DB 14605 N 73RD STREET SCOTTSDALE AZ 85260 SBIRDWELL@DISCOVE RYLANDCO.COM OWNER MADISON CLUB OWNERS ASSN P 0 BOX 1482 LA QUINTA CA 0 Printed: Monday, December 07, 2015 10:31:45 AM 1 of 2 C SYS TEti1S DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD .. BY BSAS SB1473 FEE 101-0000-20306 0. $2.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $2,00 $0.00 BSA: SERVICES 101-0000-42403 0 $24.17 $0.00 SERVICES PC 101-0000-42403 0 $12.09 $0.00 Total Paid for ELECTRICAL: $36.26 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 _ $0.00 Total Paid for PERMIT ISSUANCE:. $91.85 $0.00 TOTALS: $130.11 00 INSPECTIONS SEQID "• INSPECTION TYPE` INSPECTOR SCHEDULED COMPLETED, DATE. DATE RESULT, . REMARKS.: NOTES, ELECTRICAL FINAL" REVIEWS RETURNED STATUS REMARKS REVIEW TYPE.:':,REVIEWER' SENT, DATE DUE, DATE.. NOTES._: DATE ELEC. SERVICE ONLY PERMIT MAY NOT BE ISSUED UNTIL CONTRACTOR NON-STRUCTURAL JIM JOHNSON 9/23/2014 9/30/2014 9/23/2014 APPROVED ELEC. SERVICE ONLY IS ENTERED AND LIC. ARE VARIFIED. VARIFY ADDRESS NOT PROVIDED ON APPLICATION BOND INFORMATION ATTACHMENTS Printed: Monday, December 07, 2015 10:31:45 AM 2 of 2 C SYS TEhiS t. 1 y • `,• �- 1 N%�1143604AV F . �_ , �•• �z). S. 1000 -ABC • 1!. ( w JOB ' i . \ �/• SITE 17 O� ,�� �•.Q�� 114364 �� ti �'e''~ _' •I VICINITY MAP NN �/s J' - N.T.S. qy f CONDUIT & WIRE NOTES_ C STOMER"INSTAL-C-��— CH. 40 PVC CONDUIT (60') W1 • y W1 f • /IID IN: 1/0 AL TRI. 120/240V i 1PH FOR SEC. SERVICE (80') l ' ' 100A PED - 11,93720 - I 20/240V i `• 300 -ABC —EXISTING-------�-- �.. y. 1PH s 11151 I SEC. BOX W 1, -r 0100-C f • i i CIT( OF LA QUINTA a •� U !NG &SAFETY DEPT. o Aim ��E FOR CONSTRU }Oiy 1162210 w 100-A �- ( ( '� " ` 11151 DATE�2�� 1 / ger - • j o PCN -11�••''` IMPERIAL IRRIGATION DISTRICT N 7p�s22pP �SQ i A* 1162209 F IV NOTE TO CUSTOMER: . PLEASE CONTACT IID INSPECTOR PRIOR .j �• 1 inch = 100 feet TO UNDERMINING ENERGIZE STRUCTURE. 760-398-5828 SUB: JEFFERSON CKT: N170 PLEASE HAVE ADDRESS AND SERVICE °t THE MADISON CLUB INC NOTIFICATION NUMBER AT HAND.'' , 52302 MERIWETHER WAY LA QUINTA, CA 92253 r _- SERVICE LAYOUT SERVICE NOTIFICATION:4017511 I SERVICE ORDER:60091343 I DRAWN BY:LMARRUJO I DATE: 9/30/2014 Bin # City of La Quin to . Building &r Safety Division Permit # 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 �d Building Permit Application and Tracking Sheet Project Address: J`oZ /��,�/ IP Owner's Name: A. P. Number: Address: 2 -- Legal Description: Legal City, ST, Zip: r• t Contrac o . i r Telephone: v Address: 52- Project Description: City, ST, Zip: TeleP h 0 n e: -)It Z V State Lie. #.: ?j C ity Lie. #: Arch., Engr., Designer: Address: City, ST, Zip: ne: Telephone: h 0 cY: n tructi n Type: Occupancy: Cos o P P a S t to Lie. Project type circle ne • New Add'n Alter Repair Demo Name of Contact Person:Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE tl 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 Calcs. Plans picked up Construction ' Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrections/issue. Electrical Subcontactor List Called ContactPcrson Plumbing ..Grant Decd Plans picked up S.M.I. Ii.O.A. Approval' Plans resubmitted Grading IN HOUSE:- 3H. 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 �y Bin .# ......,.. Cit}r Of Quintd 80ding a Safety DivJston Permit # P.O. Box' 1504, 78-495 Calle. Tampico [a Quinti, CA 92253 - (760) 7774012 Building Permit Application and Tracking Sheet , .Project Address: V%aQ —Jl sun C 1.x b, Owner's Name:O g / e11 SO 52-10? mer'jwp6b 9,r WGIA 5 h A- P. Number: -1 u 16-7(3000 18 Address: JL4 %O 5 /,j -7 3 r Legal Description: -Xc;- City, ST, Zip: SC O ft d o4 e. 7J 5-5260 Contractor: 7139 Address: �. �.. Telephone: O .62q' O o Project Description: City, ST, Zip: C// o ► U C Q. r C V W Telephone: `"z o. `► SOIa 1 l on V G n 2 f tl° ►1 State Lic. #: City Lie. #: Arch.,ngt. Designer on Sa t� I (� f JI- G u t oW n n b ri>., A Address: 2=4422- Amts` e.. A Gf D r V o( Ccs7►^ C^ J R r`'./ CO -c City, ST; Zip: L2.j tino, J -f SIIS CA !G!53 I uy VC, I V G Telephone: (j !^) ti 5 3 - O J I State Lic. #: C- 6 'j?j 3 en lion Type: IT Occupancy: jecttype (circle one): New Add'n ter Repair Demo Sq. Ft: t o o d # Stories: # I wis: d Name of Contact Person:. Fr fit) Telephone # of Contact Person: 4N V W S 3 - of I 1 e 2C} 6X Estimated Value of Project: I l7 $ O O U APPLICANT: OT WRITE BELOW THIS UNE # Submittal Wd Recd TRAC MG PERMIT FEES Plan Sets a Plan C eck submitted CI flJ Item Amount Structural Calcs. R owed, ready for corrections Pian Check Deposit Truss Cities. Ailed Contact Person Plan Check Balance Title 24 Cala. Plans picked up Construction Flood plain plan Pians resubmitted Mechanical Grading plan 21d Review, ready for correcti e 11/2-3 Electrical Subeontactor List Called Contact Person "l12 Plumbing Grant Deed Plans picked cap SMI. H.O.A- Approval Plans resubmitted- Grading IN HOUSE:- '^' Review, ready for correctionsAssae Developer Impact Pee Planning App val � Called Contact Person A.LP.P. Pub. Wks ppr Date of permit Issue Sch ea LI 'I- Total Permit Fees C5C, Tb WO BD wbf- 56-p-wzur- 013 Cy