BELC2016-0028Ci0 V 4 Qalarcu VOICE (760) 777-7125
44
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/22/2016
Application Number:
BELC2016-0028
Owner:
Property Address:
45120 SUNBERRY CT CT
ERIC CHAROS
APN:
604412009
45120 SUNBERRY CT
Application Description:
CHAROS / ELECTRICAL PANEL UPGRADE
LA QUINTA, CA 92253
r7
Property Zoning:
Application Valuation:
$2,000.00
<=
>i
Applicant:
Contractor:
MARK NELSON BUILDERS
MARK NELSON BUILDERS
_ ["
13570 ST MARYS AVENUE
13570 ST MARYS AVENUEf
``
RED BLUFF, CA 96080
RED BLUFF, CA -96080
530 200-5581
( )
Llc. No.: 815898
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, C-8. D49 License No.: 58 8
Date: �r Contractor: G
4
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, after, 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 70315 by any applicant for a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
(__J 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 bne 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
Lender's
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 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 performance of the work for which this permit
is issued. My workers' compensation insurance. carrier and policy number are:
Carrie r:� 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 La or Code, I shall forthwith
comply with those provisions.
Date: ✓ � pplican, C L
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?Anter uponifie
above-mentioned property for inspection purposes.
Date: J 5 gnature (Applicant or Agent):
P'.,
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DESCRIPTION �
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BSAS SB1473 FEE
101-0000-20306 _ 0 $1.00 $1.00 3/22/16
PAID. BY r�
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7.NEI WE, ���; `
METHOD � =�" v CHECK:#j'— CLTDBYk
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ONETIME CONSTRUCTION INC.
CHECK MR282 6130 SKH
Total,Paid for BUILDING ,STANDARDS ADMINISTRATION. BSA: $1.00'
DESCRIP}TIONt am
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QTY
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SERVICES
101-0000-42403
0
$24.17
$24.17
3/22/16
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TIME CONSTRUCTION INC.
CHECK
MR282 , •
6130
SKH
SONE
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PAID DATE
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'4{'1Ri*r,-, .,-?•<2E fx..s,., aTY :S ,.:f`.i'Mr �C ..c�';'t.59<...x.`.R
SERVICES PC
101-000042600
0
$12.09
$12:09
3/22/16.
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ONE TIME CONSTRUCTION INC.
CHECK . •
MR282
6130 . ,
SKH
Total Paid for ELECTRICAL: $36.26' $36.26 .
.T :
£
fC3-.4 *a>.:.3'
ACCOUNT'
QTY
+'ES'u€' ,Y
s €
;s��.'.sia.. $ 5aT..I i�z' ,,:N . i x
4>cPAID:
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DATE
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PERMIT ISSUANCE
101-0000-42404
0
$91.85 -
$91:85
3/22/16
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-RECEIPT#r`CHECK:iiaCLSY4
ONE TIME CONSTRUCTION INC.
CHECK
MR282
6130
SKH
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
o
J
l
Description: CHAROS / ELECTRICAL PANEL UPGRADE
CONDITIONS
Type: ELECTRICAL
Subtype:
Status: APPROVED
Applied: 3/22/2016 SKH
Approved: 3/22/2016 SKH
Parcel No: 604412009 Site Address: 45120 SUNBERRY CT CT LA QUINTA,CA 92253
Subdivision: TR 23995-4
. Block:
Lot: 18
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $2,000.00
Occupancy Type:
Construction Type:
Expired:
No. Buildings:.0
No. Stories: 0
No. Unites: 0
RED BLUFF
Details: ELECTRICAL PANEL UPGRADE TO 200 AMP. 2013 CALIFORNIA BUILDING CODE.
96080
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
MARK NELSON BUILDERS
13570 ST MARYS
AVENUE
RED BLUFF
CA
96080
CONTRACTOR
MARK NELSON BUILDERS
13570 ST MARYS
AVENUE
RED BLUFF
CA
96080
OWNER
ERIC CHARDS
45120 SUNBERRY CT
LA QUINTA
CA
92253
FINANCIAL INFORMATION
Printed: Tuesday, March 22, 2016 1:42:19 PM 1 of 2 CN?
SYSTEMS
INSPECTIONS
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Tuesday, March 22, 2016 1:42:19 PM 2 of 2 C
SYSTEiMS
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
3/22/16
MR282
6130
CHECK
ONETIME
CONSTRUCTION INC.
SKH
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $1.00
BSA:
SERVICES
101-0000-42403
0
$24.17
$24.17
3/22/16
MR282
6130
CHECK
ONETIME
SKH
CONSTRUCTION INC.
SERVICES PC.
101-0000-42600
0
$12.09
$12.09
3/22/16
MR282
6130
CHECK
ONETIME
SKH
CONSTRUCTION INC.
Total Paid for ELECTRICAL: $36.26 $36.26
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
3/22/16
MR282
6130
CHECK
ONE TIME
SKH
CONSTRUCTION INC.
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
TOTALS,
INSPECTIONS
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Tuesday, March 22, 2016 1:42:19 PM 2 of 2 C
SYSTEiMS
"'"
Permit #I78-495
�(p
City of La Q uin to
Building ez Safety Division
Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: pZ.(�
6 �'
Owner's Name:.
A. P. Number:_
.
Address:
Legal TXcription:
City, ST, Zip: / 4
C� LL r n/�� �" t �
Contractor: 4�LOf
/�,Ce�
�•� .tgcu ens'
.,
�ctci�hoy:
.: sN .
r:��;ia :
Address: 57 S/ 3i•G1 S /�—!/�
// L�<
ProjectDescription: e/(e
City, ST, Zip:�l
%� � �
G4 lod�b
_ _
6-r`r-� -e O baa ,q�
Telephone. d -M
'r ras`s
State Lic. # : / ��
City Lie. #;
Arch., Engr., Designer:
Address:
_
City, ST, Zip:
Telephone:
p
.<.< ...,. ,.
h
s , :� .�� �
�.. ..«�.
Construction Type: Occupancy,.
project type (circle one): New Add'n Alter Repair Demo
State Lie. #:
Name of Contact Person: -
Sq. Ft.;
# Stories,:
# Units:
Telephone # of Contact Person:
Estimated Value of Project-b�
APPLICANT: DO NOT WRITE BELOW THIS LINE
f/
Submittal
Rcq'd
Recd
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
f
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"Q Review, ready for corrections/issue
Electrical
Subcorttactor hist
Called Contact Person
Plumbing
Grant Deed
Plans picked up =
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN MOUSE:-
'•'. Repiew, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P. .
Pub, Wks. Appr
Date of permit issue
Total Permit lees
EM