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BELC2016-001878-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 `&+�t 4 rwQum& COM MUNITY.DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BELC2016-0018 Property Address: 53521 AVENIDA VELASCO APN: 774124026 Application Description: SPRUEILL / CHANGE OUT 200 AMP PANEL Property Zoning: Application Valuation: $2,500.00 Applicant: ELECTRICIAN FOR HIRE INC 68795 VISTA CHINO CATHEDRAL CITY, CA 92234 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.: 900433 Date: 3 l -3111P Contractor: 1�_7 /..Q �-1—r1 /� S,, `f-o_d T7c 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 11, 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.). (_J 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.). (_J I am exempt under Sec. . BAP.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: 38 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/3/2016 Owner: NOELLE SPRUEILL 53521 AVENIDA VELASCO LA QUINTA, CA 92253 Contractor: ELECTRICIAN FO �FF ` 3 Zr)15 68795 VISTA CHI l CATHEDRAL CITY]CAW--23 10E-- - (760)272-6115 Llc. No.: 900433 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 th ork 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 issuedAp ppppnn� compensation insuranc€,ca-mer and olicy number are: Carrier: "S` Number: 4— L' � o oZ�3 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. Dates//& Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSA f 0 AGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES A66 CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3106 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 u on the above-mentioned property for inspection purposes. Date: 3 3 /�O Signature (Applicant or Agen FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT : PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD .. RECEIPT W CHECK # CLTD BY... Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00. DESCRIPTION ACCOUNT QTY AMOUNT.: PAID PAID DATE. SERVICES 101-0000-42403 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNTQTY AMOUNT ' PAID PAID DATE SERVICES PC 101-0000-42600 0 $12.09 $0.00 PAID BY METHOD ` RECEIPT#' : CHECK # 'CLTD BY. Total Paid for ELECTRICAL: $36.26. $0.00 DESCRIPTION ACCOUNT •° QTY AMOUNT PAID PAID DATE' PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 PAID BY METHOD . RECEIPT # CHECK # . CLTD BY Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:0• Description: SPRUEILL / CHANGE OUT 200 AMP PANEL CONDITIONS Type: ELECTRICAL Subtype: Status: UNDER REVIEW Applied: 3/3/2016 SKH Approved: Parcel No: 774124026 Site Address: 53521 AVENIDA VELASCO LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 229 Lot: 2 Issued: UNIT 22 CITY STATE ZIP' Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $2,500.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 [Details' PANEL CHANGE OUT 200 AMP. 2013 CALIFORNIA BUILDING CODE. CHRONOLOGY CONDITIONS • NAME TYPE NAME ADDRESSI CITY STATE ZIP' PHONE FAX EMAIL APPLICANT ELECTRICIAN FOR HIRE INC 68795 VISTA CHINO CATHEDRAL CA 92234 CITY CONTRACTOR ELECTRICIAN FOR HIRE INC 68795 VISTA CHINO CATHEDRAL CA 92234 CITY OWNER NOELLE SPRUEILL 53521 AVENIDA LA QUINTA CA 92253 VELASCO Printed: Thursday, March 03, 2016 10:35:07 AM 1 of 2 SYSTFti1S DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CL BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: SERVICES 101-0000-42403 0 $24.17 $0.00 SERVICES PC 101-0000-42600 0 $12.09 $0.00 Total Paid for ELECTRICAL: $36.26 $0.00 PERMIT ISSUANCE 101-0000-42404 1 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:•• PARENT PROJECTS ATTACHMENTS Printed: Thursday, March 03, 2016 10:35:07 AM 2 of 2 CM sysreMs Din # City of La Quin to Building 8i' Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: _5 Owner's Name: 1 A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: r• \' hone: Telephone: Address., \/ �� . Project Description: City, ST, Zip: �OA, 't2, L X el 1 C Telephone: t0 State Lie. # : COO -14 3 City Lie. #c Arch., Engr., Designer: Address: City., ST, Zip: Telephone: State Lie. #• : ...................... ...... ...... ............. Construction Type: Occupancy: Pa circle one): New Add'o Alter Repair Derno Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: Z jo l� D APPLICANT: DO NOT WRITE BELOW THIS LINE I/ Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. 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. correc tions/iss u e . __ _ _Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. II.O.A. Approval Plans resubmitted -Grading IN HOUSE:- '"! 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