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BELC2015-009978-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4tit . 4 4 Qulhto COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BELC2015-0099 Property Address: 44155 VILLETA DR APN: 604143010 Application Description: CROSBY/ UPGRADE 125 AMP PANEL TO 200 AMP Property Zoning: CANADA V7V, A8 92253' Application Valuation: $1,500.00 Applicant: HILL ELECTRIC INCORPORATED 42335 WASHINGTON STREET F 405 PALM DESERT, CA 92211 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.: 717777 Date: I 1 —5-�—' 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).: ( ) 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.). (� 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 Name: Lender's Address: 11111111111111111111 49 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/5/2015 Owner: CHRISTIAN CROSBY WEST VANCOUVER BC CANADA V7V, A8 92253' Contractor: €ra HILL ELECTRIC INCORPORATED h 42335 WASHINGTONSTREET PALM DESERT, CA 92211 erl (760)772-1770 Llc. No.: 717777 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 or or which this permit is issued. 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 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 hall forthwith comply with those provisions. Date: Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERA E 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. t n I121 Date: I L— ZI7Signature (Applicant orAgeiStjCD'��"1 FINANCIAL INFORMATION DESCRIPTION :. ACCOUNT QTY AMOUNT. PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: suo $0.00 DESCRIPTION ACCOUNT QTY AMOUNT; PAID PAID DATE OTHER ELECTRICAL EQUIPMENT 101-0000-42403 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK #• CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE OTHER ELECTRICAL EQUIPMENT PC 101-0000-42600 0 $24.17 $0.00 PAID BY = METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL: $48.34 $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: CROSBY / UPGRADE 125 AMP PANEL TO 200 AMP CONDITIONS Type: ELECTRICAL Subtype: Status: UNDER REVIEW Applied: 11/5/2015 SKH Approved: Parcel No: 604143010 Site Address: 44155 VILLETA DR LA QUINTA,CA 92253 Subdivision: TR 23269 Block: Lot: 195 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $1,500.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 92211 Details: UPGRADE ELECTICAL PANEL- EXISTING 125AMP TO 200AMP. 2013 CALIFORNIA BUILDING CODES. CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT HILL ELECTRIC INCORPORATED 42335 WASHINGTON PALM DESERT CA 92211 STREET F 405 CONTRACTOR HILL ELECTRIC INCORPORATED 42335 WASHINGTON PALM DESERT CA 92211 STREET F 405 . OWNER CHRISTIAN CROSBY WEST VANCOUVER BC CANADA V7V A8 92253 Printed: Thursday, November 05, 2015 1:21:39 PM 1 of 2 CN? SYS7LAAS BOND REVIEWS REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS DATE NOTES ' - ATTACHMENTS CLTD DESCRIPTION ACCOUNT QTY ] AMOUNT. PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: OTHER.ELECTRICAL 101-0000-42403 0 $24.17 $0.00 EQUIPMENT OTHER ELECTRICAL 101-0000-42600 0 $24.17 $0.00 EQUIPMENT PC Total Paid for ELECTRICAL: $48.34 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:•• BOND REVIEWS REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS DATE NOTES ' BOND INFORMATION ATTACHMENTS Printed: Thursday, November 05, 2015 1:21:39 PM 2 of 2 rp , , , SYSTEMS Bin # City of La Quinta Building &r Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: y.L �- 1 Owner's Name: G Y J- A. P. Number: Address: L L_ V e V Legal Description: City, ST, Zip: La ZZ 5 � ContraCt r � c Telephone—S 15 Address: L�2 r S S �'� F r ct Description: �, City, ST, Zip: �- 221,1 r O ^� T on e: ele h P T-7 ...............:.....................:............:::. Imo, 1(2 ctJ . State Lic. # : `7 City Lic. #•: Arch., Engr., Designer: Address: City., ST, Zip: one: Telephone: h . an• Con tru tion Type: Occupancy: cY State L ic. #•- Project type one): New Add'n Alter Repair Demo Name of Contact Person: �' g..�.... Sq. Ft.: # t ries: # Units: Telephone # of Contact Person: -- V Estimated Value of Proi C APPLICANT: DO NOT WRITE BELOW THIS LINE W Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrections/issue 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