BELC2016-00024.
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253`
c&tr 4 Zfv Qalaz
COMMUNITY DEVELOPMENT. DEPARTMENT
BUILDING PERMIT
Application Number:
BELC2016-0002
Property Address:
55121 WINTER HAVEN CT
APN:
767860014
Application Description:
MONTERRA/ WOODBRIDEGE PACIFIC/TEMP POWER
Property Zoning:
Application Valuation:
$1,500.00
Applicant:
S R BRAY LLC DBA POWER
PLUS
1210 N RED GUM STREET
AN AHEiM, CA 92806
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. CSO, D31 License No.: 980589
Date: (`� (tf Contractor: SQ 15
OWNER-8UILDER 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, atter, 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 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
63
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/14/2016.
Owner:
MONTERRA PROP
�-
55075 MONROE ST
)
LA QUINTA, CA 0
�n
Contractor: -"
S R BRAY LLC DBA POWER P US
1210 N RED GUM STREET.
ANAHEIM, C^92806•
(714)507-.1881
Llc. No.: 980589
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
Sedi4l� 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 shall forthwith
comply with those provisions.
Date: Applicant: Sot � G1ti
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 enter upon the
above-mentioned property for inspection purposes.
Date: (4 I` Signature (Applicant or Agent)
. rA
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ACCOUNTyQ PAID PAIDkDATE
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BSAS SB1473 FEE
101-0000-20306
0 $1.00 $0.00
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x ' :fez�PAID BY ' :. y �� Y '
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Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
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AMOUNT
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TEMP POWER SERVICE
101-0000-42403.
0
$24.17
$0:00
PAIDrBY,n
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,P AIDUATE.
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TEMP POWER SERVICE PC
101-0000-42600
0
-$16.92
$0.00
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Total Paid for ELECTRICAL: .$41.09 $0.00
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fm ACCUUNT r
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QTY
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s AMOUNT
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PERMITISSUANCE
101-0000-42404
0
$91.85
$0.00
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CHECKS#'S
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Total Paid for PERMIT ISSUANCE: $91.85 $0.00
Description: MONTERRA / WOODBRIDEGE PACIFIC / TEMP POWER
Type: ELECTRICAL
Subtype: Status: UNDER REVIEW
Applied: 1/14/2016 SKH
Approved:
Parcel No: 767860014 Site Address: 55121 WINTER HAVEN CT LA QUINTA,CA 92253
Subdivision: TR 32742
Block: Lot: 14
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.
ANAHEIM
Details: TEMPORARY POWER POLE. 2013 CALIFORNIA BUILDING CODES.
92806
ADDITIONAL
CHRONOLOGY
CONDITIONS
NAME TYPE
NAME
ADDRESSI
CONTACTS
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
5 R BRAY LLC DBA POWER PLUS
1210 N RED GUM
STREET
ANAHEIM
CA
92806
CONTRACTOR
S R BRAY LLC DBA POWER PLUS
1210 N RED GUM
STREET
ANAHEIM
CA
92806
OWNER
MONTERRA PROP
55075 MONROE ST
LA QUINTA
CA
0
FINANCIAL INFORMATION
Printed: Thursday, January 14, 2016 9:35:04 AM 1 of 2
SYSTEIrfS,
t Permit Details PERMIT NUMBER
` City of La Quinta BELC~2016=0002
•t 9 `'Y' MSI
PARENT PROJECTS
REVIEWS
REVIEW TYPE REVIEWER FS-ENTDATE, DUE DATE RETURNED r STATUS - REMARKS NOTES
DATE
BOND INFORMATION
Printed: Thursday, January 14, 2016 9:35:04 AM 2 of 2
• CRsysrr:Ms
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:
TEMP POWER SERVICE
101-0000-42403
0
$24.17
$0.00
TEMP POWER SERVICE
101-0000-42600
0
$16.92
$0.00
PC
Total Paid for ELECTRICAL: $41.09 $0.00
.PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85. $0.00
TOTALS:•4 $0.00
PARENT PROJECTS
REVIEWS
REVIEW TYPE REVIEWER FS-ENTDATE, DUE DATE RETURNED r STATUS - REMARKS NOTES
DATE
BOND INFORMATION
Printed: Thursday, January 14, 2016 9:35:04 AM 2 of 2
• CRsysrr:Ms
S-450372
Job -- 270571 7ol29/14
(PH. -)
Rental Terms: 6 -Months (LOTS:
Tract: 37242
*>.
I
0
0
55T" AVE & MONROE ST
f 17410'
07?3g won
is
x 30
S
17 22 24
00
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25 G
21
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hm"!* !f u,
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. . . . . . . . .
13 t 26 27 33 34
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t
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my -- — ---—--------------
- — — — — — — — — — — — — — -
4
BUILDING & SAFEI-Y DEPT. ------
APPROVEID
FOR CONSTRUCTION
DATE BY
W001)BRII)GE PACIFIC GROUP. LLC
m(ERMCom)
"LA QUEN LLC�oo
LA QUINTA 05
Bin #
Permit #
Project Address:
City of La Quinto
Buifdin. &r Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application ,and Tracking Sheet
Owner's Name: > Oo(J 0" d PQ L; f i L
A. P. Number:
Address:
Legal Description: ZOO A Te*/\
P ' outi'e_r rv�eAer
City, ST, Zip:
Contractor: 7
S �Xa (✓t
0 u- S
TI hn
e e one:
P
� 1
Address: I a I D ""A l - Ve G1 a n -i s }-
Project Description: 2t� o P m rvu P r -
City, ST, Zip: &Y'r-1-+e ; �V� 1
O} e '�0 ��c c� co, SA r
Telephone: — '{2O
State Lie. # : C1 �d 5S 1)
City Lie. #l..
Arch., Engr., Designer:
Address:.
City, ST, Zip:
Telephone:
aneY
Constructionn Type: Occupancy:
Con
State Lu
ProJec ttYPeci (circle one): New Add'n Alter Repairair Demo
Name of Contact Person:
Ck
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: W o
APPLICANT: DO NOT WRITE BELOW THIS LINE
H
Submittal
Rcq'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan .
2nd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
II.0.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'"! Review, ready for correctionstiissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees,
Total Permit Fees