BELC2016-001978-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
COVE ELECTRIC INC
77824_ WILDCAT DRIVE
PALM DESERT, CA 92211
Tiat 4 4� Q"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BELC2016-0019
77670 LOS ARBOLES
658260006
KELLEHER/ PANEL CHANGE OUT
$1,600.00
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, C-7 License No.: 397002
Date: ✓" 16 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:).
(_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.).
(_ 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
11111111111.111111111
39
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
DONALD KELLEHER
1543 5TH AVE
SAN RAFAEL, CA 92253
Contractor:
COVE ELECTRIC INC
77824 WILDCAT DRIVE
PALM DESERT, CA 92211
(760)360-0036
Llc. No.: 397002
Date: 3/4/2016
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 o or 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 polity number are:
Carrier: _ Polity 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.1 should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: 7'ZI Applicant;'Id "'..) _w7
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. „ A -
Date: K l Signature (Applicant or Agent): ,�`
FINANCIAL ./.
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: $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
ACCOUNT
QTY
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
• 1 00
Description: KELLEHER/ PANEL CHANGE OUT
FINANCIAL
INFORMATION
Type: ELECTRICAL Subtype:
Status: UNDER REVIEW
Applied: 3/4/2016 SKH
Approved:
Parcel No: 658260006 Site Address: 77670 LOS ARBOLES LA QUINTA,CA 92253
Subdivision: TR 14496-1 & INT IN COMMON AREAS Block:
Lot: 72
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $1,600.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
CA
Details: ELECTRICAL- CHANGE OUT 200 AMP PANEL LIKE FOR LIKE. 2013 CALIFORNIA BUILDING CODES.
info@coveelectric.com
Printed: Friday, March 04, 2016 3:27:06 PM 1 of 2 CR
SYSTEMS
FINANCIAL
INFORMATION
CONTACTS
DESCRIPTION ACCOUNT QTY
AMOUNT
PAID
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP PHONE
FAX EMAIL
APPLICANT
COVE ELECTRIC INC
77824 WILDCAT DRIVE
PALM DESERT
CA
92211
info@coveelectric.com
CONTRACTOR
COVE ELECTRIC INC
77824 WILDCAT DRIVE
PALM DESERT
CA
92211
info@coveelectric.com
OWNER
DONALD KELLEHER
1543 5TH AVE
SAN RAFAEL
CA
92253
Printed: Friday, March 04, 2016 3:27:06 PM 1 of 2 CR
SYSTEMS
FINANCIAL
INFORMATION
DESCRIPTION ACCOUNT QTY
AMOUNT
PAID
PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD
'
BY
BSAS SB1473 FEE 101-0000-20306 0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00
$0.00
BSA:
Printed: Friday, March 04, 2016 3:27:06 PM 1 of 2 CR
SYSTEMS
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY
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
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
BOND INFORMATION
Printed: Friday, March 04, 2016 3:27:06 PM 2 of 2 C
SYS7EIdS
Din#
City of La Quinta
Building 8T Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
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Project Address: j,
Owner's Name:
A. P. Number: -
Address:
Legal Description:
City, ST, Zip:
Contractor:�''-1Gt? Ic A) e .
Telephone:
P
Address: 2
Project Description: ` , (,� CW A-
City, ST, zip: CAI poeper e. y'22l t
, C.ALA2 WSAW)"
Telephone
-76.. onx
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...............................................:..
State Lic. # : QQ 2-
City Lic. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
''
.
ccupancy:Construction Ty e: 1O;7O
a
State Lic. #
Project type one New Add'n Alter Repair Demo
Name of Contact Person6oNnAtO
Sq. Ft.:
# Stories: J
# Units:
Telephone #,of Contact Person:-7-66 .-2 % 4o Z
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance.
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"a Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Dced
Plans picked up
S.M.I.
H.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