BSPN2017-005278-495'XALLE_T.AM,P1CO D
LA QUINTA, CALITDRNI'A`92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: SPECIAL INSPECTION/
Application Number: BSPN2017-0052
Property Address: 79940 CEDAR CREST
APN: 762051004
Application Description: GOODMAN / IID/ MAIN BREAKER CHANGEOUT
Property Zoning:
Application Valuation: $250.00
Applicant: Q
DESERT ELITE ELECTRIC D
P 0 BOX 2513
PALM DESERT, CA 92260 DEC 0 7 2017
CITY OF LA QUINTA
DESIGN AND DEVELOPMENT DEPARTMENT
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.:1000013
Date7IZ 7 ' c[or: __0
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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).:
(_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 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
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/7/2017
Owner:
CHARLENE GOODMAN
79940 CEDAR C=REST .
LA QUINTA, CA 92253
Contractor:
DESERT ELITE KLECTRIC
P 0 BOX 2513 -
PALM DESERT, CA 92260
(760)636-1128
Llc. No.: 1000013
WORKER'S COMPENSATION DECLARATION f
I hereby'affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certifica:e of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the performance
of _ rrkk 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 polity number are:
Carrier: NORGUARD INSURANCE COMPANY ' Polity Number: DAWC771512
-I certify that in the performance ofithe work for which this permit is issued, 1
shall not employ any person in any manner sc as to become subject to the workers'
compensation laws of California, and agreet8at, if I should become subject the
workers' compensation provisions of Section 3700 of the La r ode, i sh fo with
comply with those provisions.
Date:` I Zp7pl ca.
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 tie Building Official for a permit subject to
the conditions and restrictions set forth on th6 application.
1. Each person upon whose behalf this applkation 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.3f La Quinta, its officers, agents, and
employees for any act or omission related to Lne 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 allcity and county ordirances and state laws relating tobui n
construction, and hereby authorize representatives of this city to ent,on.
on the ov
mentioned pr perty for inspection purposes.
Date: 7 Z�I / Signature (Applicant ar Agent):
Date: 12/7/2017
Application Number:
BSPN2017-0052
Owner:
Property ss -l--' `'79940.
X1i]dre
CEDAR CREST
CHARLENE GCODMAN
APN:
762051004
79940 CEDAR REST
Application Description:
GOODMAN / IID/ MAIN BREAKER CHANGEOUT
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$250.00
Applicant:
Contractor:
" DESERT ELITE ELECTRIC
DESERT ELITE =LECTRIC
POBOX2513
P0BOX 2513
"PALM DESERT, CA 92260
PALM DESERT, CA 92260
(760)636-1125
---------------------------------------------------------------------------------------
Llc. No.: "1000013
Detail: SPECIAL INSPECTION FOR (1) MAIN BREAKER CHANGEOUT. PER 2016 CALIFORNIA ELECTRICAL CODE
CRIPTION
FINANCIAL INFORMATION
ACCOUNT CITY
AMOUNT
SPECIAL INSPECTION
101-0000-42404 0
$78.02
Total Paid for COMPLIANCE SURVEY/SPECIAL INSPECTION:
$78.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
TOTALS:
$5.00
GEM ,;f,l– or.T:K.V — -
PERMIT #
PLAN LOCATION:
Project Address: CIA('I
V
Project Description: Pool, Remodel,-Add't, Elect, Plumb, Mech
APN #:
Conditioned Space SF
City; St, Zi.Garage
� a.a
Applicant Name:
rX
Telephone:?
lb WAI W,(- r ss -c+ VK4
Address: S
Get (`wut Y, 10A -
City, ST, Zip;
6A, 2
f1
Telephon :.� _r�
State Lic:
Email: �n
kttGc�l%,
Valuation of Project $I/� v
M
Contractor Name: �� r,,1
' ` L
New SFD Construction:
Address:
V
City, ST, Zip J.. 0
Telephone:
Conditioned Space SF
City; St, Zi.Garage
� a.a
Email:
SF
Telephone:?
( 2 (�
Patio/Porch SF
Email:
Fire Sprinklers SF
State Lic:
City Bus Lic:
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
City, ST, Zip J.. 0
Telephone:
Bedrooms:
Stories:
# Units:
Email:
State Lic: City Bus Lic:
°
Property Owner's Name:AIA
New Commercial / Tenant Improvements:
Address: _
Total Building SF
City, ST, Zip J.. 0
Construction Type: Occupancy:
Telephone _
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
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` ' Submittali ;
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Plan Sets
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r y
Structural Calcs
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Truss Calcs
Title 24 Calcs
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Soils Report
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Grading Plan (PM 10)
Landscape Plan
Subcontractor List
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Grant Deed
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HOA Approval
3 �
School Fees
Burrtec Debris Plan
Planning approval
1
Public Works approval
Fire approval
City Business License
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