Loading...
BELC2018-000778-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT. DEPARTMENT BUILDING PERMIT VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 rtk r: Permit Type/Subtype: ELECTRICAL/ Owner: Application Number: BELC2018-0007 HOLLY MEDBERRY Property Address: 51983 AVENIDA CORTEZ 51983 AVENIDA CORTEZ APN: 773152024 LA QUINTA, CA 92253 Application Description: MEDBERRY / SERVICE CHANGEOUT Property Zoning: Application Valuation: �� n n f'1 Applicant: Contractor: RUDY G REYES LrLJAN..2 2 2018 RUDY G REYES 736 PALM AVENUE 736 PALMAVENUE COACHELLA, CA 92236 TYOFLAQUINTA COACHELLA, CA 92236 DEVELOPMENTDEPARTMENT (760)275-6307 Llc. No.: 496913 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.: 49691 Date'k - � Coi ntra or: 1. OWNER -BUILDER DECLARA ON 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 theapplicant 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 )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 ) 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 Date: 1/22/2018 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjq y 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 ork for which this permit is issued. -i have and will maintain workers' compensation insurance, as required by Se ion 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: EXEMPT 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 agre tha if' should. become subject to the workers' compensation provisions of Seco n 37 0 of th Labor Code, I shall forthwith comply with `those uprovisions. D e: —�• U AppIifivt: ku4 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, ANDATTORNEY'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 ads to laws relating, to building construction, and hereby authorize representatives of his ity to ePon the above- mentioned property for inspection purposes. 1 ) Signature (Applicant or Date: 1/22/2018 . Application Number::.. BELC2018-0007 Owner: Property Address: .51983 AVENIDA CORTEZ HOLLY MEDBERRY APN: 773152024 51983 AVENIDA CORTEZ. Application Description: MEDBERRY / SERVICE CHANGEOUT LA QUINTA, CA 92253 Property Zoning: Application Valuation: Applicant: Contractor: RUDY G REYES RUDY G REYES 736 PALM AVENUE 736 PALM AVENUE COACHELLA, CA 92236 COACHELLA, CA 92236 (760)275-6307 ---------------------=------------------ --- --------=-------- Llc. No.: 496913 Detail: 200A ELECTRICAL --- ------------°--=--------------- SERVICE CHANGE OUT [100A EXISTING] THIS PERMIT DOES NOT INCLUDE RELOCATION OF EQUIPMENT.'2016 CALIFORNIA BUILDING CODES. DESCRIPTION FINANCIAL INFORMATION ACCOUNT QTY AMOUNT SERVICES 101-0000-42403 0 $26.01 DESCRIPTION ACCOUNT QTY AMOUNT SERVICES PC 101-0000-42600 0 $13.00 Total Paid for ELECTRICAL: $39.01 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE .101-0000-42404 0 $98.83 Total Paid for PERMIT ISSUANCE: $98.83 DESCRIPTION ACCOUNT QTY. AMOUNT RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00' TOTALS: r ©§ will d: .�� ... . . . ... ... .... /+ /r PERMIT # F PLAN LOCATION: Project Address:..—� �� . , Conditioned Space SF Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech APN 6C Patio/Porch SF' Email: Applicant Name:,t.�(2 State Lic: `Kt3 City Bus Lic: Address: State Lic: City Bus Lic: City, ST, Zip: Telephone: a U — _ - 66 U ' Email: �q Valuation of Project $ IS Contractor Name: S� ��-- New SFD Construction: Address: Conditioned Space SF City, St, Zip Garage SF. Telephone: Patio/Porch SF' Email: Fire Sprinklers SF State Lic: `Kt3 City Bus Lic: Arch/Eng Name: Construction Type: Occupancy: Address: Grading: City, St, Zip Construction Type: Occupancy: Telephone.. Bedrooms: Stories: # Units: Email: State Lic: City Bus Lic: Property Owner's Name:49�A vU, ain New Commercial / Tenant Improvements: Address: 'r Y Total Building SF City, ST, Zip Ltt��t Construction Type: Occupancy: Telephone: Email: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 OFFICE USE ONLY ' � Submittal Req'd �Rec'd r Plan Sets Structural Calcs ,. Truss Calcs Title 24 Calcs Soils Report Grading Plan (PM 10) Landscape Plan Subcontractor List 'Grant Deed HOA Approval School Fees Burrtec Debris Plan. Planning approval Public Works approval Fire approval City Business License r