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BELC2018-002378=495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Permit Type/Subtype: ELECTRICAL/ Application Number: BELC2018-0023 Property Address: 52521 AVENIDA HERRERA APN: 773293013 Application Description: LEWIS/ADD (2) RECEPTICLES TO KITCHEN AND GARAGE Property Zoning: Application Valuation: $920.00 Applicant: VINTAGE E & 5 INC 49950 JEFFERSON STREET 130-388 FEB 2 ® 2018.JJ INDIO, CA 92201 11 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 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class- CSO C46 License No.: 48 52 Date: Co` ntractor. =— . OWNER-BUILDE LARATION 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).: (1 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 Lender's Address: VOICE (760) 777-7125 FAX (760)777-7011 INSPECTIONS (760) 777-7153 Date: 2/20/2018 Owner: JAY LEWIS 52520 AVENIDA HERRERA LA QUINTA, CA 92253 Contractor: _ VINTAGE E & S INC 49950 JEFFERSON STREET 130-388 INDIO, CA 92201 (760)775-0135 Llc. No.: 481352 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 work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Se n 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: OLD REPUBLIC INSURANCE COMPANY . Policy Number: 57WECZH7563 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 cNe Labor Code, I shall forthwith comply with those provisions. Date: RrQ LI Applicant: 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: tt1 S nature (Applicant or Agent) Date: 2/20/2018 Application Number: BELC2018-0023 Owner: Property Address: 52521 AVENIDA HERRERA JAY LEWIS APN: .773293013 52520 AVENIDA HERRERA Application Description: LEWIS /ADD (2) RECEPTICLES TO KITCHEN AND GARAGE LA QUINTA, CA 92253 Property Zoning: Application Valuation: $920.00 Applicant: Contractor: VINTAGE E & S INC VINTAGE E &.S INC 49950 JEFFERSON STREET 130-388 49950 JEFFERSON STREET 1307388 INDIO, CA 92201 INDIO, CA 92201 (760)775=0135 ------------------------------------------------------------------------------------------------- Llc. No.: 481352 . Detail: ADD (1) GFCI PROTECTED RECEPTICLE FOR GARAGE DOOR OPENER AND (1) FOR REFRIGERATOR AT KITCHEN. THIS PERMIT DOES NOT INCLUDE ANY OTHER WORK. PER 2016 CALIFORNIA ELECTRICAL CODE. FINANCIAL • • DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 • Total Paid for BUILDING. STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 101-0000-42403 0 $26.01 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 PC 101-0000-42600 0 $26.01 Total Paid for ELECTRICAL: $52.02 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 502-000043611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 TOTALS: ♦ PERMIT # -PLAN LOCATION: Project Address: S`ZSZI +,r►t)a Ae CfeiQ Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech APN #:, w (�, �� G� r 1�lrA 30-141k— WEU' Patio/Porch SF Email: Applicant Name: ^ 1'�2. l 9� �. �� U P W►� 41' Address: City, ST, Zip: Ir1C17.Z;4 1 Telephone: �� ,�15. •� l3S Email: Jp,.,�,`•L V ,�p�>�� r 1 C• V S Valuation of Project S �•� Contractor Name: g� � �- '� �� New SFD Construction: Address: SWva' k . Q"vim Conditioned Space SF City, St, Zip Garage SF Telephone: Patio/Porch SF Email: a Fire Sprinklers SF State Lie: LJS'Z, City Bus Lie: Arch/Eng Name: Construction Type: Occupancy: Address: Grading: City, St, Zip Construction Type: Occupancy: Telephone: Bedrooms: Stories: # Units: Email: State Lie: City'Bus Lie: Property Owner's Name: ,�(��s . New Commercial / Tenant Improvements: Address: Total Building. SF . City, ST, Zip Construction Type: Occupancy: Telephone: Email: 78495 CALLE TAM PICO LA QUINTA, CA 92253 760-777-7000 ' Submittal. Reqd Ree'd Plan Sets, f Structural Calcs 4 Truss Calcs Title 24 Calcs Soils Report Grading Plan (PM10) Landscape Plan Subcontractor List Grant Deed HOA Approval School Fees. -Burrtec Debris Plan Planning approval . Public Works approval Fire approval City Business License