BELC2018-003778�95.CALLE TAMPICO VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT FAX (760) 777-7011
FAX
(760) 777-7153
BUILDING PERMIT
Date: ' 3/28/2018
Permit Type/Subtype: ELECTRICAL/ Owner:
Application Number: BELC2018-0037 ERIC AND LINDSEY BENNETT,
Property Address: 51445 CALLE HUENEME 51445 CALLE. HUENEME
APN: 770163022 LA QUINTA, CM 92253
Application Description: BENNETT / KITCHEN ELECTRICAL ry
Property Zoning:
Application Valuation: $1,000.0Di p
Applicant: MAR 2 S ZQ�$ Contractor:
FRANCISCO GONZALES REHOME SOLATIONS INC DBA REHOME REINSULA
4335 E LOWEL ST STE G
CITY OF LA QUINTA ONTARIO, CA 41761
9910N PNP PEVEWPMENT P".. FMENT (888)568-866$
Llc. No.: 100354
LICENSED CONTRACTOR'S DECLARATION
1 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: C-2. B License No.: 100353A � A 1—
Date: :5 -24--1 GJ Contractor: /'" �7 !� /
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).:
(_ _)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.)'.
(1 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 Address:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one 3f 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 tt r o k 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 policy number are:
Carrier: NORGUARD IN COMPANY Policy Number: REWC846140
I certify that in the performance oEthe 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:
WARNING: FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO.CRIMNAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,030). 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 if La Quinta, its officers, agents, and
employees for any act or omission related to tie 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 ordirances 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: /nature (Applicant or Agent):
Date: 3/28/2018
Application Number:
BELC2018-.0037
Owner:
Pro 4 -Address:
51445 CALLE HUENEME
ERIC AND LINDSEY BENNETT
APN:
770163022
51445 CALLE MJENEME
Application Description:
BENNETT / KITCHEN ELECTRICAL .
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$1,000.00
Applicant:
Contractor: `
FRANCISCO GONZALES
REHOME SOLUTIONS INC DBA REHOME REINSULA
4335 E LOWELL ST STE G
ONTARIO, CA 91761
(888)56&8668
---------------------------------------------------------------------------------------------
Llc. No.: 10035.34
Detail: NEW LINE IN FLOOR
FOR ISLAND NEW SWITCH AND [4] CAN LIGHTS AND ]1] PENDANT LIGHT
FINANCIAL INFORMATION
- DESCRIPTION ACCOUNT QTY AMOUNT
BSAS-SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRAT•ON 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 ELEC-TRICAL: $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 MANAGEM-ZNT 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: $166.85
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PERMIT # ELGI+�1 prp
PLAN LOCATION:
?roject Address: J`r� � 5 (1 p� 1t
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Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
CPN #:
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Garage SF.
applicant Name: (15� • tMIL�Z�
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kddress: 3 "I �U �` .i'C�,
.mail:
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elephone:
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Valuation of Project
:ontractor Name:
Construction Type: Occupancy:
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+,ddress:
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Conditioned Space SF
;ity,St, Zip
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Garage SF.
elephone:
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Patio/Porch SF
.mail:
Fire Sprinklers SF
tate Lic:
3� 3 City Bus Lic:
.rch/Eng Name:
Construction Type: Occupancy:
.ddress:
Grading:
ity, St, Zip
ity, ST, Zip(3
elephone:
Bedrooms:
Stories:
# Units:
mail:
i
:ate Lic: City Bus Lic:
roperty Owner's Name:
I ew Commercial / Tenant Improvements:
ddress: S
Total Building SF
ity, ST, Zip(3
Construction Type: OccLpancy:
:lephone:
nail:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000