BELC2017-0100r
78-495 CALLE TAMPICO
LA'QUINTA;'CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: ELECTRICAL/
Application Number: BELC2017-0100
Property Address: 51855 AVENIDA MORALES
APN: 773151005
Application Description: DIXON /METER RELOCATION AND UNDERGROUD SERVICE
Property Zoning:
Application Valuation: $3,500.00 ®
Applicant: \1
FRANK CABALLERO CASTILLO NOV 1 rf 2017
PO BOX 1139
INDIO, CA 92202
CITY OF LA QUINTA
DESIGN AND DEVELOPMENDEPARTMENT
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.: 101712
OWNER -BUILDER DECLA TION
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 fora 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.).
U 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:
VOICE (760)777-7125
FAX (760)777-7011
INSPECTIONS (760) 777-7153
Date: 11/17/2017
Owner:
DIXON, LEO
51855 AVENIDA MORALES
LA QUINTA, CA 92253
Contractor:
FRANK CABALLERO CASTILLO
PO BOX 1139 -
INDIO, CA 92202
(760)899-8644
Llc. No.: 1017128
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 work 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 insurancecarrier and policy number are:
Carrier: EXEMPT Polity Number:
(F!�: 71 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 of the Labor Code, I shall forthwith
comply with those provisions.
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 tiny act or omission related to the work being performedunder 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.
1 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:- --I:�'Signature.(ApplicantorAgent):"'
I
Date: 11/17/2017
Application Number:
BELC2017-0100
Owner:
Property Address ''
'x`5155 AVENIDA MORALES
DIXON, LEO
APN:
773151005
51855 AVENIDA MORALES
Application Description:
DIXON / METER RELOCATION AND UNDERGROUD SERVICE
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$3,500.00
Applicant:
Contractor:
FRANK CABALLERO CASTILLO
FRANK CABALLERO CASTILLO
PO BOX 1139
PO BOX 1139
INDIO, CA 92202
INDIO, CA 92202'
(760)899-8644
Llc. No.: 1017128
Detail: CHANGE OVERHEAD SERVICE TO UNDERGROUND SERVICE. PERMIT INCLUDES RELOACTION OF MAIN PANEL. PER 2016 CALIFORNIA BUILDING
CODES.
I
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT. CITY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
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
ACCOUNT
CITY
AMOUNT
101-0000-42404
0
$98.83
Total Paid for PERMIT ISSUANCE: .$98.83
$10.00
•AMOUNT
Total Paid for RECORDS. MANAGEMENT FEE. $10.00
ACCOUNT
CITY
AMOUNT
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS:
DESCRIPTION
ACCOUNT
CITY
RECORDS- MANAGEMENT FEE
101-0000-42416
0
$10.00
DESCRIPTION
TECHNOLOGY ENHANCEMENT FEE
-- -'---- . - --- P E R M IT 14 �� L G 9,ol 7 - D 100
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Project Address: Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN
Address:�p GJ o/ r 3
Conditioned Space SF
City, St, Zip b! a a0
Applicant Name: rrrat'k- e&1col//ef�/
Telephone: 6d ��/ IgG Yy
Address: �� 1
Email:Fire
e l« `, A -r .c
City, ST, Zip: i -
State Lic: •�dl iag City Bus Lic:
Telephone: < 6
;tate Lic: City Bus Lic:
Email:t- / 41
jLr� `- e(eC r1G�(ILe- C��
Valuation of Project S
Contractor Name: lCra4, �� (UO
New SFD Construction:
Address:�p GJ o/ r 3
Conditioned Space SF
City, St, Zip b! a a0
Garage _ SF
Telephone: 6d ��/ IgG Yy
Patio/Porch SF
Email:Fire
e l« `, A -r .c
Sprinklers SF
State Lic: •�dl iag City Bus Lic:
,krch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
-ity, St, Zip
Construction Type: Occupancy: .
Telephone:
Bedrooms:
Stories:
# Units:
-nail:
;tate Lic: City Bus Lic:
'roperty Owner's Name: LSD b %x aw
New Commercial /Tenant Improv.emcnts:
address: j 5 /'A -P r� l�
Total Building SF
:ity, ST, Zip . �6, Qv.� a7 3
Construction Type: Occupancy: .
elephone:
mail:
\
78495 CALLE TAM PICO.
.LA QUINTA, CA 92.253
760-777-7000
L� � -