BELC2017-007978-495 CALLE TAMPICO
LA QUINTA','tALIFORNIA'92253 DESIGN & DEVELOPMENT DEPARTMENT
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
BUILDING PERMIT
ELECTRICAL/
BELC2017-0079
50945 CALLE PALOMA
770104003
BROWER / 200AMP PANEL CHANGEOUT
$900.00
Applicant:
DESERT SANDS ELECTRICAL
83-614 MECCA HILLS AVENUE
COACHELLA, CA 92236
PD
SEP 26 217
DESIGN ,lnlf) P;:Vr-L 011MENT OEPARTMENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions Chapter 9
(commencing with Section 7000) of Division 3 of the Business and P.rofessi s Code, and
my License is• in full force and effect.
License Class: C10 License No.: 968972 /r
Date: I L' Contra :S��Ca
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 E
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).:
( 11, 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 Name:
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/26/2017
Owner:
DAVID BROWER
50945 CALLE PALOMA
LA QUINTA, CA 92253
Contractor:
DESERT SANDS ELECTRICAL
83;614 MECCA HILLS AVENUE
COACHELLA, CA 92236
(760)601-8070
Llc. No.: 968972
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 orkers' compensation insurance carrier and policy number are:
Car Policy Number: _
I certify that in the performance of the work for which this permit is issued, 1
s no 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.
Dafen t 1 ,Rppli-c=
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 ab ve-
mentioned propertyfor inspection purposes.
D
IA, 1 7 SignatuFe,(Ap 'canto _en
Ce
Date: 9/26/2017
Application Number: BELC2017-0079
Owner:
Property'Ad'dre"s`s: 50945 CALLE PALOMA
DAVID BROWER
APN: 770104003
50945 CALLE :'ALOMA
Application Description: BROWER / 200AMP PANEL CHANGEOUT
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $900.00
Applicant:
Contractor:
DESERT SANDS ELECTRICAL
DESERT SANCS ELECTRICAL
83-614 MECCA HILLS AVENUE
83-614 MECCA HILLS AVENUE
COACHELLA, CA 92236
COACHELLA,.CA 92236
(760)601-8070
----------------------------------------------------------------------------------------------
Llc. No.: 9689;72
Detail: 200A ELECTRICAL SERVICE CHANGE OUT [200A EXISTING] -THIS PERMIT DOES NOT INCLUDE RELOCATION 0:= EQUIPMENT. 2016 CALIFORNIA
BUILDING CODES.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS S131473 FEE
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SERVICES
101-0000-42403
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SERVICES PC
101-0000-42600
0
$12.67
Total Paid for ELECTRICAL: $38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT HSUANCE: $96.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
Bin#
City of La Quinta
Building & Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
• Building Permit Application and Tracking Sheet
Permit#
Project Address:
0s Name:
A.P. Number `
Address: W''``q . J r
Legal Description:_�
City, ST, Zip ZZ5
Contractor: T SA
Telepho
Address: 6' 46
Project Description:
City, ST, Zip:nO ,SAG �1 I I� CA
Q
-) 2 Zl3.6
Telephone:
State Lica#:9 0 q 1 �
l
City Lie #:
� /� 6 k
Arch, Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type:
Occupancy:
State Lie. #:
Proj. Type
New
Add'n
Alter
Repair
Demo
Name of Contact:
V2
J
SgFt:
#Stories
# Units:
Telephone of Contact: -7
( 0 a,
a
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check Submitted
Item
Amount .
Structural Calcs
Reviewed, ready for corrections
Plan Check Deposit:
Truss Calcs
Called Contact Person
Plan Check Balance:
Title 24 Calcs
Plans Picked Up'
Constriction:
Flood Plain Plan
Plans Resubmitted
Mechanical:
Grading Plan
2nd Rev, Ready for corrections/
Electrical:
Subcontractor List
Called Contact Person
Plumbmg:
Grant Deed
Plans Picked Up
S.M.I.
HOA Approval
Plans Resubmitted
Gradi%
IN-HOUSE
3rd Rev, Ready for corrections /
Developer Impact Fee
Planning Approval
Called Contact•Person
A.I.P.E'.
Pub. Wks. Apps
Date of permit issue
School Fees
Total Permit Fees