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BELC2018-0030is 38495.CA1:'L��`I�MPiCA.. ,p LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: ELECTRICAL/ BELC2018-0030 47028 VIA LORCA DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT LAKE LA QUINTA / PEDESTAL CHANGEOUT / 100 AMP $500.00 Applicant: DRIVEN ELECTRIC INC 72078 CORPORATE WAY STE 105 THOUSAND PALMS, CA 92276 oD D vo MAR � Cli'1 Q� �M�.N D�ePRRTM��� A�SIQN �NDp�ELOP 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.: 881356 /�. _�,r Date: EP, Contractor: DrN-" 6 J�7 'C, (YI C. OWNER -BUILDER DECLARATION I I hereby affirm under penalty of perjury that I am exempt from the Contractor's State VOICE (760) 777-7125 . FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/8/2018 Owner: LAKE LA QUINTA 42635 MELANIE PACE STE 103 PALM DESERT, CA -92211 Contractor: DRIVEN ELECTRIC NC 72078 CORPORAT= WAY STE 105 THOUSAND PALM -D, CA 92276 (760)343-3222 Llc. No.: 881356 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of :he following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 :)f the Labor Code, for the performance of th ork 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: STATE COMPENSATION INSURANCE FUIUD Policy Number: 9215852 License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any I certify that in the performance of tLe work for which this permit is issued, I city or county that requires a permit to construct, alter, improve, demolish, or repair shall not employ any person in any manner so a: tobec a subject to the workers' any structure, prior to its issuance, also requires the applicant for the permit to file a compensationlaws of California, and agree tha if I s Id beco subject to the signed statement that he or she is licensed pursuant to the provisions of the workers' compensation provisions of Section of a Labor de, I shall forthwith. Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division comply with those provisions. 3 of the Business and Professions Code) or that he or she is exempt therefrom and the g basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a Date: Applicant permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: WARNING: FAILURE TO SECURE WORKERS' COMPE SATION COVERAGE IS UNLAWFUL, (� I, as owner of the property, or my employees with wages as their sole AND SHALL SUBJECT AN EMPLOYER TO CRIMINR. NALTIES AND CIVIL FINES UP TO compensation, will do the work, and the structure is not intended or offered for sale. ONE HUNDRED THOUSAND DOLLARS ($100,000`. IN ADDITION TO THE COST OF (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not COMPENSATION, DAMAGES AS PROVIDED FOR SV SECTION 3706 OF THE LABOR CODE apply to an owner of property who builds or improves thereon, and who does the work INTEREST, AND ATTORNEY'S FEES. 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.). (__j 1, 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: 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 Cly 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 applicafon becomes null and void if work is not commenced within 180 days from date of is!uance of such permit, or cessation of work for 180 days will subject permit to cancella:ion. I certify that I have read this application and stat:= that the above form ' n is correct. I agree to comply with all city and county ordinances and state w e ng building construction, and hereby authorize representatives of this cit o t the above-mentioned property for inspection purposes. Date: Signature (Applicant of Age Date: 3/8/2018 Application Num6emh-. _fB.EL 018-0030 Owner: Property Address: 47028 VIA LORCA LAKE LA QUINTA APN: 42635 MELANIE PLACE STE 103 Application Description: • LAKE LA CIUINTA/ PEDESTAL CHANGEOUT / 100 AMP PALM DESERT, CA 92211 Property Zoning: Application Valuation: $500.00 Applicant: Contractor: DRIVEN ELECTRIC INC DRIVEN ELECTRIC NC 72078 CORPORATE WAY STE 105 72078 CORPORAT WAY STE 105 THOUSAND PALMS, CA 92276 THOUSAND PALMS, CA 92276 (760)343-3222 Llc. No.: 881356 ---------------------------------------------- ----------------------------------------------- betail: REPLACE EXISTING HOA ELECTRIC METER PEDESTAL. LIKE FOR LIKE-120/240V 100AMP. SERVICING HOA LIGHTING AND IRRIGATION CLOCK ONLY. PER 2016 CALIFORNIA ELECTRICAL CODE. FINANCIAL INFORMATION .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 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: 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 I $5.00 Contractor Name: PERMIT # Q PLAN LOCATION: Project Address:®�D V �A ��{C'� APN #: Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech `� (,� x:1(,1 A (lq [40A 618Cl'i 6 M e�f i City, St, Zip U - Z r Sam Applicant Name: r vGl(�j PP 161 �a � _ � 20 2 D d OD 'erY(u Address: ��©1 Aaly SlelQf HDA 11,E '0r1rl aAlcr\ Clor,1- `Ong City, ST, Zip: ✓ G (�4 vZl State Lic: City Bus Lic: Telephone: Email: Tf7/� C, CDivI' Valuation of Projects r Contractor Name: C New SFD Construction: Address: 72 6)79 6 Q 5 . Conditioned Space SF City, St, Zip U - Z Garage SF Telephone: 7�eD. �/ < 3. 3� Patio/Porch SF Email:-� G� O� Fire Sprinklers SF State Lic: bla135Ce City Bus Lic: State Lic: 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: New Commercial / Tenant Improvements: Address: �A h e5e� `li Uiw* �k0A (R"ps-o_C4. Total Building SF g City, ST, Zip LA J_ 5 il�elonie ` 103 Construction. Type: Occupancy: : 'VAMM QSk(-* CgZS k , E -76D— 3 _ it 78495 CALLE TAMPICO Q LA QUINTA, CA M53 760-777-7000 Goo'' Mips M11, ' r ::Cr r: I � n : m• � -r,lr^. . r.r , i rt ..G '^k"'"T^'S : - ^'rnv. u, I '••^.m•+v ,. .. :-.! ,,, ;' ...,. k ,.:� :!J' 6 a:.., r. -rir.^t,'� , PI?: ! r� .11 '� . .ou,r. r"r. T. r r x1.r �` rxuu, . 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