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BELC2018-009378-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: IE INC 31225 LA BAYA WESTLAKE VILLAGE, CA 91362 c%4�wQ"rw DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT ELECTRICAL/ BELC2018-0093 78511 DEACON DR E 770220013 MRAULE / TESLA CHARGING STATION VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: ROBERT MRAULE 78511 DEACON DR EAST LA QUINTA, CA 92253 Contractor: TROUT ELECTRIC SEP 8 Z018 17843 GLEN HOLLOW WAY RIVERSIDE, CA 92504 CITY OF LA U JINTA (951)743-0702 )i11Ut1";D1LGl1.(il"g DPk1lT h! Llc. No.:933396 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: C10 License No.: 933396 Da • da Contr 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).: () 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 Name: Lender's Address: Date: 9/18/2018 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. C, ft have and will maintain workers' compensation insurance, as required by Sectlon 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: N GUARD INSURANCE COMPANY Policy Number: MAWC936580 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 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 ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application , the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any act or omission related to the work being performed under or Following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building ,onstruction, and hereby authorize representatives of this city to enter upon the above -mentioned property for inspection purposes. 1$ (Applicant or Agent):c Application Number: BELC2018-0093 Property Address: 78511 DEACON DR E APN: 770220013 Application Description: MRAULE / TESLA CHARGING STATION Property Zoning: Application Valuation: Applicant: IE INC 31225 LA BAYA WESTLAKE VILLAGE, CA 91362 Owner: ROBERT MRAULE 78511 DEACON DR EAST LA QUINTA, CA 92253 Contractor: TROUT ELECTRIC 17843 GLEN HOLLOW WAY RIVERSIDE, CA 92504 (951)743-0702 Llc. No.: 933396 Date: 9/i$/20i8 Detail: Electrical Circuit for Vehicle MRAULE / INSTALL (1) 240V 50AMP DEDICATED CIRCUIT AT GARAGE INSTALL (1) 240V 50AMP DEDICATED CIRCUIT AT GARAGE FOR VEHICLE CHARGING. 2016 CALIFORNIA BUILDING CODES. FINANCIAL INFORMATION DESCRIPTION ACCOUNT CITY AMOUNT DEVICES, FIRST 20 101-0000-42403 0 $26.01 DESCRIPTION ACCOUNT CITY AMOUNT DEVICES, FIRST 20 PC 101-0000-42600 0 $26.01 Total Paid for ELECTRICAL: $52.02 DESCRIPTION ACCOUNT CITY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $98.83 Total Paid for PERMIT ISSUANCE: $98.83 DESCRIPTION ACCOUNT CITY AMOUNT RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 DESCRIPTION ACCOUNT CITY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 — GEM nfeb, D@SERT — PERMIT PLAN LOCATION: Project Address: 78511 Deacon Drive East Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech APN #: Install 240 volt 50 amp outlet for Tesla electric vehicle charging station Applicant Name: Steven Schnierer Address: 31225 La Baya Drive Suite 213 City, ST, Zip: Westlake Village, CA 91362 Telephone: 818-735-7876 Email: swschnierer@roadrunner.com Valuation of Project $ 498.00 Contractor Name: Trout Electric New SFD Construction: Address: 17843 Glen Hollow Way Conditioned Space SF City, St, Zip Riverside, CA 92504 Garage SF Telephone: 951-743-0702 Patio/Porch SF Email: Fire Sprinklers SF State Lic:933396 City Bus Lic: Arch/Eng Name: Address: City, St, Zip Telephone: Email: State Lic: City Bus Lic: Property Owner's Name: Robert Mraule Address: 78511 Deacon Drive East City, ST, Zip La Quinta, CA 92253 Telephone: 831-206-8888 Email: Construction Type: Grading: Bedrooms: I Stories New Commercial / Tenant Improvements: Total Building Construction Type: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 Occupancy: # Units: Occupancy: SF OFFICE USE ONLY # f Submittal Req'd Rec'd Plan Sets Structural Calcs 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 -781 ! 4-4 Six& Lijj . 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