BELC2019-001378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
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DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: ELECTRICAL/
Application Number: BELC2019-0013
Property Address: 53360 AVENIDA VILLA
APN: 774094006
Application Description: HAERTEL/ PANEL UPGRADE
Property Zoning:
Application Valuation:
Applicant:
ASTRO ELECTRIC
78667 TORINO DR
LA QUINTA, CA 92253
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
ELISABETH HAERTEL
71872 ELEANORA LN
RANCHO MIRAGE, CA 92253
,/�� U Contractor:
ASTRO ELECTRIC
JAN 2 9 2019 78667 TORINO DR
LA QUINTA, CA 92253
CITY OF LAQUINTA (760)641-4817
DESIGN & DEVELOPMENT DEPARTMENT Llc. No.: 997335
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: B. C10 License No.: 997331
}r
• Cantractor:
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: 1/29/2019
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'
co*tian3
n, as provided for by Section 37DO of the Labor Code, for the performance
ofor which this permit is issued.
ave and will maintain workers' compensatlon Insurance, as required by
Se of the La bar Code, for the performance of the work for which this permit is
issued. My workers' compensatian insurance carrier and policy number are:
Carrier: NORGG ARD INi 5 1RL ARCE COMPANY Policy Number: G EWC906774
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 t t, if I should become subject to the
workers' compensation provisions of Section 00 of the Labor Code, I shall forthwith
comply with thhoyse prroovis€ons.
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1_ / `7 6dYiF L` J[
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 appl[cat Ion 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 war 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 stag laws relating to building
-onstruction, and hereby authorize representatives of this ci to enter upon the above -
mentioned property for inspection purposes.
]ate: / ^ 2� ! 6 Signature (Applicant
Date: ' �1/29/2019
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
ASTRO ELECTRIC
78667 TORINO DR
LA QUINTA, CA 92253
BELC2019-0013
53360 AVENIDA VILLA
774094006
HAERTEL/PANEL UPGRADE
Owner:
ELISABETH HAERTEL
71872 ELEANORA LN
RANCHO MIRAGE, CA 92253
Contractor:
ASTRO ELECTRIC
78667 TORINO DR
LA QUINTA, CA 92253
(760)641-4817
Llc. No.: 997335
------------------------------------------------------ -------- --------------•------------------
Detail: UPGRADE EXISTING 100AMP PANELTO A 200 AMP PANEL. RELOCATION &S Q� INCLUDE❑ IN PERMIT. PER 2016 CALIFORNIA ELECTRICAL CODES.
i, , "; I
ACCOUNT CITY
AMOUNT
DESCRIPTION
0
$26.68
101-0000-42403
SERVICES
ACCOUNT CITY
AMOUNT
DESCRIPTION
0
$13.34
101-0000-42600
SERVICES PC
Total Paid for ELECTRICAL:
$40.02
ACCOUNT CITY
AMOUNT
DESCRIPTION
0
$101.40
101-0000-42404
PERMIT ISSUANCE
Total Paid for PERMIT ISSUANCE:
$101.40
ACCOUNT QTY
AMOUNT
DESCRIPTION
0
$10.00
RECORDS MANAGEMENT FEE
101-0000-42416
Total Paid for RECORDS MANAGEMENT FEE:
$10.00
ACCOUNT CITY
AMOUNT
DESCRIPTION
17:
0
$5.00
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
$5.00
ta PERMIT #
PLAN LOCATION:
Project Address: - Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
7Z LA
APN #: `j e
oR I la -A Y_ I rVrTJMA
Applicant Name:
Address: 7%
City, ST, Zip:
Telephone:
Email: _
e
Valuation of Project $
Contractor Name: �� ? New SFD Construction:
!L
Address: G6,7 Rq �� ` Conditioned Space _ SF
City, St, Zip Al. Garage SF
Telephone: ILO 1 Patio/Porch SF
Email: G Fire Sprinklers SF
!� v+ C EQS . C ��.
State Lic: c:;;;o n -> City Bus Lic:
Arch/Eng Name: Construction Type: Occupancy:
■C �rC�
Address: Grading:
City, St, Zip
Telephone: Bedrooms: Stories: / # Units: 1
Email:
State Lic: City Bus Lic:
Property Owner's Name:.�r��3�3a
Address: S3.3 v
City, ST, Zip J.1 7.,
Telephone:
Email:
4CA New Commercial / Tenant Improvements:
Total Building _ SF
Construction Type: Occupancy:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY