BELC2019-003578-495 CALLE TAMPICO, VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/27/2019
Permit Type/Subtype: ELECTRICAL/ Owner:
Application Number: BELC2019-0035 EAST OF MADISON
Property Address: 81259 COLUMBUS WY P 0 BOX 1482
APN: 767670035 LA QUINTA, CA 0
Application Description: SUTTON / 100 TEMPORARY POWER SERVICE
Property Zoning:
Application Valuation:
Applicant: Contractor:
DANIELSUTTON D DBRADSHAW CONSTRUCTION INC
81335 THUNDER GULCH WAY 2U19 81335 THUNDER GULCH WAY
LA QUINTA, CA 92253 MAR 2 7 LA QUINTA, CA 92253
CITY OF LAQUINTA (760)347-4246
DESIGN & DEVELOPMENT DEPARTMENT LIc. No.: 848057
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; R License No.: 848057
514 Co%ractor: _
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:
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
ofWforwhich this permit is issued.
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: ST�PENSATIDN INSURANCE FIEND Policy Number: 9245081
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 37 e Labor Code, hall forthwith
comply with those provisions,
�y�,��,�
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 ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is correct.
I hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all city and county ordinances and state laws relating to building
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives of this cit en er upan th
above -meet ned property for inspection purposes.
Lender's Name:
e: ere (Applicant or Agent)
Lender's Address:
Date: 3/27/2019
Application Number: BELC2019-0035
Property Address: 81259 COLUMBUS WY
APN: 767670035
Application Description: SUTTON / 100 TEMPORARY POWER SERVICE
Property Zoning:
Application Valuation:
Applicant:
DANIELSUTTON
81335 THUNDER GULCH WAY
LA QUINTA, CA 92253
Detail: 100A TEMPORARY ELECTRICAL SERVICE. 2016 CALIFORNIA BUILDING COk3�$. '�1. 7: "
Owner:
EAST OF MADISON
P 0 BOX 1482
LA QUINTA, CA 0
Contractor:
BRADSHAW CONSTRUCTION INC
81335 THUNDER GULCH WAY
LA QUINTA, CA 92253
(760)347-4246
Llc, No.: 848057
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT CITY AMOUNT
Credit Card Fee
101-0000-43505 0 $2.91
Total Paid for Credit Card Fee: $2.91
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TEMP POWER SERVICE
101-0000-42403
0
$26.68
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TEMP POWER SERVICE PC
101-0000-42600
0
$18.68
Total Paid for ELECTRICAL: $45.36
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$101.40
Total Paid for PERMIT ISSUANCE: $101.40
DESCRIPTION
ACCOUNT
CITY 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: $5.00
TOTALS:
CALIFORNIA
PERMIT # �C`C20 l — DO3S
qtaQw1fra
PLAN LOCATION:
Project Address: — s9 �Q(uv►•l�us ulcc
Project Description:
APN #:
Applicant Name: �� <��JAb v�
Address: r,JCtN
City, ST, Zip:
Telephone:
Email: i
Valuation of Project $
Contractor Name:C �' �`,
New SFD Construction:
Address:
1 �u her u
Conditioned Space SF
City, St, Zip u
Garage SF
Telephone: �� � �� (� c�
Patio/Porch SF
Email:RC
^ Fire Sprinklers SF
State Lic: 246257 City Bus Lic:
Architect/Engineer Name:
Construction Occupancy:
Address:
Grading:
City, St, Zip
Telephone:
Bedrooms: Stories:
# Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name:
New Commercial / Tenant Improvements:
Address:
Total Building SF
City, ST, Zip
Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
#
Submittal
Required
Received
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
Lcj--t � S 1,
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CITY OF LA QUINTA
BUILDING 8, SAFETY DEPT.
APPROVED
FOR APPROVED
DATDmo- BY
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wwvvJid,com
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UNDERGROUND INSPECTION SERVICES
Customer Project Development
Coachella Valley Office Phone: 760-398-5828
81600 Avenue 58 Fax: 760-391-5999
La Quinta, CA 92253 LQUGlnspections@iid.com
TO SCHEDULE AN INSPECTION, CALL 760-398-5828.
Please leave the following information:
1. Your name.
2. Phone number / best way for us to contact you.
3. Customer service proposal (CSP) number.
4. Service order number.
5. Type of inspection(s). Please choose from the following required inspection types and
note all that apply:
a. Trench and Conduit
b. Encasements
c. Cad Welds
d. Pads / Vaults
e. Carson Boxes
f. Shade-Backfilled
g. Buried Electrical Line
h. Tape
PLEASE CALL FOR INSPECTIONS DAILY FOR THE DURATION OF
THE PROJECT OR UNTIL NEEDED.
All underground inspections need to be verified and approved by an IID inspector. Any work not
verified by an III) inspector, will need to be re -done. Please do not bury anything unless you
have received approval by IID. Failure to do so, may cause delays to your project and/or the
re -digging of trench work.
IID inspectors are required to give you an inspection receipt. If you do not receive one please
ask your inspector for one, or call 760-398-5828 prior to moving forward with the project.
1,M'f)ERIAL IRRlra ?E0i, DIS ('RiC r . 81-6010 AVM NIJE: ` 8 . LA QIJIN IA, CA 92 2.5
EXISTING ENERGIZED
UNDERGROUND CABLE.
UN1162203P
100-80
CUST IN: 2" CND SCH. 40 PVC (1
IID IN: 1 /0 AL. TPX XLP CA.
1201240V 10 (20) _
m
raw
IDCOLUMBUS WAY
T
2TEM
8B
UN1162204P
CAUTION,
EXISTING ENERGIZED
UNDERGROUND CABLE.
m
108 11
CONDUIT NOTES:
1) INSTALL 1-2"CND.R-R PER SHOWN LENGTH FOR SERVICE.
(REFER TO SHEETS 10-11,104-105, 107-110, 112-115 OF THE D.E.P.G. REV. 4.8 2018)
2) � TYPICAL TRENCH DETAIL FOR ALL SERVICES AND SECONDARY RUNS.
(REFER TO SHEETS 109 & 115 OF THE D.E.P,G. REV, 4.8 2018)
TRENCHING NOTES:
1ID
TYPICAL. CONTRACTOR SHALL INSTALL 2" LINE GUARD TAPE (RED)
"CAUTION: BURIED ELECTRIC LINE BELOW."
0
(REFER TO SHEET 115 OF THE D.E.P,G. REV. 4.8 2018)
T•7, R.6,SEC.1
CONTRACTOR NOTES / IID ELECTRICAL LAYOUT SCALE 1:100_
❑ DISTRIBUTION �1 [;tf570tvfCF;
[] POWER DOCK
In,t.�
„ y ❑ INSPECTOR ® DIVISION MANAGER
«:.axcpaei
METR SHOP
(IrAP ucAMX)
11D ❑ TROUBLE SHOOTER ❑ GIS UNIT
PROJECT LOCATION:
��:.• 81259 COLUMBUS WAY LA QUINTA, CA 92253
CAUTION: ENERGIZED STRUCTURES & CABLE
DO NOT PERFORM ANY TYPE OF WORK ON OR AROUND
ENERGIZED STRUCTURES. A QUALIFIED IID ELECTRICAL
WORKER MUST BE PRESENT AT JOB SITE BEFORE ANY
CONDUIT OR ANY TYPE OF WORK IS PERFORMED,
PLEASE CONTACT IID INSPECTION DESK AT
LA QUINTA @:(760) 398-5828 ; IMPERIAL @:(760) 482-3300.
INSPECTION SCHEDULES ARE SUBJECT TO A MINIMUM
48 HOUR ADVANCE NOTICE AND ARE 13Y APPOINTMENT
ONLY.
UNDERGROUND SERVICE ALERT
1-800-422-4133
CALL
CALL USA/SCISC
FOR UNDERGROUND LOCATING
2 WORKING DAYS BEFORE YOU DIG
PG#j DATE I BY [ DESCRIPTION
MAT. RES:16144281
DIG ALERT TICKET: NIA
EFFECTIVE DATE: NIA EXPIRATION DATE:Nl
CUSTOMER NAME:KELLY BRADSHAW
CONTACT NUMBER:760-347-4246
'ROJECT COORDINATOR:IVAN LOPEZ
CONTACT NUMBER:760.427-7409
SUBSTATION: JEFFERSON CIRCUIT: N170
SERVICE NOTIFICATION; 4026819 V
SERVICE ORDER: 60117922 a
'RIORIT{: CATEGORY 0 r
IMPERIAL IRRIGATION DISTRICT
IMPERIAL, CA
COACHELLA VALLEY ENERGY PROJECT w
U.G. DISTRIBUTION
13RADSHAW CONSTRUCTION INC.
84259 COLUMBUS WAY LA QUINTA, CA
IPPROVED: ZiLk, DATE: z'
SlGN'D:IVAN LOPEZ_ DATE
)E:211212[]19 ='