BELC2019-005378-495 CALLE TAMPICO t 0 f
LA QUINTA, CALIFORNIA 92253
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Permit Type/Subtype: ELECTRICAL/
Application Number: BELC2019-0053 Owner:
Property Address: 52404 AVENIDA RUBIO NELDA ESMERALDA
APN: 773253026 52404 AVENIDA RUBIO
Application Description: ESMERALDA / 200A ELECTRICAL SERVICE CHANGE OUT LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
Applicant:
COVE ELECTRIC INC D
lZ Contractor:
77-971 WILDCAT DRIVE SUITE F COVE ELECTRIC INC
PALM DESERT, CA 92211 q Z 2019 PALM DES77-971 ERT, T DRIVE82211 SUITE F
CR OF LA QUINTA (760)360-0036
DESIGN & DEVELOPMENT DEPARTMENT Llc. No.: 397002
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 Cla License No.:
Date: �� Contractor:
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. 70315 Businessd P
Date: 4/22/2019
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'
compensation, as provided for by Section 3700 of the Labor Code, far the performance
ri
of t�{&rk 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:
F H �
T Policy Number: $
• an rofessions Code: Any _ � I certify that in the performance of the work for which this permit is issued, I
city or county that requires a permit to construct, alter, improve, demolish, or repair any shall not employ any person in any manner
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
so as to become subject to the workers'
compensation laws of California, and agree that, if I should become subject to the
State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he or is
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
she exempt therefrom and the basis for the
alleged exemption. Any violation of Section 7031.5 by any applicant for
Z�'
a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
Date:
Applicant:
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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
sale.
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000).
property who builds or improves thereon, and who does the work
himself or herself through his or her
IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION
own employees, provided that the improvements
are not intended or offered for sale. If, however, the building or improvement is
3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
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.). or
(_) I, as owner of the property, a m exclusively contracting with licensed contractors
ACKNOWLEDGEMENT
n is hereby made to the Building for a permit subject to
to
construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State
License Law does not apply to
theconditionsons and restrict ons et forth on this appl n.
1. Each person upon whose behalf this application
an owner of property who builds or improves thereon,
and who contracts for the projects with a contractor(s) licensed pursuant to the
is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit issued
Contractors' State License Law.).
as a result of this application, the owner, and the applicant, each agrees to, and shall
(_) I am exempt under Sec. . B.&P.C. for this reason
defend, indemnify and hold harmless the City of La Quinta, its officers, agents and
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
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
-ommenced within 180 days from date of issuance of such permit, or cessation of work
:or 180 days will subject permit to cancellation.
certify that I have read this application and state that the above information is correct.
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 upo theabove-
's
prop rrty for inspection purposes.
late:Tldl-T Signature (Applicant or Agent):
Application Number:
BELC2019-0053
Property Address:
52404 AVENIDA RUBIO
APN:
773253026
ESMERALDA / 200A ELECTRICAL SERVICE CHANGE OUT
Application Description
Property Zoning:
Application Valuation:
Applicant:
COVE ELECTRIC INC
77-971 WILDCAT DRIVE SUITE F
PALM DESERT, CA 92211
Dat::: 4/22/2019
Owner:
NELDA ESMERALDA
52404 AVENIDA RUBIO
LA QUINTA, CA 92253
Contractor:
COVE ELECTRIC INC
77-971 WILDCAT DRIVE SUITE F
PALM DESERT, CA 92211
(760)360-0036
Llc. No.: 397002
Detail: 200A ELECTRICAL SERVICE CHANGE OUT [200A EXISTING] THIS PERMIT DOES NOT INCLUDE RELOCATION OF EQUIPMENT 2016 CALIFORNIA
BUILDING CODES.
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
AMOUNT
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT
QTY
SERVICES
101-0000-42403
0
$26.68
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SERVICES PC
101-0000-42600
0
$13.34
Total Paid for ELECTRICAL: $40.02
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$101.40
Total Paid for PERMIT ISSUANCE: $101.40
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: $5.00
ta
ci.tvi1 of arr [7{.i�T;la Qaiwra
PERMIT # �L 20 14 — 00
PLAN LOCATION:
Project Address: 52404 Avenida Rubio
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
Main panel change out like for like
Garage
200 am
Applicant Name: Cove Electric, Inc.
Patio/Porch
Address: 52404 Avenida Rubio
Email: info@covelectric.com
City, ST, zip: La Quinta, CA 92253
IVD SF
Telephone:
Email:
Valuation of Project $
Contractor Name: Cove Electric, Inc.
New SFD Construction:
Occupancy: Ye -5
Address: 77-971 Wildcat Dr., STE F
Conditioned Space
332 o SF
city, st, zip Palm Desert, CA 92211
Garage
SF
Telephone: (760) 360-0036
Patio/Porch
Z `'D SF
Email: info@covelectric.com
Fire Sprinklers
IVD SF
State Lic: `7 0 D `ZCity Bus Lic: OtDOO ®`1 I
Arch/Eng Name: N/A
Construction Type: Electrical
Occupancy: Ye -5
Address:
Grading:
Construction Type: Occupancy:
City, St, Zip
Email:
Telephone:
Bedrooms: Stories: /
# Units: N/ .
Email:
State Lic: City Bus Lic:
Property Owner's Name: Nelda Esmerelda
t New Commercial / Tenant Improvements:
Address: 52404 Avenida Rubio
Total Building _ SF
City, ST, Zip La Quinta CA 92253
Construction Type: Occupancy:
Telephone: 760 285_0468
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000