BELC2018-004178-495 CALLE TAMPICO
LkQU'INTH; CALIFORNIA92253
c&t1t4lw4�w
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype:
ELECTRICAL/
Application Number:
BELC2018-0041
Property Address:
42800 WASHINGTON ST
APN:
609040007
Application Description:
WASHINGTON STREET APTS / TEMP POW
Property Zoning:
Application Valuation:
$1,500.00
Applicant:
B
S R BRAY LLC DBA POWER PLUS
,^
1210 N RED GUM STREET
ANAHEIM, CA 92806
_
APR , 6 2015
'VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/5/2018
Owner:
REDEVELOPMENT AGENCY CITY OF
78945 CALLE TAMPICO
,LA QUINTA, CA 92253
V ontractor:
n /Ta " )U1 1*r R BRAY LLC DBA POWER PLUS"
^ 1210 N RED GUM STREET
to PoS�WENT ANAHEIM, CA 92806
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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 CI s: B. CSO. D31 Lice o.- 980589
---Date: — Contractor:
OWNER-BUIL R 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 anb th'e--
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.).
(_) 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:
(714)507-1881'
Llc. No.: 980589
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.
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:, FEDERAL INSURANCE COMPANY - Policy Number: 543096S2
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.
Dater ✓ - Applicant:
WARNING:'TAILURE TO SECURE WORKERS' CQVIPENSATION 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
construction, and hereby authorize representatives of this city to en pon the
above -.me tion d property for inspection purposes.
Date:—� _Signature (Applic rAge*
Date: 4/5/2018 ,
Application Number:
BELC2018-0041
Owner:
Property AcMress:
42800 WASHINGTON ST
REDEVELOPMENT AGENCY CITY OF
APN:
609040007
78945 CALLE TAMPICO
Application Description:
WASHINGTON STREET APTS / TEMP POWER
LA QUINTA, CA 922S3
Property Zoning:
Application Valuation:
$1,S00.00
Applicant:
Contractor:
S R BRAY LLC DBA POWER
PLUS
S R BRAY LLCDBA POWER PLUS
1210 N RED GUM STREET
1210 N RED GUM STREET
ANAHEIM, CA 92806
- ANAHEIM, CA 92806
(714)507-1881
LIc. No.: 98OS89
Detail: TEMP POWER FOR
CONSTRUCTION TRAILER. AND PRODUCTION. SEPERATE PERMIT FOR CONSTRUCTION NOT REQUIRED. PER 2016 CALIFORNIA
BUILDING CODE.
'e •
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT CITY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT .
TEMP POWER SERVICE
101-0000-42403
0
$26.01
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TEMP POWER SERVICE PC
101-0000-42600
0
$18.20
Total Paid for ELECTRICAL: $44.21
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: $5.0a
TOTALS:•
i
I
i
WASNiNGTON STREET
1 Site/Accessibility Plan
This Site Plan with additions is specifically for the placement of temp
facilities and not intended to used for measurement as the temp facilities are
not to scale and subject to be adjusted by Field Supt.
Keynotes - Site Plan
General Notes - P1 Site Plan
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PLAN LOCATION:
Project Address-
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN#:
2—OCA -e-0021<—_
r' - • %t ,
l c-r GC/1 cQ. ✓t uc �E 0,.1 ,
CApplicant Name: 0� aY�I
Address:
VJ �j� k 41 1-G rA0,-n d �/
City, ST, Zip:
D
Telephone:
.AlZ_CJ
Email:
t a r Q_ f>OU e,-rt ts.S• Ca M
Valuation of Project $
�6
Contractor Name: �� ( PI(AS
New SFD Construction:
Address: [0 �( u s
Conditioned Space. SF
City, St, Zip a'� r , j
-"`�'C
Garage SF.
Telephone: �� — 35 �_ l� 'zCR
Patio/Porch SF
Email: @ pouwer 1JIu-S. Cv(YI
Fire S klers SF
State Lic: l CityBus Lic: .
Arch/Eng Name:
Construction Type: _Feyv Occupancy:
Address:
Grading:
City, St, Zip
Telephone:.
Bedrooms:
Stories:
# Units:
Email:
State ic:. City Bus Lic:
Property Owner's Name: Wzvl(n
New Commercial / Tenant Improvements:
Address:
Total Building SF
City, ST, Zip
Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO-
LA QU I NTA, CA 92253
760-777-7000.
Submittal •
Req'd
Ree'd
Plan Sets
Structural Calcs
Truss Calcs
-
Title 24 Calcs
r
Soils Report
Grading Plan (PM 10),
Landscape Plan
y
Subcontractor List
Grant Deed
HOA Approval
School Fees'
Burrtec Debris Plan
-
Planning approval
Public Works approval .
Fire approval
City Business License
I
Y