BELC2019-008278-495 CALLE TAMPICO T4h/ D
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: ELECTRICAL
Application Number: BELC2019-0082
Property Address: 78525 HIGHWAY 111 STE 200
APN: 643220025
Application Description: SPINELLO / IID RELEASE
Property Zoning:
Application Valuation: $0.00
Applicant: n
DIANE SAMPSON / SPINELLO PROPERTY MANAGEMENT
D
P.O. BOX 1419
CATHEDRAL CITY, CA 92235 JUL 2 2 2019
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
JDD
78555 HIGHWAY 111
LA QUINTA, CA 92253
Contractor:
N/A
Date: 7/22/2019
CITY OF LA QUINTA Llc. No.:
DESIGN & DEVELOPMENT DEPARTMENT
--------------------------------------------------------------------------------------------
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: 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. 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
al a ed exemption, Any violation of Section 7031.5 by any applicant for a permit
As Je is 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
e did not build or improve for the purpose of sale.).
A
.
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 for this reason
Date: _ Owner 9
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
Lender's Add
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:
Car Policy Number: _
I certify.that in the performance of the work for which this permit is issued, 1
sh II 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 0 of the Labor Code, I shall forthwith
comply with those provisions.
Dater Applicant:
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 ofthis 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 ryty 4o enter on the above -
mentioned property for inspection purposes. r J
Date Signature (Applicant or Age
Date: 7/22/2019
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:,
Application Valuation:
BELC2019-0082
78525 HIGHWAY 111 STE 200
643220025
SPINELLO / III) RELEASE
$0.00
Applicant:
DIANE SAMPSON / SPINELLO PROPERTY MANAGEMENT
P.O. BOX 1419
CATHEDRAL CITY, CA 92235
Owner:
JDD
78555 HIGHWAY 111
LA QUINTA, CA 92253
Contractor:
N/A
Llc. No.
Detail: IID RELEASE INSPECTION POWER OFF FOR OVER 180 DAYS. PER 2016 CALIFORNIA BUILDING CODES
DESCRIPTION
ACCOUNT I CITY I AMOUNT
ELECTRICAL - UTILITY RELEASE 101-0000-42400 0 $80.05
Total Paid for ELECTRICAL - UTILITY RELEASE: $80.05
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PERMIT # ELC, ZO I 0
CALIFORNIA
PLAN LOCATION:
Project Address: `�
Project Description: Ex. Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:�
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Applicant Name:
Address:
City, ST,
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Telephone:
Email:
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Valu a_Oon of roject $
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Contractor Name:
New SFD Construction:
Address:
Conditioned Space SF
City, St, Zip
Garage SF
Telephone:
Patio/Porch SF
Email:
Fire Sprinklers SF
State Lic: City Bus Lic:
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
Telephone:
Bedrooms:
Stories:
# Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name: 6,�.
New Commercial / Tenant Improvements:
Address:
Total Building SF
City, ST, Zip
Construction Type: Occupancy:
Telephone: _
Email:
78495 CALLE TAMPICO LA QUINTA, CA 92253 (760)777-7125
W W W. LAQU I NTACA.GOV
OFFICE USE ONLY
#
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
LETTER OF TRANSMITTAL
DATE: July 22, 2019
TO, City of La Quinta
FROM; Brett Landes
RE: Electrical Inspection Permit
Tea Whom 1t May Concerr -
authorize Diane Sampson, with Spinello Property Management, Inc, to sign as agent for owner
.:) obtain a permit to have Suite 200 at 78525 US Highway 111, La Quinta, CA inspected for
electrical usage.
5incere°il
Brett Landes
Managing Member
jDD,LLC, commonly known as La Quinta Court