BELC2019-008778-495 CALLE TAMPICO Tihf D Sep Q94(& VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/23/2019
Permit Type/Subtype: ELECTRICAL/ Owner:
Application Number: BELC2019-0087 PATRICIA CIFUENTES
Property Address: 44800 FRONTERRA DR 44800 FRONTERRA
APN: 604272002 LA QUINTA, CA 92253
Application Description: CINFUENTES / MAIN BREAKER CHANGEOUT
Property Zoning:
Application Valuation: $250.00
Applicant: Contractor:
MENDOZA ELECTRIC D
MENDOZA ELECTRIC
50-313 CALLE TOLOSA 50-313 CALLE TOLOSA
COACHELLA, CA 92236 AUG 2 3 2019 COACHELLA, CA 92236
(760)404-7214
CITY OF LAQUINTA Llc. No.: 904511
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: C10 License No.: 904511
Date: Contractor:
OWNER -BUILDER DECLARATION c.'
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).:
(_) 1, 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 Na
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 tJhI work for which 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: CITIZENS INSURANCE COMPANY OF AMERICA Policy Number:
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.
Date Applicant: Ct,?J-L,
_
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
worse 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 enter upon the
above -mentioned property for inspection purposes.
Date 1q Signature (Applicant or Agent):
Date: 8/23/2019
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
MENDOZA ELECTRIC
50-313 CALLE TOLOSA
COACHELLA, CA 92236
BELC2019-0087
44800 FRONTERRA DR
604272002
CINFUENTES / MAIN BREAKER CHANGEOUT
$250.00
Owner:
PATRICIA CIFUENTES
44800 FRONTERRA
LA QUINTA, CA 92253
Contractor:
MENDOZA ELECTRIC
50-313 CALLE TOLOSA
COACHELLA, CA 92236
(760)404-7214
Llc. No.: 904511
---------------------------------------------------------------------------------------------
Detail: MAIN BREAKER CHANGE OUT ONLY. THIS PERMIT DOES NOT INCLUDE RELOCATION OF EQUIPMENT OR ANY UPGRADES. 2016 CALIFORNIA BUILDING
CODES.
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
SERVICES
101-0000-42403
0
$26.68
DESCRIPTION
ACCOUNT
CITY
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
- -- GFAi 6, DESLiRii'i--
PERMIT # � G
PLAN LOCATION:
Project Address:
i, li �3O0
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
Applicant Name:
Address: 0.-
3 is 1 _ - _ t A
City, ST, Zip:
C p n-Cked CA
Telephone:
-7 p t
-, �}
Email:. fv�Z jAV �a e-C +,, C ir1'�Cic C
I l .
Valuation of Project $
Contractor Name: �� Z�
New SFD Construction:
Address:
Conditioned Space SF
City, St, Zip
Garage SF
Telephone:
Patio/Porch SF
Email:
Fire Sprinklers SF
State Lie: b S ` City Bus Lie:
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
Telephone:
Bedrooms:
Stories: # Units:
Email:
State Lie: City Bus Lie:
Properly Owner's !'dame: C � �t,e
New Commercial / Tenant Improvements:
Address: q L{ SOU �t
Total Building SF
City, ST, Zip L4� ���
Construction Type: Occupancy:
Telephone: -760 Qj� _cj3U J '
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
August 19, 2019
From: Patricia Cifuentes
To: City of La Quinta Permit Department
Re: 44800 Fronterra Dr, La Quinta, CA 92253
The only purpose of this letter is to allow Mendoza Electric which was hired by Matthew Smith the
tenant at 44800 Fronterra Dr, La Quinta, CA, 92253 to complete the paperwork need for the permit
required by the city of La Quinta to inspect the electrical panel.
This letter is not a general authorization or release of liability to the tenant or the contractor from any
liability that may result from the work that was done.
Sincerely,
Patricia Cifuentes, Landlord