BELC2019-0093OWNER -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:
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:
78-495 CALLE TAMPICO D1[1�(/ VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/5/2019
Permit Type/Subtype: ELECTRICAL/ Owner:
Application Number: BELC2019-0093 LENNAR HOMES OF CALIF INC
Property Address: 81705 HAFLINGER WY 4675 MACARTHUR CT NO 1550
APN: 767800008 NEWPORT BEACH, CA 0
Application Description: GRIFFIN RANCH / LOT 83 TEMPORARY METER AND (6) POLES
Property Zoning:
Application Valuation: $2,500.00 DApplicant: \ Contractor:
S R BRAY LLC DBA POWER PLUS SEP 0 5 Zp�g S R BRAY LLC DBA POWER PLUS
1210 N RED GUM STREET 1210 N RED GUM STREET
ANAHEIM, CA 92806 ANAHEIM, CA 92806
CITY OF LA QUINTA
DESIGN & DEVELOPMENT DEPARTMENT (714)507-1881
Llc. No.: 980589
-----------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Cha ereby affirm under penalty of perjury one of the fallowing declarations:
9 {commencing with Section 70001 of Division 3 of the Business and Professi ode, I have and will maintain a certificate of consent to self -insure for workers'
and my License is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance
License Class: B, C10, D31 License No.: 980589 '0, of th. for which this permit is issued.
In�/ II have and will maintain workers' compensation insurance, as required by
Date: — ( Contractor: k Pfa bM AUJ-r 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 IN.UFiANCE COMPANY Policy Number: 54309652
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 subjec he
workers' compensation provisions of Section 3700 of the Labor C shall forthwith
comply with those provisions, C
Date: /'5--1!pApplicant:
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.
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: I Signature (Applicant or Agent)
Date: 9/5/2019
Application Number:
BELC2019-0093
Property Address:
81705 HAFLINGER WY
APN:
767800008
Application Description.
GRIFFIN RANCH / LOT 83 TEMPORARY METER AND (6) POLES
Property Zoning:
Application Valuation:
$2,500.00
Applicant:
S R BRAY LLC DBA POWER
PLUS
1210 N RED GUM STREET
ANAHEIM, CA 92806
Owner:
LENNAR HOMES OF CALIF INC
4675 MACARTHUR CT NO 1550
NEWPORT BEACH, CA 0
Contractor:
S R BRAY LLC DBA POWER PLUS
1210 N RED GUM STREET
ANAHEIM, CA 92806
(714)507-1881
LIc. No.: 980589
Detail: INSTALL 200AMP TEMP METER ON LOT 83 AND 6 TEMPORARY POWER POLES TO RUN SOUTH OF LOT 83 AND END AT LOT 91. PER 2016 CALIFORNIA
ELECTRICAL 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
TEMP POWER SERVICE
101-0000-42403
0
$26.68
DESCRIPTION
ACCOUNT
QTY
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
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
zaQa�tra
CALIFOKNI A —
Project Address: %CAS a l e( I,Jo�
PERMIT # W- CEO
PLAN LOCATION:
Project Description:
APN #:
QL
_
Applicant Name: ILer 17p,Ws
T°r- v
.f-�
Address: M-0 �✓�¢ eC� �f� 4-3
City, ST, Zip: Co r-0^0' ,,- _
Telephone: CLZ — 36 %p
Email: S'r L� C fl�
Project Valuation $ -00
Contractor Name: S Qr.
New Construction:
Address: 1 2lfl Al-
Conditioned Space SF
City, St, Zip �� �, b
Garage SF
Telephone: z 3 . -7
Patio/Porch SF
Email: 0 30_� 0,
Fire Sprinklers SF
State Lic: qgoS�GI City Bus Lic:
Architect/Engineer Name:
Construction Occupancy:
Address:
Grading:
City, St, Zip
Telephone:
Bedrooms: —F
Stories: #Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name: Lehr
New Commercial / Tenant Improvements:
Address: '796 a 3�v
Total Building SF
City, ST, Zip f ¢Z� "I
Construction Type: Occupancy;
Telephone: c"-
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
CVWD Fire Flow Letter
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
School Fees
Burrtec Debris Plan
Y
Planning approval
Public Works approval
Fire approval
City Business License
CITY OF LA QUINTA
BUILDING DIVISION
REVIEWED FOR
CODE
COMPLIANCE
DATE
TEMP METER
LOCATION
LOT 83
Job:267857
Rental Terms: 0 Months
Tract:
AVENUE 54 & MADISON STREET
TEMP METER
LOCATION
LOT 83
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Is 93
BUILDING DIVISION
� „, �� >�1 91 �/. REVIEWED FOR i'
.�,, .>
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LENNAR HOMES
rc��� M= [P� [P�= M 6�� [�� (�� D�=fl
LA QUIMA as
PERMIT INSPECTION HISTORY REPORT (BELC2019-0093)
FOR CITY OF LA QUINTA
Electrical 09/05/2019Application Date:Permit Type:767770028Parcel
Electrical 09/05/2019Work Class:Issue Date:81740 MERV GRIFFIN WY
LA QUINTA, CA 92253
Address:
Expired 03/30/2020Expiration Date:Status:Description:GRIFFIN RANCH / LOT 83
TEMPORARY METER AND (6) POLES
*** INSTALL 200AMP TEMP METER ON
LOT 83 AND 6 TEMPORARY POWER
POLES TO RUN SOUTH OF LOT 83
AND END AT LOT 91. PER 2016
CALIFORNIA ELECTRICAL CODES.
#|||# GRIFFIN RANCH / LOT 83
TEMPORARY METER AND (6) POLES
*** REV-1 ADDING 10 TEMP POWER
POLES
Owner:Contractor:Applicant:LENNAR HOMES OF CALIF INC SR BRAY LLC POWER PLUS SR BRAY LLC POWER PLUS
Scheduled
Date Inspection Type Inspection No.Inspection Status Primary Inspector Reinspection
Required?CompleteActual
Start Date
09/19/2019 Temporary Power JAN:190918050201
3341
Disapproved Duane Clayton No Complete
NOTES Created By TEXT Created Date
Duane Clayton - SIEMENS BREAKERS REQUIRED IN
SIEMENS SERVICE PANEL.
- 100 AMP BREAKER NOT INSTALLED PER
MANUFACTURER SPECS. SEE PANEL
NOTES.
- PROVIDE IN USE COVERS AND WET
RATED RECEPTACLES.
09/19/2019
10/02/2019 Temporary Power JAN:191001044215
3366
Approved Duane Clayton No Complete
78-495 Calle Tampico Page 1 of 1October 11, 2024