BELC2019-010478-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
ELECTRICAL/
BELC2019-0104
78390 SINGING PALMS DR
643181024
CHAVEZ/ PANEL UPGRADE
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/19/2019
Owner:
Chavez Shannon M / Chavez Andrea R
78390 SINGING PALM DR
LA QUINTA, 92253
Applicant: Contractor:
LEGACY ELECTRIC D
a LEGACY ELECTRIC
487AKINDALE WAY 487AKIN DALE WAY
BEAUMONT, CA 92223 NOV 19 2019 D
BEAUMONT, CA 92223
0 (951)570-7445
L
CITY OF LA QUINTAlc. No.: 1032780
------------------------ DESIGN&AVEI.�RMI=NIDEPARTMENL----------------------------_____----------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9
(commencing with Section 70001 of Division 3 of the Business and Professions Code, and
my License is in full force and effect.
License Class:: CC10 License No.: 1032780
Date: /�_ ly /"f /� 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
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
Da
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
Lender's Address:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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:9aMPY_ Policy Number;_
certify that in the performance of the work for which this permit is issued, I
sha 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: /— — I 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 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: — l— C Signature (Applicant or Agenth
Date
11/19/2019
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
LEGACY ELECTRIC
487 AKIN DALE WAY
BEAUMONT, CA 92223
BELC2019-0104
78390 SINGING PALMS DR
643181024
CHAVEZ / PANEL UPGRADE
Detail: CHAVEZ / MAIN SERVICE PANEL UPGRADE100A TO 200A. 2016 CALIFORNIA BUILDING CODES.
Owner:
Chavez Shannon M / Chavez Andrea R
78390 SINGING PALM DR
LA QUINTA, 92253
Contractor:
LEGACY ELECTRIC
487 AKIN DALE WAY
BEAUMONT, CA 92223
(951)570-7445
Llc. No.: 1032780
FINANCIAL
DESCRIPTION
INFORMATION
ACCOUNT
CITY
AMOUNT
SERVICE CHANGEOUT/UPGRADE
101-0000-42403
0
$26.83
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SERVICE CHANGEOUT/UPGRADE PC
101-0000-42600
0
$26.83
Total Paid for ELECTRICAL 2019: $53.66
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$101.97
Total Paid for PERMIT ISSUANCE: $101.97
DESCRIPTION ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE 502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS;.0 .
ta 0"tra
PERMIT
PLAN LOCATION:
Project Address: 3—1 0 �i n �� Im ,� J f
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
t IoQ-Am))
c o AM
Applicant Name:
;0 &1� CZ A ( .
Address:
City, ST, Zip: U J (Vl�� C (5V-1-1,5
U-
Telephone: "I
Email:
Valuation of Project $
Contractor Name:
d0 ( I— �fUG✓C`
New SFD Construction:
Address: LIE-
A , r-�,1a tjGi t
Conditioned Space SF
City, St, Zip '
,� yyL u r Cf� 23
Garage SF
Telephone:
I
_ S 70 _
Patio/Porch SF
Email:
Fire Sprinklers SF
State Lic: �jZ 7 b City Bus Lic:
C —1 (D
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
Bedrooms: Stories: # Units:
City, St, Zip
Telephone:
Email:
State Lic: City Bus Lic:
Property Owner's Name:s h U,,l �� 2
New Commercial / Tenant Improvements:
Address: 7) QO Si `
Total Building SF
City, ST, Zip L �
Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
#
Submittal
Plan Sets
Req'd
Req'd
Structural Calcs
Truss Cates
Title 24 Cates
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