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BELC2019-010878-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Tjht 4 44" DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT ELECTRICAL/ BELC2019-0108 46052 WASHINGTON ST 604050037 CITY OF LA QUINTA CIP/ 200AMP ELEC. METER PEDISTAL CHANGEOUT $12,964.00 Applicant: SHAWN O'HARA - CREATIVE LIGHTING & ELECTRICAL INC 1654 ILLINOIS AVE SUITE 13 PERRIS, CA 92571 C IW -?Lo3eCr CC.I Pa d SSueo 1 /$ a,640 No FEES DUE 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: QQ LicenseNo.: 101ZJL4 Date:W 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 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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/8/2020 Owner: WASHINGTON ADAM PARTNERSHIP 42620 CAROLINE CT 102 PALM DESERT, CA 92253 Contractor: CREATIVE LIGHTING & ELECTRICAL INC 1654 ILLINOIS AVE SUITE 13 PERRIS, CA 92571 (909)466-1200 Llc. No.: 1017604 WORKER'S COMPENSATION DECLARATION 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 Zrk 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: ACCREDITED SURETYAND-CASUALTY COMPANY INC 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 wi th se provisions. Date: —Applicant:6C 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. 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 pro arty fF/ojr inspection purposes. Date: i �" Signature (Applicant or Agent): 41, Date: 1/8/2020 Application Number: BELC2019-0108 Owner: Property Address: 46052 WASHINGTON ST WASHINGTON ADAM PARTNERSHIP APN: 604050037 42620 CAROLINE CT 102 Application Description: CITY OF LA QUINTA CIP/ 200AMP ELEC. METER PEDISTAL CHANGEOUT PALM DESERT, CA 92253 Property Zoning: Application Valuation: $12,964.00 Applicant: Contractor: SHAWN O'HARA - CREATIVE LIGHTING & ELECTRICAL INC CREATIVE LIGHTING & ELECTRICAL INC 1654 ILLINOIS AVE SUITE 13 1654 ILLINOIS AVE SUITE 13 PERRIS, CA 92571 PERRIS, CA 92571 (909)466-1200 Llc. No.: 1017604 -------------------------------------------------------------------------------------------- Detail: CITY OF LA QUINTA CIP PROJECT (CIP2019-0013). 200A�ELECTRICAL METER PEDISTAL SERVICE UPGRADE [100A EXISTING] FOR INSTALLATION OF NEW EV CHARGING STATION. THIS PERMIT DOES NOT INCLUDE RELOCATION OF EQUIPMENT. PER 2016 CALIFORNIA BUILDING CODES. Arch/Eng Name: Construction Type: Occupancy: Address: Grading: City, St, Zip Telephone: Bedrooms: Stories: #Units: Email: State Lie. City Bus Lie: Property Owner's Name: Addresslg—ek211� City, ST, Zip Telephone; Email: New Commercial / Tenant Improvements: j�G I Total Building Construction Type: 78495 CALLE TAMPICO LA QUINTA, CA 92253 (760)777-7125 WWW.LAQUINTACA.GOV Occupancy: SF % AAA-AutomDbile Club of Southern California 1� qk N N Af, ' .16 ILI E PANEL ID: SERVICE EV NEW FEEDER/SYSTEM LOAD TYPES (LOCATION: Park Lot UTILITY blank or NON: NON -CONTINUOUS MAIN: 200AI2P M.C.B. R OCP: LCL: LONG -CONTINUOUS BUS AMPS 200 FFEDOM: M: 2401120V,1-PH, REEC: DEMANDABLE RECEPT'S AIC RATING 10KAIC 'UNIT: RESI. UNIT MTR: MOTOR LOAD LOAD (VA) LOAD (VA) LOAD CKT DESCRIPTION TYPE 8KR PH. A PH.B BKR TYPE DESCRIPTION CKT 1 EV CHARGER 1 LCL 40 3840 SPACE 2 3 EV CHARGER 1 LCL /2 3840 SPACE 4 5 EV CHARGER 2 LCL 40 3840 SPACE 6 7 EV CHARGER 2 LCL /2 3840 SPACE 8 9 EV CHARGER 3 LCL 40 3840 SPACE 10 11 EV CHARGER 3 LCL /2 3840 SPACE 12 13 SPACE SPACE 14 15 SPACE SPACE 16 17 SPACE SPACE 18 19 SPACE SPACE 20 21 SPACE 1 SPACE 22 23 SPACE 7TJ SPACE 24 CONNECTED p DEMANDVA PHA PH B GEN'L LOAD: 001.0 11520 1 11520 j CONNECTED LOAD PER PHASE LONG CONTIN.: 129900 1 23040 TOTAL CONNECTED LOAD (VA) GEN'L RECEPT: 0 0 1 96 AMPS OF TOTAL CONNECTED LOAD MOTOR LOAD: 0 + 25% OF LARGE 1 28800 TOTAL DEMAND VA (BALANCED) 0 120 HIGH PHASE AMPSILCL RECEIVED DEC 0 4 2019 CITY OF LA QUINTA DESIGN AND DEVELOPMENT DEPARTMENT