BELC2020-000878-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
T-iht 4 ZPO"
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
ELECTRICAL/
BELC2020-0008
79807 VIA SAN MATEO
776220012
FLORESTA/TEMP POWER POLE AND METER
$2,500.00
Applicant:
S R BRAY LLC DBA POWER PLUS
1210 N RED GUM STREET
ANAHEIM, CA 92806
L
D
1111121110
CITY OF LA QUINTA
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 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: License No.: 980589
Date: Z 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 worl,
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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/30/2020
Owner:
BEAZER HOMES HOLDINGS CORP
1600 E IMPERIAL HWY STE 200
BREA, CA
Contractor:
S R BRAY LLC DBA POWER PLUS
1210 N RED GUM STREET
ANAHEIM, CA 92806
(714)507-1881
Llc. No.: 980589
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:
Carrier: FEDERAL INSURANCE-C-OMPANY Policy Number: 54309652
1 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 CodC, t hall forthwith
comply with those provisions.
Date: ( /& ^ Z--> 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. _r., -------�
Date: i � ) o— tP ig. ture (Applicant or Agent)
Date:
1/30/2020
Application Number: BELC2020-0008
Property Address: 79807 VIA SAN MATEO
APN: 776220012
Application Description: FLORESTA / TEMP POWER POLE AND METER
Property Zoning:
Application Valuation: $2,500.00
Applicant:
S R BRAY LLC DBA POWER PLUS
1210 N RED GUM STREET
ANAHEIM,CA 92806
Detail: TEMP POWER POLE ON LOT PER 2019 CALIFORNIA ELECTRICAL CODES.
Owner:
BEAZER HOMES HOLDINGS CORP
1600 E IMPERIAL HWY STE 200
BREA, CA
Contractor:
S R BRAY LLC DBA POWER PLUS
1210 N RED GUM STREET
ANAHEIM, CA 92806
(714)507-1881
Llc. No.: 980589
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
$26.83
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TEMP POWER SERVICE PC
101-0000-42600
0
$18.78
Total Paid for ELECTRICAL 2019: $45.61
DESCRIPTION ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE 101-0000-42404
0
$101.97
Total Paid for PERMIT ISSUANCE: 5101.97
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
Contractor Name:
D
Address:
City, St, Zip
Telephone: 1_2 9_ o37 c0
Email: J
State Lie: G91ifo S ??(] City Bus Lie:
Arch/Eng Name:
Address:
City, St, Zip
Telephone:
Email:
State Lie: City Bus Lie:
Property Owner's Name:
Address: 5 to CoNt�ca
City, ST, Zip `
Telephone: /Y - 6 7
Email: ,- ► _ • . . r
- 7ooD
New SFD Construction:
Conditioned Space
Garage
Patio/Porch
Fire Sprinklers
Construction Type:
Grading:
Bedrooms: I Stories:
SF
SF
SF
SF
Occupancy:
# Units:
j/L(.� New Commercial /Tenant Improvements:
Total Building SF
a2 Construction Type; Occupancy:
Co
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
Job: 273560
Rental Terms: 0 Months
Tract: NSA
JEFFERSON
AVENUE
& AVENUE 52
G&JOIC-C=*
CITY OF LA OUINTA
BUILDING, & SAFME DEPT.
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