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Home My WebLink AboutELPU19-0064City of Palm Desert PERMIT NUMBER: ISSUE DATE: Building and Safety Department 73510 Fred Waring ELPU19-0064 6/25/2019 Palm Desert, CA 92280 60 Permit Type: ELECTRICAL PANEL Appl. Date: 612512019 UPGRADE Permit Appr. Date: 512512019 Subtype: Exp. Date: 12/22/2019 ,lob Valuation: $1,100.00 Project Address: 41677 112 ARMANAC CT Project Description: ATTACHED TO WALL APN1Tract/Lot No: Owner: Contractor: Applicant: 622050068 CASA BLANCA OWNERS ASSN PROGRESSO ELECTRIC PROGRESSO ELECTRIC TR 14079 & INT IN 11500 W OLYMPIC PL 4 79140 KAYE COURT 79140 KAYE COURT COMMON AREAS LOS ANGELES, CA 90064 LA QUINTA, CA 92253 LA QUINTA, CA 92253 9999 (760)343-8952 (760)343-8952 Licensed Contractor Declaration Fee Summary I hereby affirm under penalty of periury that I am licensed under provisions of Chapter 9 ARCHIVE FEE-8.5X11 UP TO 11X17 GL-1100000-34116DO $0.14 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. ELECTRICAL PANEL UPGRADE GL-1100000.32211 DO $159.00 Initial GREEN BLDG FEE S91473 GL-6100000-22810DO $1.00 PERM IT ISSUANCE FEE GL-110000D-3411400 $105.00 Owner -Builder Declaration O1 hereby affirm under penalty of oetury that I am exempt from the Contractors' State Total Fees Paid: $265.14 License Law for the reason(s) indicated below by the checkmar8(s) I have placed nett 1 hereby affirm under the penalty of perjury that there Is a construction fending agency for the to the applicable item(s) Section 7031.5 Business and Professions Code: Any city or performance of the work for which this permit is issued (Sec 3097, CMI Code) county which requires a permit to construct, alter, Improve, demolish, or repair any Lenders Name and address structure, prior to 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 Contractors' State Asbestos Declaration License Law(Chapter %Commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she Is exempt and the basis fertile alleged exemption. Any violation of Section by any applicant fora permit subjects the Written asbestos notification pursuant to Para 61 of Title 40 of the Code of Federal Regulations is required applicant to a civil penalty of Dal morree than five hundred dollars ($500}.) when asbestos exists in buildings, or portions thereof, undergoing demolition. I hereby declare that I, as owner of the property, or my employees with wages as their sole compensation, demolition authorized by this permit is from construction that does or does not contain asbestos, or that no demolition is authorized by this permit. 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 NOTICE: You may protest any of the fees for this permit in accordance with CA Gov Code Sec. 66020 an owner of property who builds or improves the property, provided that the (a). The protest must satisfy the requirements of Gov, Code Sec.66020(a) and must be filed within 90 improvements are not intended or offered for sale. If, however, the building or days of the date of this notice. In addition, you must tender payment of the protested fees at the time of improvement is sold within ore year of completion, the Owner•Builderwill have the the payment or provide evidence of arrangements to pay the protested fees or exactions at the time they burden of proving that it was not built or Improved for the purpose of sale.) are due if they are not already due. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a licensed contractor pursuant to the Contractors' State License Law.) - I am exempt from Llcensure under the Contractors' State License Law for the following reason: DalelSignature of property owner or agent Workers' Compensation Declaration 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 (S1100,000), IN ADDITION TO THE COST OF COMPENSATION DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. •, I hereby affirm under the penally of perjury Q,�IE o(_he faJlowln4 declarations: o I have and will maintain a certificate of consent to self4nsum for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work forwhich this permit issued. Initial Policy No. i 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 poky number are: _ Initial Carrier & Policy Number WESCO INSURANCE COMPANY W WC3358737 Expiration Date 7127/2019 I certify that in the performance of the work for which lh rmit Is Issued, I shall not employ any person in any manner so as 10 becomes j t io the workers' compensation laws of California and agree that if 1 0 become subject to the L workers' compensation provisions of Section 370 f e Labor Code, t shall forthwith comply wlip those rovisions. Date QApplicant _ Initial r1 City of Palm Desert Department of Building and Safety Building Permit Application (For Office +Uses Only) r �y j, JOB ID:a�1rpL L i Ob(A PLANS FILED: Project Address: I r 6 J i '17-4222Q4?t)61L' Suite # Total Value of work: $ 0,0 as Note: Plan Review Fees may be adjusted after Plan Review Project Description (be specific): p t W4 J 1004 -tD 100 ^ Contractor Business Name re6o dep'9 - e P operty O ner c c✓ ame sari Address g�qU f y � C f [1 /� �'� Address an � 0 GG W r5 city F Zip �} city pp Zip Phone 6) �.J —4 �_i.� Phone n [7 �n 1161 f7 Fax ViT VZ' SSa �.tG fi Q��' Ca>�—► Fax E-m E-mail <— Contractor License No. []Architect Name ❑Designer Name Engineer Name Address Address City Zip City Zip Phone Phone Fax Fax E-mail E-mail License No. License No. Applicant Name I�/1/Ld ,rK0Ytd -C� Signature Date Contact Telephone Number E-Mail PLEASE COMPLETE THE REVERSE SIDE 73-510 Fred Waring Drive, Palm Desert, CA 92260 • (760) 776-6420 • (760) 776-6392 fax • www.cityofpalmdesert.org