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HomeMy WebLinkAboutELPU18-0006City of Palm Desert PERMIT NUMBER: ISSUE DATE: Building and Safety Department ELPU18-0006 1/2612018 73510 Fred Waring Drive Palm Desert, CA 92260 Permit Type: ELECTRICAL PANEL Appl. Date: 1/26/2018 UPGRADE Permit Appr. Date: 1/26/2018 Subtype: Exp. Date: 7/25/2018 Job Valuation: $500.00 Project Address: 74065 ASTER DR Project Description: 100AMP to 200AMP ON GARAGE APNlTract/Lot No: Owner: Contractor: Applicant: 624191001 DIANA G BOYD MICHAEL EDWARD BOYD MICHAEL EDWARD BOYD SHADOW VILLAGE 1 74066ASTER DR CONSTRUCTION CONSTRUCTION 31 PALM DESERT, CA 92260 74065 ASTER DR 74065 ASTER DR PALM DESERT, CA 92260 PALM DESERT, CA 92260 (760)899-5123 (760)899-5123 Licensed Contractor Declaration Fee Summary( I hereby affirm under penalty of penury that I am licensed under provisions of Chapter 9 ARCHIVE FEE - 8.5X11 UP TO 11X17 GLA100000-3411600 $0.21 (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-1100000.3221100 $159.00 Initial GREEN BLDG FEE SB1473 GL-8100000-228100D $4.00 PERMIT ISSUANCE FEE GL-11GODDO-341140D $105.00 Owner -Builder Declaration 1 hereby affirm under penalty of penury that I am exempt from the Contractors' State Total Fees Paid: $268.21 f hereby affirm under the penalty of perjury that there Is a construction lending agency for the License Law for the reason(s) Indicated below by the checkmark(s) I have placed next 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, Civil 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 9(commencing with Section 7000) of DI99IDn 3 of the Business and Professions Code) or that he or she is exempt and the basis for the alleged exemption. Any violation of Section by any applicant for a permit subjects the Written asbestos notification pursuant to Part 61 oT Title 40 of the Code of Federal Regulations Is required applicant to a civil penalty of not morree than five hundred dollars ($500},) when asbestos exists in buildings, or p0nions 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 wont, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' Stale License Law does not apply to NOTICE: You may protest any of the fees for this permit in accordance with CA Gov Code Sec. 6602D an owner of property who builds or improves the property, provided that the (a). The protest must satisfy the requirements of Gov. Code Sec.66D20(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 one year of completion, the Owner -Builder will have the the payment or provide avidence 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. 0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7D44, 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' $tale License Law,) I am exempt from Licensure under the Contractors' State License Law for the following reason: Dale/Signature of property owner or agent Mr tJ grs' Compensation Declaration WARN?NG: 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), INADDMON TO THE COST OF COMPENSATION DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEI^S FEES. t4ereby affirm under the penalty of peduryt e f oil owing declarations: blfvl� ave and will maintain a certificate of consent to self -insure forworkers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit issued, - Initial olicy No. Ohave f and will maintain workers' compensation insurance, as required by Section 700 of the Labor Code, for the performance of the work forwhich this permit is _ issued, My workers' compensation insurance carder and policy number are: Carrier & Policy Number Initial Expiration Date I certify that in the performance of the work for which this permit is issued, l shall not employ any person In any manner so as to became subje to the workers' ompensation laws of California and agree that If l sho become subject to the workers' c mpensa on provisions of Section 3700 of Labc �de, I shall forthwith complyw se rovisions. � � _ Initial Date Applica 11 City of Palm Desert Department of Building and Safety Building Permit Application w.M Project Address: Total Value of work: $</© 7-8-Z fir, (For Office Use Only) JOB ID: _ f:LP9 i�-OODC� PLANS FILED: Suite # Note: Plan Review Fees may be adjusted after Plan Review Project Description (be specific): JZ�P_L ec,*70 C-t-L �U/°.� j -e✓ -ro k)&[,V ZOQ 4-m > 7a_"-e-L :AI ,IMF= L,l /sex r�a�a sue. 14aysL i5-r ox.'I •C 'fV NCLtJi�- i.(J bL (I pl/1-10 V 5 6?-� -f-0 & -2 . Contractor Business Name Property Owner Name Address Address cltyZip City Zip Phone / O f _ 57,9— 6-1 a j�' Phone Fax Fax E-mail ���m 17 es c n 3v,c�r ova E-mail Contractor License No. El 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 Z3 Signature Date Contact Telephone Number E-MaiI ev760 a/c- a CO/f PLEASE COMPLETE THE REVERSE SIDE 73-510 Fred Waring Drive, Palm Desert, CA 92260 a (760) 776-6420 a (760) 776-6392 fax • www.cityofpalmdesert.org \A/ s• t > CITY QP P t�M r Ult� D'EPA� APPROVE�(�4,&C, i + IS 19 � S1GiA1.b 9� �l�yC�AP '15 ►�9 106 (1 t7 �O a� �y 06.E �s�-��. � r► p6paPRavel7 p� i A PERM"' CONSTSU o� P OF T+ aCp LAWS � ORI)l PL PNS CITY OF PALM DEPARTMEI COMMUNITY DELI APPROVIED BY: ❑ C.0 RES. NO WSFAI ❑ RC. RESS.fNO ___ __ _ ❑ ARC BY ! Y Vndtr�ravnd in.� � &SAWN d ra r wspF-cno" .?S OF ISSUANG .GG:�FIGAIII 17 t4o UK/► . giAL L. -r SS .ppFjavAL. Ai , ppjawsloNs OF Ktis SET, of APp4iovrrA ESERT 'OF _OPMENT LETTER IN ���� ovel�►� �� fLP(A fro- 000lo