06-3335 (ELEC)I
. . 11::� 4
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA; :CALIFORNIA 92253 BUILDING & SAFETY. DEPARTMENT
BUILDING. PERMIT
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
52717 AVENIDA OBREGON
773-284-024-11 -000000-
ELECTRICAL
COVE RESIDENTIAL
300
Architect or
Owner`
GAMMINO PATRICIA A
52717 AVENIDA OBREGON
LA QUINTA; CA 92253
Contractor:
13RANNEN'ELECTRIC
46324:ROUDEL LN
VOICE (760) 777=7012
FAX (760) 7.77-7011
INSPECTIONS (760) 777-7153
Date: . 9/13/06
LA QUINTA_ CA 92253
`J
(760).347-3829
LiCi `-No : 376189
•• LICENSED CONTRACTOR'S DECLARATION..`
- Thereby u
-affirm nderpenalty.of_ perjury that I am licensed under provisions of Chapter 9 (commencing with
WORKER'S COMPENSATION -DECLARATION '
I hereby affirm under penalty, of perjury one of the following declarations:
Section 7000) oCDivision '3'of the Business and Professionals Code, and my License.is in full force and "effect.
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: CIO , A License No.: 376189 :'^.-
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
W% "' 1 -Co - or: .. -:
Ce�
Dand
y
_ I have issued.
will maintain workers' compensation insurance, as required by Section 3700 of the Labor
v ' '
Code; for the performance of the work for which this permit is issued. My workers' compensation
' - OWNER BUILDER DECLARATION
insurance;carrier and; policy numberare:.. `
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier STATE FUND- Policy Number 0014396-2006
following reason (Sec. 7031.5, Business and Professions_ Code: Any city or county that requires a permit to
_ 1 certify that, in the performance of the work for which this, permit is issued, I shall -not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance,also reg6ires'the applicant -for the
person in any manner so as*to become subject.to the workers' compensation laws of California,
permit to file a signed statement -that he or she is license' pursuant to theprovisions of the Contractor's State
and agree that, if I sho .b a subject to the workers' compensation provisions of Section
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
370 6,f the Labor ode I shall. h 'th co ly with those provisions.
(4(j
any applicant for apermit'subjects the applicant to a civil. penalty of not more than five hundred dollars ($500).:
Dater tJ't Applic -
f _ 1 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
WARNING: FAILURE TO SECURE WORKERS' C ENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State:License Law does not apply to an owner of property who builds of improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENAL S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and,who does the work himselfor herself through his or her own employees,provided that the
DOLLARS (5100,000). IN ADDITION TO THE COST OF.COMPENSATION,.DAMAGES AS PROVIDED. FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.). 'J
APPLICANT ACKNOWLEDGEMENT .
(_ 1 1, as owner of the property; am: exclusively. contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building 'and, Safety for permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.. -
-property who builds or improves thereon, and who contracts for the projects with a contractors) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). -
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_) I am exempt under Sec. , B.&P.C. for thisreason
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.
,EDate:" I 401 ,40�
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
CONSTR T N LENDING AGENCY
I hereby affirm under penalty of perjury that there is a co uction lending agency for the performance of the
permit to cancellation. ,
I certify that I have read this application and state that t above info atio 's re I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.I.
- city and county ordinances and state laws relating to ilding constr n here authorize representatives
Lender's Name: �
of this coun to a jer upon the above-mentioned pr perty for in e i po
/g ®(C�y
f�e
D� I Signature�(ApplicanYor Agen "
Lender's Address:
!"
LQPERMIT
Application Number . . . . . 06-00003335
Permit ELEC-MISCELLANEOUS
Additional desc . .
Permit Fee . . . . 16.50
Plan Check Fee
4.13
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 3/12/07
Qty Unit Charge Per
Extension
BASE
FEE
15.00
2.00. .7500 PER ELEC
DEVICE/FIXTURE 1ST 20
1.50
-----------------------------------------------.------------------------------
Special Notes and Comments
2 LIGHT FIXTURES WITH SWITCH ON
EXISTING WALL
Fee summary Charged
Paid Credited
Due
----------
Permit Fee Total 16.50
---------- ----------
.00 ..00
16.50
Plan Check Total 4.13
.00 .00
4.13
Grand Total 20.63
.00 .00
20.63
LQPERMIT
Bin #*
Gty .of. La. uiftta -
Building & Safety Division
P.O. Box 1504, 78=495 Calle Tampico,
La Quinta, CA 92253 - (760) 777 7012
Building Permit. Application and Tracking Sheet
Permit #�
Project Address:
O}vrier's Name:
A. P. Number:
Address:
Legal Description:
Contractor: 610
City, ST; Zip: K:F=til/
Telephone: -
Address:
Project Description: -•- '
City, ST, Zip:
Telephone:
-
State Lic. # : City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: u�
State Lic. #:
-Name of Contact Person:
',Construction Type: Occupancy:
Wr Act.type (circle, one): ;New . Add'n Alter Repair Demo
Sq Ft:: E
#Stories: `
#Units:
Telephone # of Contact Person:
Estimated Value;of Project:' •.. ^�
APPLICANT: D4?. NOT WRITE, BELOVV THIS UNEP, ,
# ',
Submittal.;
Req'd
Recd -
TRACEING ;
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
:.
Rlan Check Deposit
Truss Calcs.
Called Contact Person
PIan.Check Balance
Energy Calcs.
Plans picked up
Consfruction
Flood plain plan
Plans resubmitted
'MechaniW'
Grading plan
2nd Review; ready for corrections/issue
Electrical
Subcontactor List
'Called Contact Person �' _
''^
Plumbing
Grant Deed
Plans picked upS:M.I.
�..
H.O.A. Approval
°:Plans-resubmitted .
_ _r.
.Grading
IN HOUSE:-
Review, ready for correctionVissue
Developer Impact Fee
Planning Approval
Called Contact Person=
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
.School Fees
i
:.Tota
l,-PermitTees .