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08-1596 (ELEC)4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/19/08 Application Number: 08-00001596 Owner: Property Address: 55403 RIVIERA CULLIGAN TOM & DEBBIE APN: 775-153-004- - - 55403 RIVIERA Application description: ELECTRICAL LA QUINTA, CA 92253 D Property Zoning: LOW DENSITY RESIDENTIAL ( Application valuation: 00 _ Contractor: Applicant: Architect or Engineer: LANDRY, BRAD C1 874 BORDER #D-16p!n'Op�q 1/ Ce JOSHUA TREE, CA 92252 vgNCF Fp/NTq (760)218-0357 Lic. No.: 816900 -———-------------- 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 Professionals Code, and my License is in full force and effect. License Class: B C10 % LicenseNo.: /8►16900 Date:! `VrContractor: 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 155001.: (_ 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 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.l. . ( _1001) 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 nrnnPrtv whin hiiilds nr imnrnvrs thr.re.nn, and whn rnntrsrts fnr the nrnients with a rontrwor(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: LQPERMIT 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 EXEMPT Policy Number EXEMPT 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 with those provisions. Date: 5 (J C4- Applicant: r3 AJ 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 Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1 . Each Derwn YPQn yftw aghalf 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 county to enter upon the above-mentioned property for in 'on purposes. Date: 914-4 Signature (Applicant or Agent): v Application Number . . . . . 08-00001596 Permit. . . ELEC-SERVICE CHANGE Additional desc . . Permit Fee . . . . 33.50 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/18/09 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 18.5000 EA ELEC SVC <=600V/<=200A 18.50 ---------------------------------------------------------------------------- Special Notes and Comments SERVICE CHANGE OUT PANEL FROM 200 AMP TO 400 AMP Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 33.50 .00 .00 33.50 Plan Check Total .00 .00 .00 .00 Grand Total 33.50 .00 .00 33.50 LQPERMIT Bin # Permit # A� 1 Project Address: A. P. Number: City of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampicc La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet '2/ v t Owner's Name: '�G�'Ll 9�< � Z • t Cv i • � �� Address: Legal Description: City, ST, Zip: 4 4 a,, A–Lf C ZZ S 3 Contractor: or .J ,, .101i z �� Lr Telephone: _ by Address: °i if., j& �c (9–( (p Project Description: City, ST, Zip: 9 ZZ rz, Telephone: .7 GG L t 2r _L? 5— City Lic. #: State Lic. # : % (� tit Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: # Submittal Req'd Plan Sets APPLICANT: DO NOT WRITE BELOW THIS LINE Rec'd TRACKING PERMIT FEES Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Const uction Flood plain plan Plans resubmitted Nlecb;inical Grading plan 2"4 Review, ready for corrections/issue Electrical Subcoutactor List Called Contact Person Plum ling Grant Deed Plans picked up S nI L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3'd Review, ready for correctionstiissue Deve,oper Impact Fee Planning Approval Called Contact Person A,I.P_P, Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees