12-0517 (ELEC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: .
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Al
12-00000517
78630 ALDEN'`CIR
604-225-016-99 -23268
ELECTRICAL
LOW DENSITY RESIDENTIAL
950
Architect or
T 'ht 4 �Q�w
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
----------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjur hat I am licensed under pro ' ons of Chapter 9 (commencing with
Section 7000) of Division 3 of the si ss and Profess. a1s C and my License is in full force and effect.
License Cla*�nnlirpctotL
• en No.: 579400
Date:
OWNER -BUILDER DE LARATION
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 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.).
(_ 1 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.).
(_ 1 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
I IIIIIII VIII III VIII IIII
IE
67
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/09/12
Owner:
GARCIA RUBY DURAN
78630 ALDEN CIRCLE
LA QUINTA, CA 92253
Contractor:
ELECTRICAL CONCEPTS INC.
16430 LANDON CONCEPT
RIVERSIDE, CA 92504
(951)780-3315
Lic. No.: 579400
------------------
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.
YlI 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 STATE FUND 11/14/1P,olicyNumber 0001192-2010
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner as to become subject to the workers' compensation laws of California,
and agree that, if, I out become subject to the worker ' compensation provisions of Section
3700 of the Lab Code I shall forthwit omply those provisions.
at icon
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COV GE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001. 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 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. agree to comply with all
city and county ordinances and state laws relating to b ' 'ng'construction, and hereb horize representatives
of this c unty to enter upon he above-mentioned pr ert r inspection pu
te. nature (Applicant or Agent
Application Number . . . . . 12-00000517
Permit . .
. ELEC-SERVICE
CHANGE
Additional desc .
Permit Fee
33.50
Plan Check
Fee
.00.
Issue Date
Valuation
0
Expiration Date
11/05/12
Qty Unit Charge Per-
Extension
BASE
FEE
15.00
1.00 18.5000 EA ELEC
SVC <=600V/<=200A
18.50
---------------------------------------------------------------------=------
Special Notes and
Comments
REPLACE EXISTING
125 AMP SERVICE.
2010
CODES
-----------------_------------------------------------------------
Other Fees .
. . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary
Charged
----------
Paid Credited
--------------------
Due
-----------------
Permit.Fee Total
----------
33.50
.00
.00
33.50
Plan Check Total
.00
.00
.00
.00
Other Fee Total
1.00
.00
.00
1.00
Grand Total
34.50
.00
.00
34.50
LQPERMIT
Bin. #
City. of* La Quinta
Building 8z Safety Division
P.O. Box 1504,78-495 Calle Tampico
[a.Quinta, CA 92253 - (760) 777-7012
Building Permit Application'and Tracking Sheet
Permit #
1%
Project Address: J
Owner'sNam
Ix
A. P. Number.Legal
Description:City,
gc�'
STZip:Contractor. Telephone:
Poject Descnptio �
Address:
3
City, ST, Zi . : C -U`
Telephong-�`
State Lie. #:s City Lic. #;
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone: a
State Lie. #: y^%sew
Construction Type; Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft : #Stories: # Unit;:
Name of Contact Person:
Telephone # of Contact Person:
Estimated Value of Proj
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
' Reeld
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calm
Reviewed, ready for.cortections
Plan Check Deposit. .
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Pians picked up
Construction
Flood plain plan
Pians resubmitted.'.
Mechanical
Grading plan
2id Rcvlew, ready for correctiouslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grout Deed
Plans picked up
&1YLL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review; ready for correctionsAssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
171
Total Permit Fees
IIIIIII VIII III VIII IIII 8 1
IE
Building 78-630 Alden Circle
Owner
'Mailing
Address
'City
:ontractor
O mer
tddress
T4ht 4.4 a"
Zip I Tel.
State Lic. I City
& Classif. l _�% 3 Lic. #
Arch., Engr.,
Designer
Address Tel.
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
City I Zip I State I
Lic. #
.LICENSED CONTRACTOR'S DECLARATION
I hereby affirm tha�l,am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of -the Bu/s'iinyesstifnd Profe"ssioonnsslCode, and my license is -in full force and
effect. ! (—Z 00" e_ -15;1 /. /Arm
SIGNATURE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions or the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he 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):
+ .'O I, as owner of the property, or my employees with wages as their sole compensation, will
.+•ado the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds. or improves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. If, however, the building
orimprovement is sold within one year of completion, the owner -builder will have the burden
or proving that he did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner or property who builds or Improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
/�5K60py Is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that In the performance of the work for which this permit is issued, I shall not
employ any pparson in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate or Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is Issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration If work thereunder is suspended for 180 days.
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 the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No.
BUILDING: TYPE CONST. OCC: GRP.
07829
A.P. Number Acacia Hf'ftf4 m
Legal Description Tract 2326a Plan 8-3 Rev,
Project Description f eft 04
REMARKS = '
ill} tl�tF47'h<`V�-
i
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date 5/4/gOPermit
Validated by:
Validation:
Sq. Ft. 2721
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$93, 558
PERMIT , .-
AMOUNT
Plan Chk' Dep.
Plan Chk.,Bal. ",
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure.
TOTAL
53.509.16
REMARKS = '
ill} tl�tF47'h<`V�-
i
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date 5/4/gOPermit
Validated by:
Validation:
CCNSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. I SO. FT. ®
GROUT
WATER HEATER
WALL SO. FT.
FINAL INSP.
DRINKING FOUNTAIN.
SO FT ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
FRAMING
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER, B.T.U.
SO. FT. ® c
BATH TU8
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
INSULATION/SOUND
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINISH GRADING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING / ELECTRICAL HEATING & AIR COND. SOLAR
log
SETBACK
GROUND PLUMBING ,
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
CU. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.` S
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL