04-5337 (ELEC)�F�Q�rw
BUILDING & SAFETY DEPARTMENT
P.O. BOX 1504 _•,�' (760),777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number Date x;7/02/04
Property Address .. . . 49505 ALI CT, ..;
APN: 649-520-014-31' -290532-
Application description ELECTRICAL
Property Zoning LOW DENSITY -RESIDENTIAL
Application valuation.. .500
Owner Contractor
PM RENAISSANCE, LLC BRAY CORP,. SR DBA POWER PLUS
9968 HIBERT _STREET; STE.. 102 1.005 .N. .EDWARD. CT,
SAN: DIEGO... CA 921:31. ANAHEIM -928 92806
(714) .288-8.366.
.:WCC: STATE FUND .
WC : 197.8720.04.: 01/01/05
CSLB:..- 523596. 01/13/.06
CCC: `.. B,=C6.1-Cl-,D.31
Permit ELEC-TEMPORARY POWER..
Additional desc
Permit. Fee 18.0.00 Plan Check Fee .00.
Issue Date Valuation' 0
Qty Unit Charge, Per.. .Extension
BASE FEE 15.00
1.00 15.0000 EA ELEC 'TEMPORARY POWER POLE ,,:t 15.00
2 0.00 7.15.000 -EA ELEC .TEMP `SUB' POLE 150.'00
---
---- -_ -- - -
Special Notes and Comments
ONE (1) TEMPORARY POWER POLE (200 AMP)
AND TWENTY (20) SUB --POLES.
Fee summary Charged Paid Credited Due
Permit Fee Total 180.00 ...00-
.00 180.00
Plan' Check Total 00 00 00 00
Grand Total 180.00 .00 .00 180.0.0
. F JUL 0 2 2004
CIN OF LA QUINTA
994
P.O. Box 1504 ot
78-495 CALLE TAMPICO 11V
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number: -IM
Applicant:
Applicant`s Mailing Address:
I hereby affirm under penalty of
Code, and my Licenrle iarn full
..1121 C)
Architect or Engineer:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:
Architect or Engin is Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and.. Professionals,
License No. 5 2 �6 0
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that 1 am exempt from the Contractors' 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 fide a signed
statement that he or she Is licensed pursuant to the provisions of the Contractors' 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 fie 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).):
U 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 or through has or tier own employees, provided that the improvements are not intended or offered for sale. N, 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, 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 contracts licensed
or() pursuant to
the Contractors' State License Law.).
.0 1 am exempt under Sec. 0 . BA P.C. for this reason
Date Owner.
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations: .
_ 1 have and will maintain a certificate of consent to selfinsure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance "
of the work for which tfds permit is issued.
1 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• y ems' con sation insurance carier and policy number
Cartier H.1 Policy Number
ce"y that, in the perfonnai of the work for which e s issue , all not employ any person In any.marer so as to become subject to the workers'
compensation laws of Ca la, and agree that, lf 1 should to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with ions:
/Date*_q�Appficant 17
WARNING: FAILURE TO SECURE WO ERS' 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 ATTORNEYS FEES.
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
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 wok 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, d, indemnify and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission related to tt}e work being perfomhed oder r following issuance of this permit
2. Any permit issued as a result of this application beco s null and void If IN not comme ced thin 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit to n Ilation.
.I certify that have read this application and state that the abov of ration is correct. lag comm y a�c;ltyand county ordinances and state laws relating to building
;ns: ,and hereb amdhorizerepresentatives of this cou to enter upon the a ti p fon purposes.
V Signature (Applicant or Agent): t
JOB ID: 130546
RENTAL: 6 MONTHS PHASE 1
49415
49-410 49-415 49-410
28
27 X14 13
5//13104 4945
LOTS 1-34
49 49-445 494
�49-475
4970 4975 4970>
25 016 11
l :49-5 5 4-500
49-605 0 49.600
x-31 .O 24 1,017 v 10
v
149-535
/ � `X 32 Q 49-530 49.535 Q 49-53
23 18 � 9
1`
149-565
49 -SBO® 49-565 49-560,
33 22 f 19 8
r
5 ufj_R�46s 49-59Q I 9595 49-6900
I 21 X 20 7
DER ALAN DRIVE
9-771 79-785 9-799179-813121
79-8279-8:
6a4, �o, 1
5470-A5
N:�T HOUSING
FIORE
METER 200A UfG
-®x
L
Y OF LA QUINTA
DING & SAFETY DEPT.
APPROVEDOR CONST RU TION
BY
C "G