05-3955 (ELEC) `.a.. { IIIIIIIIIIIIIIIIIIIIIIII 65IE
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P.O. BOX 1504 �—-- —' 4 �^' VOICE(760)777-7012
78-495 CALLE TAMPICO FAX (760)777-7011
LA QUINTA, CALIFORNIA 922 DING&SAFETY DEPARTMENT INSPECTIONS (760)777-7153
`4 Z005 BUILDING PERMIT
SEP 1
Date: 9/12/05
Application Number: 05-0000395 Owner:
Property Address: 81860 AVE E CITY OF LAQUINTA K. HOVNANIAN FORECAST HOMES
APN: 764-010-01 -F - ,C-DEPT. 4240 E. JURUPA ST. STE. 402
Application description: ELECTRICAL CHINO, CA 91710
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 1200
Contractor:
Applicant: Architect or Engineer: COCHRAN COMMUNCATION CONST INC
36630 CATHEDRAL CYN DR
CATHEDRAL CITY, CA 92234
' (760)328-6778
Lic. No. : 478543
---- ------------ -------- ----- - - ---- -------- --- ---------- -------------- - ------- - --------- ------ -- -
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000)of Division 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: C7 License No.: 478543 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is
_ issued.
Datey��Y-VS ontra'Or. 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
OWNER-BUILDER DECLARATION insurance carrier and policy number are:
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 04600082625
following reason(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to _ I 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 requires 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 licensed pursuant to the provisions of the Contractor's State . and agree that,if I should become 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 3700 of the L bor Code,I shall forthwi�t ,co/rt/]ply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by L4/'�-.--
any applicant for a permit subjects the,applicant to a civil penalty of not more than five hundred dollars($500).: ate: 7 i 7pplicant:
(_) 1,as owner of the property,or my employees with wages as their sole compensation,will do the work,and 100,
the structure is not intended or offered for sale(Sec.7044,Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL
Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND '
and who does the work himself or herself through his or her own employees,provided that the DOLLARS($100,000). 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.). 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 a 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 contractor(s)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,
(_1 I am exempt under Sec. ,B.&P.C.for this reason 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.
Date: Owner: 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
CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued(Sec.3097,Civ.C.). city and county ordinances and state laws relating to building construction,and hereby authorize representatives
of this co my to enter upon the above-mentioned property for inspection purposes.
Lender's Name:
r ^_ te:/ /Sioa2{ure(Applicant or Agent):!F�
Lender's Address: l►-r//j
LQPERMIT
Application Number . . . 05-00003955
Permit . . . ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . . 33.50 Plan Check Fee .00
Issue Date . . . . Valuation 0
Expiration Date 3/11/06
Qty Unit Charge Per . Extension
BASE FEE 15.00
1.00 . .18.5000 .EA ELEC SVC <=600V/<=200A 18.50
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Special Notes and Comments
100 AMP METER PEDESTAL
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ------ --- ----------
Permit Fee Total 33 .50 .00 .00 3.3 .50
Plan Check Total .00 .00 .00 .00
Grand Total 33.50 .00 .00 33 .50
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COCHRAN COMMUNICATIONS CONSTRUCTION
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Cathedral City, CA 92234 w
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BIr, " City of la Quinta
Building S% Safety DlVision
P.O. Box 1504
Pernnft 78.495 Calle Tampico
La Quinta, CA 92253
Building Permit Application and Tracking Sheet
Project Address: Owner's Name: TIME MMIYf R CAA L Z
Ar P. Nuunbcr: A -ess:
Legal Description: Ciry,ST,zip:,PA LM OfSE N 7- 72ZeC
QCRIFAn CD MM C DNS l Telephone
Contractor: C Tel hone: �D"/.� /2 s",''
Address:36"C-90 CATH£.D R,4L C YIY Project Dmcription:
City.ST,Zip: G147i'� Rff�}L CITY 92'23 F_y 700 AMP 1vTf,,5 PrEOES7A_ L
ff 11p
Telephone: /F��/I
State Lic.#:q 795 # 5 Ciry Lic,#: 819 .9
Arch.,Engr.,Designer:
Address:
City,ST,Zip:
:;>'i.«• y \� ' Consuucuoa T 1A
Telephone: ,Y<.. . ;c<? �['x<.:a; Ciccupanry
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State Lic.#: ^ : "-%`i°w >'tyr'! ? i3: Project type(circle one): New Add"n Alter Repair Demo
Name of Contact Person: Sq.lrt. #Stories: N.Units:
O�
Telephone#of Contact Person: Esdmated Value of Project: IZ
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