12-0148 (ELEC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
I111111VIIIIIIVIII(III 41
IE
Application Number:c-x'12-00000148
Property Address: 54420 AVENIDA ALVARADO
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
774 -241 -028 -
ELECTRICAL
COVE RESIDENTIAL
800
Tay/ 4 4 athiral
Architect or Engineer:
1 ft
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
REYES DIEGO/MURILLO CHASSIDY
54420 AVENIDA ALVARADO
LA QUINTA, CA 92253
Contractor:
CADD WORKS INC
31475 CALLE HELENE
THOUSAND PALMS, CA
(760)272-5183
Lic. No.: 917955
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/16/12
922 ,6 Cm OF LAC)
FINANCE f-?cPT.
UCENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 a licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3,of the Business an Professionals Code, and my License is in full force and effect.
License Class: B -D06 -C29 License No.: 917955
ab te: Li& -24 Zntractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I :m exempt from the Contractor's State License Law for the •
following reason (Sec. 7031.5, Business and rofessions Code: Any city'or county that requires a permit to
construct, alter, improve, demolish, or repair ny 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 (5500).:
( ) 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.).
( I 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 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.).
Lenders Name:
Lender's Address:
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 •
VI certify that, in the performance of the work for which this permit i5 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 shoo become subject to the workers' compensation provisions of Section
3700 of the Labor C I shall forthwith comply with those provisions.
e:?%'I4
WARNING: FAILURE TO SECURE W RKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL.
SUBJECT AN EMPLOYER TO CRIMI L PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,0001. IN ADDITIO 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 Ouinta, 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 ab ve information is correct. I agree to comply with all
city and county ordinances and state laws relating to buil.'. • struction, and hereby authorize representatives
of this c�•.unty to enter upon t e above-mentioned prop-vg-ction purposes.
U
D. e: ( 6-(�L12, ature (Applica
Application Number 12-00000148
Permit
Additional desc
Permit Fee . .
Issue Date . .
Expiration Date
ELEC-SERVICE CHANGE
33.50
8/14/12
Qty Unit Charge Per
Plan Check Fee
Valuation
BASE FEE
1.00 18.5000 EA ELEC SVC <=600V/.<=200A
.00
0
Extension
15.00
18.50
Special Notes and Comments
UPGRADE EXISTING ELECTRICAL FROM 100 AMP
TQ 200 AMP. 2010 CODES. .
Other Fees
Fee summary
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
LQPERM IT
BLDG STDS ADMIN (SB1473) 1.00
Charged Paid Credited Due
33.50
.00
1.00
34.50
.00
.00
.00
.00
.00
.00
.00 .
.00
33.50
.00
1.00
34.50
ern.#....
C!�/. of i s .Qu!nta
• Bultding st Safety Division •'
P.O. Box 1504, 78-495 Calle Tampico .: •
La.Quinta, CA 92253 - (760) 777-7012
Building Permit AP plication and Tracking Sheet •
•
•
Permit #
ll'
Project Address: rJ 4. q 2 O , NADA A cv,40.60o
Owner's Name:. Lu C>r(lo(2 S . •
A. P. Number.. .. 7/4- 241. p2.6 .
Address: . .•
Legal Description: Lo'- 1 a
City, ST, Zip:
Contractor• c op koxiNC.5 r PO G, •Telephone:
Ntrittifilti:n7
Address: 3 (4-1s- • cA u% 646Le,„
: Project Description: 'E cz-r� C 1. Me' n'
City, ST, Zip: 74°QSg0_0 ' Pn , GA 2277S.
OPGR Du.6 i '�(o M
Telephone•;
�;,:C,•.r> " z'INFi
�0� T'� Z
State Lic. # :. • •
City Lie. #;
Arch., Engr., Designer
Address:
City, ST, Zip: .
•
Telephone:
•
`\>°:
.pSC '"Construction
:
y � ' '•••
type: Occupancy: .
State Lic. #:
. Project type circle one): New Add'n Alter Repair Demo
Name of Contact Person: R t cmz(xp .m3U l�� • Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 1 bo 222 �?
5i j Estimated Value of Project . ' • .
APPLICANT: DO NOT WRITE BELOW THIS UNE '
#
Submittal •
Req'd
• Rec'd .
TRACKING
' PERMIT FEES
Plan Sets
Plan Check submitted
Item •
• Amount •
Structural Cates.
•
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
_
. Called Contact Person
Plan Check Balance.
•
Title 24 Calcs.
Plans picked up
Construction •
Flood plain plan
Plans resubmitted
Mechanical
•
Grading plan
tad Review, ready for corrections/issue
Electrical
Subeontactor Inst
Called Contact Person
'
Plumbing
. Grant Deed
•
Plans picked up •
S.M.I. '
H.O.A. Approval
Plans resubmitted •
Grading .
• IN HOUSE:-
'''' Review; ready for corrections issue
Developer Impact Fee.
Planning Approval.
Called Contact Person
A.I.P.P.
Pub. Wks. Appr •
Date of permit issue . .
School Fees • •
•
•
Total Permit Fees
Received From:
Address:
Account No.
Service Address
❑ Meter(s)
❑ Service(s)
❑ Backflow(s)
❑ House Lateral(s)
-/
LPt). &-/ oC94'
/3 ot(s)
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL
❑ DetectorCheck(s)
❑ Meter Surcharge
1Xsanitation Capacity Charge 57c-
0
7 _❑ WSBFC
❑ Temporary Construction Meter
❑ Turn on Charge . -
❑ Uncollected Account - Name
❑ Inspection Fee - Tract -
Fee -
ID Plan Check Fees Water I Sewer -
Tract -
• Bond Payment - A D - Bond
Assmt
❑ Customer Deposit
❑ Other
Remarks:
❑Copy to:
Check
Money
Order
11111111111111111111 42
Na 4A?62
Date:
f -,
Trach-
Y 41*--- G.A. Code
TOTAL $ 7=-2 SSG
Water Service