ELEC (09-1282)61405 Living Stone Dr
09-1282
Application Number: 09-000.01282"
Property Address: C61 04 5 LIVING STONE DR
APN: 764-280-999-11 -300236-
Application description: ELECTRICAL
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 900
Applicant: Architect or Engineer:
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 s an of sionals Code, and my License is in full force and effect.
License Cla -D06 License No.: 841588
-Date:_ _ on[r tca or
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 ($500):
(_ 1 'l, 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 I,am exempt under Sec. BAP.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
Owner:
TAYLOR RESIDENCE
61405 LIVING STONE DRIVE
LA"QUINTA, CA 92253
Contractor:
DESERT EMPIRE HOM
85400 GRAPEFRUIT
COACHELLA, CA 922
(760)398-7100
Lic. No.: 841588
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/21/09
WORKER'S COMPENSATION DECLARATION 5
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 STATE FUND Policy Number 459000382
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 be subject to the workers' compensation laws of California,
a d agree that, if I should become su ct to the workers' compensation provisions of Section
3 FOO 91 the Labor Co II forth ith comply with those provisions.
_Date_ - .91)p _
WARNING: FAILURE TO SECURE WORKERS' COMP SATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO'CRIMINAL PENALTIE 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.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 t Wormation correct. I agree to comply with all
city and county ordinances and state laws relating to b ' dinghereby authorize representatives
of this cou ' y o enter upon the above-mentioned prope�r7ty o ises.
Date:- Signature-(Appl�r� _Agent):
Application Number . . . . 09-00001282
Permit . . . . . . ELEC-MISCELLANEOUS
Additional desc
Permit Fee 33.50
Plan Check
Fee
00
Issue Date, . .
Valuation
. . .
. 0
Expiration Date 6/19/10
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 18:5000 EA ELEC
SVC <=600V/<=200A
18.50
---------------------------------------------
Special Notes and Comments
7 ------------------------------
SUB -PANEL FOR FUTURE POOL.
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
J
Bin #
City of La Qu.
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:
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Owner's Name: (OV-
A. P. Number: ���
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Address:
Legal Description:
City, ST, Zip: V)J 3
Contractor:
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Telephone:s4y.aC:
Address: �
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Project Description:
City, ST, Zip:
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Telephone: �j `j Q O
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State Lie. # :
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City Lie. #:
Arch., Engr., Designer:
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Address: Address:
City., ST, Zip: til S�3
m ..' ,<s.Tele hone: —(0.......>3..
State Lie. #:>{.k' 'jw v 4
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:
A S -(e 3
],Estimated -Value of-ProJect-..�,--
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
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 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing'
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctlonstiissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
GIVIL ENGINEER APPROVED DETAIL REQUIRED PRIOR TO C4CAGTRUGTI0N
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