ELEC (10-0087)61565 Living Stone Dr
10-0087
Application Number: 10-00000087 - -
Property Address: 61565 LIVING STONE DR
APN: 764-280-999-16 -300236-
Application description: ELECTRICAL
Property Zoning: MEDIUM HIGH DENSITY RES.
Application valuation: 300
Applicant:
Architect or Engineer:
d/P
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT .
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LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
LicenSe Class: B C53 License No.: 185102
Date:2 $ O ontractor:
OWNE -BUILDER DECLARATION
I hereby affirm under penalty of per hat 1 am exem 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 improvment 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.).
( ) 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
Owner:j r
TORRES D
61565. ING STONE DRIVE
LAQU T `� �2JI
�1
Contrac o .
--
CALIFORNIA POOLS & SPAS
78696 HIGHWAY 111
LA QUINTA, CA 92253
(760)771-6141
LiC. No.: -185102
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/08/10
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WORKER'S COMPENSATION DECLARATION
I h6eby 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 ARCH INS CO Policy Number ZAWCI9090400
_ 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 become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor C de, 1 shall forthwith comply with those provisions.
/bate: a cant:
WARNING: FAILURE TO SECURE WO KERS' COMP SATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRI ALL
PENALTIES ND 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. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this4;oZe
he above-mentioned proper[ for inspection purposes.
Date: (Applicant or Agent):
Application Number . . . . . 10-00000087
Permit . . . ELEC-MISCELLANEOUS
Additional desc .
Permit Fee 15.75 Plan Check Fee
3.94
Issue Date . . . . Valuation . . .
. 0
Expiration Date 8/07/10 '
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
.75
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Special Notes and Comments
INSTALL 125 L.F. 1" CONDUIT FOR FUTURE
ELECTRICAL (PRE -FAB FOUNTAIN). 2007
CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee Total 15.75 .00 .00
15.75
Plan Check Total 3.94 .00 .00
3.94
Other Fee Total 1.00 .00 .00
1.00
Grand Total 20.69 .00 .00
20.69'
LQPERMIT
Bin #
Permit #(�
`
lug
Project Address: G( 565 Ll J i w
City of LQ Quinti
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet =
Sloo e Owner's Name:
A. P. Number:
Address:
Legal Description: 306�j"(_(p
Lol hof f
City, ST, Zip:
T
Contractor: a ( i r0 P N 1 Q, 60{5
Telephone:
p
Address: 7 1 !'/ O uJ 14 Vt
i 1 G'
Project Description:
City, ST, Zip: L 4,,4 1 Z�S�
�G 1� o Fpr
Telephone: 60 S'7 y 6 7
riEa•, :yfi��,ti�: .
'?
City Lic. C
fakte eTru e�
State Lic. # : S d
Arch., Engr., Designer a �i11
p
Address:
City., ST, Zip:
Telephone: <`
State Lic. #:
Name of Contact Person:
;. �fi�~� £'w`w.,'h . �.
`z%ryw",�,
Construction Type: IVQ.IA% Occupancy:,
Project type (circle one): New Add'n Alter Repair Demo
Sq. FL:
# Stories:
# Units:
Telephone # of Contact Person:0
Estimated Value of Project: 3Qd, D
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Plan Sets
Req'd
Recd
TRACKING PERMIT FEES
Plan Check submitted Item Amount
Straciaral Cala
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'! Review, ready for correctionsliissue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked op
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
M HOUSE:-
J" Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I,P,P,
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
II
I