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04-6636 (ELEC)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 . . . . . 04-00006636 Date 10/06%04 Property Address . . . . . . 77895 AVENIDA MONTEZUMA APN: 773-101-005-9 -000000 Tenant nbr, name VILLAGE PARK ANIMAL HOSPI Application description . . . ELECTRICAL Property Zoning.. VILLAGE COMMERCIAL Application valuation . . . . 1500 Owner Contractor -------'----------------- ---------------- ------- FISCHER MICHAEL A JACKSON ELECTRIC 2240 YUMA WAY 8 CALLE LA REINA FULLERTON CA 92835 RANCHO MIRAGE CA 92270. (760) 408-2444 WCC: EXEMPT WC: EXEMPT 03/31%05 CSLB: 7435.40 12/31/05 CCC C10" ---------------------------------------------------------------------------- Permit ELEC-MISCELLANEOUS INV FEE Additional desc Permit Fee . . . . 70.00 Plan Check Fee 8.75 Issue Date Valuation 0 Expiration -Date 4/06/05 Qty Unit Charge Per Extension BASE FEE 30.00 2.00 1.5000 PER ELEC DEVICE/FIXTURE 1ST 20 3.00 ------------------------------------------------------ Special -------1_00 ---37_0000-EA-- -ELEC SVC <=60OV/<=200JA- -_� bM 37.00 --- I �`='jP=-------- Special Notes and Comments�l '� ELECTRICAL - INSTALL NEW 150 AMP SUB -PANEL IN TEMP STORAGE TRAILER FROM OCT,6 EXISTING SERVICE. WORK COMPLETED WITHOUT VALID PERMIT - INVESTIGATIVE FEES cITyOFLA _ �� Qtal�ir ASSESSED. 2001 CODES.- _ .,ADEPT Fee summary Charged Paid Credited` Due ----------------- -7 -------- ----------- ---------- ---------- Permit Fee Total 70.00 .00 00 70.00 Plan Check Total 8.75 00 .00 8.75 Grand Total 78.75 00 .00 78.75 P.O. BOC 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: Architect or Engineer: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: / _ O Architect or Engineer's Address: Lic. No.: tSUILUING PERMIT DECLARATIONS 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 Business and Professionals Code, and my License is in full force and effect. � L, License ijClass_j I �n License No. ( 3 �Ho Datey o —6—o i./ Contractor �1 G = i ay` �lr i OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I 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 file 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 the alleged exempfion. 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 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' 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. Policy Number 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 Code, I shall forthwith comply with those provisions. Date b b — 6 — C 1 Applicant LKee., WARNING: FAILURE TO SECURE WORKERS' 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 ATTORNEY'S 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.). Lenders Name Lenders 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 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. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. /mate ignature (Applicant or Agent): ' ' l�• { i J _ t W� •A Yom. '^�4 Y�•� °`;�� 3-�y . • f ' r. :. r � - . l i ... r "' .'sty ,..f111�• � -' 4 ; '� s ,- : - '.r-� Czi•Z�-a-iru CSG(} GU�G�+�� `" .. . CITY ®� Coil B_ UILADING & SAFETY DEPT. FOR CONSTRUCTION E® _ •� z,— SCJ, : :iJ `t t .�}, ; DATE6a d. Y. a to jjt;r, a �` f?3figgA'.3u t 7!� Oil 3RA 01Rrn I -M 3111- P: J 3+ ftp :. •yid°� Qr� � .c -,: .�� •� !• � � �..ii Iii � � �i t f •1 • x * ., , 7�tY ------------ /,/• . j ORA V►u.wsr, lAR., Ammyed by: at Peso # - 0 Planning Commission, City Council ` 'Communi Dev. Dept. y Initials Case No.'! ---~---- Exhibit ` A ith Conditions C4 OP _ ✓WJE G✓r P /"t r�2 i� Ste•- 6�t.P.� ! T' — Nt� i'1'�P�t+cnhL 2 nis l �wnt r.�.••� .... Bio ' r-v� , t „ � ..e.. .�......._ i � .._ .. �-,'.1,v` ib aON 1ROU S Construction is NOT PERI~�.ITTIoa the following Code Holidays: ozvober ! at - April 30 Niv�F:.ciay _ ricin Y� 7:00 a.m. to 5:30 p.m• on New Year 's Day S im,rclay. 8:00 a.m. to 5:00 P.M. Dr. Martin Luther King Jr. Day A» None Code ldoiidays: None President's Day vvexl2mer't 1st . September 30th Memorial Day 6:00 a.m. to 7:00 p•n independence Day l�, �r+.i1a ;Friday: y 8:00 a.m. m to 5:00 p.• Saturday: Labor Day Swiday: done None Government Code JLlolidays: Veteran's Day Thanksgiving Day Christmas Day A RE -INSPECTION FEE OF $30 WILL BE CHARGED IF THE APPROVED PLANS AND JOB CARD ARE NOT ON THE SITE FOR A SCHEDULED INSPECTION. NO EXCE?SIONSI 41 "AN ADEOUATELY SIZED DEBRIS CONTAIN!0l IS REQUIRED ON THE JOB SITE DURING ALL PHASES OF CONSTRUCTION AND MUST BE EMPTIED AS NECESSARY FAILURE TO DO SO MAY CAUSE THE CITY TO HAVE THE CONTAINER DUMPED AT THE EXPENSE OF THE OWNER/ CONTRACTOR." in 240 d -w CSG(G c.��I a 7�,erc�li �o,g- ✓ � i�G O,-COpY Aooroved by atReso # ❑ Planning Commission ❑ City Council Commune Dev Initials ®` Case. No. Exhibit. Nith Conditions_.,,_` .7Y A,$ ts-. E4O(7?.rC.f-r iss � �"SuCt•R.f,egC ... _ A�(!4�k , �✓�O lKrwyt (�S't- �r�i t l T --. 61Ji7 �!-:�P/GC�'N'C_ P4, -2 - Zo o -,,,-p ci'rt UltS I