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04-5832 (ELEC)78065 Main St 04-5832 Ot BUILDING & SAFETY DEPARTMENT P.O. Box 1504 _ (760).777-7612 78-495 CALLS TAMPICo FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION• REQUES-fS•(7,60) 777-7153 BUILDING PERMIT Application Number . . . . . Property Address APN: Application description Property Zoning . . Application valuation Owner OLD TOWN LA QUINTA 78080 CALLE ES.TADO #200 LA QUINTA CA' LA QUINTA CA 92253 4. 0_0'0r0 5.8.3 2- 78065 MAIN ST 770 -121 -003 - ELECTRICAL VILLAGE COMMERCIAL 30000 Date 8/18/04 Contractor ------.------F-. ------- . MARVIN INVESTMENTS, INC. 78080 CALLE ESTADO SUITE 201 LA QUINTA CA 92253 WCC: STATE FUND WC: 14401252004 07/01/05 CSLB: 771883 11/30/05 CCC: B Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 284.50. Plan Check Fee 184.93 Issue Date . . . . Valuation . . . . 30000 ,Expiration Date 2/18/05 Qty Unit Charge Per. -Extension BASE FEE 252.00 5.00 6.5000 THOU BLDG 25,001-50,000 32.50 Permit . ... . . ELEC-MISCELLANEOUS ; Additional desc Permit Fee 31.50 Plan -Check Fee 7.88 Issue Date . . . Valuation 0 Expiration Date 2/18/05 Qty Unit Charge Per Extension BASE FEE 15.00 22.00 .7500 EA ELEC POLE LIGHT' 16.50 -----------------=---------------------------------------------------------- Special Notes and Comments D 2'2 it— GHT--S-T-ANDARDS, OLD SLI - 4nil TOWN PHASE I & U --- ,O;ther3 Fere-Is ----------- V STRONG MOTION (SMI).- COM 6.30 CITY of LA QUINTA FINANCE DEPT. P.O. BOX 1504 • ' VOICE (760) 777-7012 78-495 CALLS TAMPIG FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4 4 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: _Q. 83 Applicant: Go.✓T/L4 To lL Applicant's Mailing Address: Date: Y - /Y- d Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING 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 e e is in full force and effect. i 1J License ClassT License No. Date 'To at kA Contractor m Qn,V`t/V, Vb0J-0 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 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).): 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 sate.). 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: 1 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 iss y workq9' compensation insurance carrier an QQIigqy r ar Carrier Policy Number I L v 1 D9 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. ►nJ Date Applicant 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.). Lender's Name Lender's 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. I 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 ab e- myenpttiioned property for inspection purposes. Date v I,/(/ ` Signature (Applicant or Agent): • 1' r M1 Page 2 Application Number 04-00005832 Date 8/18/04 Fee summary Charged Paid Credited Due Permit Fee Total 316.00 .00 .00 316.00 Plan Check Total 192.81 .00 .00 192.81 Other Fee Total 6.30 00 .00 6.30 Grand Total 515.11 .00 .00 515.11 y r DEC -09-04 THU 10:25 AM MARVIN HOMES FAX NO, 7607715057 y ' 5 s CITY OF LA QUINTA t " BUILP ING & SAFETY DEPARTMENT Eb ov _ /• 777-7012 /Sy, /INSPECTION REQUEST LINE u% 777-7153 0--- er• 1TT V IN LA QUINTA Contract©r- INVESTMENT,INC. Permit Number' POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 78-065 MAIN ST. 22 LIGHT STANDARDS TYPE OF INSPECTION DATE, INSP. TEMPORARY POWER _ SETBACKS _ U/G PLUMBING / WASTE U/G ELECTRICAL/ GROUNDING FOOTINGS / STEEL _ CONCRETE SLAB DO NOT POUR CONCRETE UNTIL ABOVE SIGNED _ ROOF NAIL / PRE -ROOF OKAY TO WRAP FRAMING (COMBINATION) ROUGH ELECTRIC _ ROUGH PLUMBING ROUGH MECHANICAL INSULATION I COVER NO WORK UNTIL ABOVE SIGNED INTERIOR GYP. BD. (DRYWALL _ EXTERIOR LATH ' GAS TEST _ SEPTIC ABANDONMENT _ SEWER CONNECTION SEPTIC ! GREASE INTERCEPTOR MASONRY INSPECTIONS FOOTINGS / STEEL BOND BEAM POOL / SPA / WATER FEATURE INSPECTIONS _ PRE-GUNITE / SETBACKS U_/G PLUMBING U/G GAS U/G ELECTRICAL PRE -PLASTER ALARMS / BARRIERS FINAL INSPECTIONS _ TEMP. USE OF PERMANENT POWER ELECTRICAL PLUMBING MECHANICAL PUBLIC WORKS DEPARTMENT _ COMMUNITY DEVELOPMENT DEPT. _ FINAL / JOB COMPLETED O C ABOVE APPROVALS DO NOT INCLUDE RIGHT TO .TURN ON UTILITIES OR OCCUPY BUILDING P, 02