ELEC (13-0945)58834 Marbella
13-0945
4 P.O. BOX 1504 S VOID VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/30/13
Application Number: 13-00000945 Owner:
Property Address: 58834 MARBELLA CORAL OPTION I
APN: 764-200-072- - - 81570 CARBONERAS D
Application description: ELECTRICAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL 4
Application valuation: 2000
Contractor: r5r
Applicant: Architect or Engineer: TD DESERT DEVELOPMENT P Lly
P.O.
Op
LAQUI7
QUINTA, 92247 F NgA
(760)771-1941 DFp l Q
Lic. No.: 762987
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers' compensation, as provided
License CI s: Lice 762987 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
// issued.
Dat li Contractor: 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
r, .......- ode, for the performance of the work for which this permit is issued. My workers' compensation
OWNER-BUILDER DECLARATION - insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier CA REST MUTUAL Policy Number CRO1134517
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3 0 of the Labor C sha rthwith mp with thos o isions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by Q
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Dat ,pplicant:
(_ 1 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 ,WARNI G: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
(_ 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
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 info n is cor ct. I agree to comply with all
city and coun ordinances and state laws relating to building con coon, and eby authorize representatives
of this count to ter upon the above-mentioned prope f nspection purp es.
Date: 0 1 ignature (Applicant or A tl:
Application Number . . . . . 13-00000945
Permit . . . ELECTRICAL 2013
Additional desc . .
Permit Fee . . . . 23.83 Plan Check Fee
.00
Issue Date . . . . Valuation .
. 0
Expiration Date . . 1/26/14
Qty Unit Charge Per
Extension
1.00 23.8300 EA. ELEC SERVICES
23.83
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Special Notes and Comments
ELECTRICAL - INSTALL 200 AMP METER
PEDESTAL FOR (HOA). 2010 CALIFORNIA
BUILDING CODES.
7 -------------------------------------------------------------------
Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, ELECTRICAL
11.92
PERMIT ISSUANCE M/P/E
90.57
Fee summary Charged Paid Credited
-7 -------- ---------- ---------- ----------
Due
-----------------
Permit Fee Total 23.83 00 .00
23.83
Plan Check Total .00 .00 .00.
.00
Other Fee Total 103.49 .00 .00
103.49 .
Grand Total 127.32 .00 .00
127.32
LQPERMIT
Bin #
Permit #
/ -,IG
Project Address:
A.P. Number. ' O
Legal Description:
Contractor:
Address:
City, ST, Zip: Z Z
Telephone:
State Lid. # : 76 2-110 7
Arch., Eagn, Designer: -
Address:
City, ST, Zip:
Telephone:
State Lid. #:
City of La Quinta
Building a Safety Division
P.O. Box. 1504, 78-495 Calle Tampico
La Quinta, CA 92253 -.(760) 777-7012
//Building Permit Application and Tracidng Sheet
/ Owner's Name:
Z Address: 030 %iG
8 l City, ST, Zip; G F 2,1
Telephone: 77MM
Project Description:
t7tu E -L P`CPfST,4t-'-
CityLic. #: 99 2i
Name of Contact Person:
Telephone # of Contact person:
# Submittal
Plan Sets
Structural Calcs.
Truss Cates.
Energy Cales.
Flood plain plan
Grading. plan-
Subcoutactor List
Grant Deed
H.OA. Approvai
W HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
Construction Type: 0ompaac,_
Project type (circle one!
New Add'n Alter Repair Dano
Sq. FL: #Stories: #Unity
E.
Estimated
Val of Projxt: 1 -C!--
i4PPLICANT. DO NOT WY e--
BELC
Rec'd TRACMG-
Plan Check Submitted
Reviewed, ready for corrections
Called Contact person
Plans.pickcd. up
Plans resubmitted
2"Review, ready for eorrections/usue
Called Contact Person
Plans picked up
Plans resubmitted
3" Review, ready for correctlous/issue
Called Contact Person
Date of permit issue
THIS UNE
[tem
Plan Check Deposit
Pian Check Balance
Construction
Mechanical
Electrical
Plumbing-
S.M.I
Grading
Developet• Impact Fee
A.LP.P.
Total Permit Fees
Amount