ELEC (11-0354)51771 Avenida Martinez
11-0354
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-00000354
Property Address:
51771 AVENIDA MARTINEZ
APN:
773-175-025-2 -000000-
Application description:
ELECTRICAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
600
Td / 4 4a Q"
Applicant: Architect or En 'h r:
----------------
LICENSED CON S DECLARATI
I hereby affirm under penalty of perjury that I am lic ed under pro ions o f (9 (commencing with
Section 7000) of Division 3 of the Business a f fessionals Code, and a see is in full force and effect.
License Class: B -C54 -C8 Licens 9 33
Date: [ Contractor:
OWNER -8 L ER 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—) 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 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 _ 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 contractors) licensed
pursuant to the Contractors' State License Law.).
(_) I am exempt under Sec. , B.&P.C. for this reason
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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:
GARCIA THOMAS P
51771 AVENIDA MARTINEZ
LA QUINTA, CA 92253
Contractor: rD
A A MAX QUALITY CONSTR.
46433 MESA VERDE TR
INDIO, CA 92201
(760)844-4045
Lic. No.: 919733
VOICE (760) 777-7012
FAX (760) 777-7011 .
INSPECTIONS (760) 777-7153
Date: 4/08/11,
°D ON APR 112011
LA
-----------------------------------------------
WORKER'S. 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.
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 nu r are:
Carrier STATE FUND Policy Number 23800119
_ I certify that, in the performancb of the work for whi this p tis issu , I s of employ any
person in any manner so as a me subject tote cers' co ens aws of California,
and agree that, if I shout
ecome subject to the o ers' c ensa ' rovisions of Section
700 of the Labor e, jsha11 fo with compl w th those provi
•Date: It Applicant
WARNING: FAILURE TO SECURE WORKERS' COMPEN6AT415N COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 0100,0001. 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 Ouinta, 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 ' of comme ed
within 180 days from date of issuance of such permit, or cessati of work for 18 days ill su ' t
permit to cancellation.
I certify that I have read this application and state that the above inf a ion is correct. 1 agree c ply th all
city and county ordinances and state laws relating to building c ion, and ereby authori rep esen tiv
of this count tt/o/P er upon the above-mentioned property inspection ur ses.
Date: Q `' Signature (Applicant or Agent):
Application Number . . . . . 11-00000354
Permit . .
. ELEC-SERVICE
CHANGE
Additional desc .
.
Permit Fee
33.50
Plan Check Fee
.00
Issue Date . . .
.
Valuation . . .
. 0
Expiration Date
10/05/11
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 18.5000
EA ELEC
SVC <=600V/<=200A
18.50
----------------------------------------------------------------------------
Special Notes and
Comments
REPLACE ELECTRICAL
METER 100 AMP
TO 200
AMP.
------------------------------------------------=---------------------------
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
3.4.50
LQPERMIT
Bin #
CityOf La Quin
Building 8r Safety Division
Permit # ✓ P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253• - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: f 77/ Owner's Name:
96 DM .4lS 4-
A.
A. P. Number: Address: Avi! 414"w CZ
Legal Description: City, ST, Zip: c.J
Contractor: 1A14 /4+)((o.L.f Iilsfijca-il
Address: 1/64(03
City, ST, Zip:
Telephone: `7Co ^ 7' '":>;,; <_>:::><:>:<:'•.:':'`>:>'•<::: >:::
State Lic. # : 9/ City 'Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
v: >::r.`{•,. }: g'?<x:.{, ::,
Project Description:
:. {.. ;C}: '[: v,.}}:}{ Q::}./v}9•. vis:
Construction Type:
State Lic. #: :;:;: •:y{.}::.}}r ,✓'` ;:}.}}.4
"z<^`•`•, .t•`:•°<r>:f n'.z:>;%'' Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Sq. Ft.: # Stories: #Units:
Telephone # of Contact Personf' ?d6) --24W
# Submittal Req'd
Plan Sets
Structural Calcs.
Truss Cities.
Title 24 Cales.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
Estimated Value of Project: &Q&o
APPLICANT: DO NOT WRITE BELOW THIS LINE
Recd
TRACKING
Plan Check submitted
PERMIT FEES
Item
Amount
Reviewed, ready for corrections
Plan Check Deposit
Plan Check Balance
Called Contact Person
Plans picked up
Construction
Plans resubmitted
Mechanical
2" Review, ready for correctionsflssue
Electrical
Called Contact Person
Plumbing
S.M.I.
Plans picked up
Plans resubmitted
Grading
Developer Impact Fee
A•I.P.P.
Review, ready for correctionsfissue
Called Contact Person
Date of permit issue
Total Permit Fees