ELEC (14-0455)r P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92
$e
Titvl 4 XP Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
LENNAR HOMES
980 MONTICETO DR
CORONA, CA 92879
(951)817-3500
Contractor:
Applicant: Architect or Engineer: POWER PLUS
1210 REDGUM
edl, ANAHEIM, CA 92806
(714)765-7551
Lic. No.: 980589
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 Pjpssional- ride, and my License is in full force and effect.
License Class: C10 D31 // Ligase No.: 980589
Date:\11 t rl&T Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of peri' ry at I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Bus s 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 _ 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 1, 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.).
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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:
LQPER1111T
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/17/14
STE.300
C D e u
.t
t A�� i 7 ?
C�TYG9F LAQUINTA
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.
I have and will maintain workers' compensat on 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'XL SPECIALTY Policy Number CWG7409307
I certify that, in the performance of the work for which this permit is issued, 1 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 bject to thea workers' compensation provisions of Section
3700 of the Labor Code, I shall f with
coaft v with those orovisions.
Date: ]� t TI I`1 Applicant: /�
WARNING: FAILURE TO SECUREERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDTHE 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 orrect. I agree to comply with all
city and county -ordinances -and state laws relating to building c nstruction, a hereby authorize representatives
o�;i`countyto-enter aabove-mentioned pro ertyfor _spe.tion p poses.
Date: Signature (Applicant-or)Age 1:
Y
Application Number:
14-00000455
Property Address:
81052—MONARCHOS CIR
APN:
767-320-999-260 -32879 -
Application description:
ELECTRICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
1200
Titvl 4 XP Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
LENNAR HOMES
980 MONTICETO DR
CORONA, CA 92879
(951)817-3500
Contractor:
Applicant: Architect or Engineer: POWER PLUS
1210 REDGUM
edl, ANAHEIM, CA 92806
(714)765-7551
Lic. No.: 980589
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 Pjpssional- ride, and my License is in full force and effect.
License Class: C10 D31 // Ligase No.: 980589
Date:\11 t rl&T Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of peri' ry at I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Bus s 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 _ 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 1, 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.).
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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:
LQPER1111T
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/17/14
STE.300
C D e u
.t
t A�� i 7 ?
C�TYG9F LAQUINTA
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.
I have and will maintain workers' compensat on 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'XL SPECIALTY Policy Number CWG7409307
I certify that, in the performance of the work for which this permit is issued, 1 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 bject to thea workers' compensation provisions of Section
3700 of the Labor Code, I shall f with
coaft v with those orovisions.
Date: ]� t TI I`1 Applicant: /�
WARNING: FAILURE TO SECUREERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDTHE 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 orrect. I agree to comply with all
city and county -ordinances -and state laws relating to building c nstruction, a hereby authorize representatives
o�;i`countyto-enter aabove-mentioned pro ertyfor _spe.tion p poses.
Date: Signature (Applicant-or)Age 1:
Y
LQPERAIIT
Application Number . . . . . 14-00000455
Permit ELECTRICAL 2013
Additional desc . .
Permit Fee . . . . 23.83
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . . 10/14/14
Qty Unit Charge Per
Extension
1.00 23.8300 EA ELEC TEMP
POWER POLES
23.83
----------------------------------------------------------------------------
Special Notes and Comments
ELECTRICAL - TEMPORARY POWER POLE. 2013
CALIFORNIA BUILDING CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . PLAN CHECK,
ELECTRICAL.
16.68
.
PERMIT
ISSUANCE M/P/E
90.57
Fee summary Charged Paid
----------
Credited
--------------------
Due
---------------------------
Permit Fee Total 23.83
.00 .00
23.83
Plan Check Total .00
.00 .00
.00
Other Fee Total 107.25
.00 .00
107.25
Grand Total 131.08
.00 .00
131.08
Bin #
City of La Quinta
BBuilding &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
s
5�
Project Address: M e to arr
Owner's Name: (� GS
A. P. Number:
Address: 6,910 M 4.0 r . 15 'v- 30v-
0 -Legal
LegalDescription: sX
City, ST, Zip: Ct{ 42 8 79
Contractor: �a
Telephone: • �� ;S�'Q
>><-<::<:.::.;;.,.:::: <:.::;.
Address: K
Project Description: -r-em o-ye
City, ST, Zip: 4eAtM CA, 4 zg Die
Telephone:ne: 5• S
� �•� s r
,.
State Lic. # :rj g
City Lie. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
Construction cy-
Type: e: /h cu
State Lie. #:
Project type (circle Ad d n ' Alter Re air De m6
Name of Contact Person:orb Gr �L Z
10%Telephone
Sq. Ft.: # Stories:
#Units:
# of Contact Person: p. J{
Estimated Value of Project: I. aac
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
t
2dReview, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted '
Grading
IN I40USE:-
7n° Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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