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ELEC (08-1243)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA,'CALIFORNIA 92253 Application Number: 08-00001243 Property Address: 77995 CALLE MONTEREY APN: 774-095-026-2 -000000- Application description: ELECTRICAL Property Zoning: COVE RESIDENTIAL Application valuation: 800 c&ht 4 4 Q" Applicant: Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of perjury that I arp\licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals CLicense is in full force and effect. Licensee Class: C10 r\ Lice a Nod 70269 v Date:? Contractor: OWNER -BUILDER D RATION I hereby affirm under penalty of perjury that I am exempt from the o rtractor'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 70001 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.). (_) 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.). 1 _ 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY 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: ED.ROSA 2425 PARK GRANADA CALABASAS, CA 91302 (818)653-4343 Contractor: ESQUIBEL ELECTRIC, FRANK 83448 STAGECOACH ROAD BERMUDA DUNES, CA 92203 (760)347-5470 Lic. No.: 870269 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/23/08 D �1 p JUL 2 31008 CITY OF QUINTA FINANCE DEPT 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' 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 EXEMPT Policy Number EXEMPT 1 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 become subject to the workers' compensation laws of California, and agree that, if I should ecome subject to tha or s' compensation provisions of Section 3700 of the Labor de, I hall forthwith c��ly wj hose provisions. Date: l__4pplicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION C VERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL NES 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. - 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 be as null and void if work is not commenced within 180 days from date of issuance of such p rmit, or cessation of work for 180 days will subject permit to cancellation. I certify that.I have read this application and stkre.,that the ab a information is corre t..-I.agree-toy ply with all city and county ordinances and state laws relato building onstruction, and here authorize rentatives of this county to ent//eerr��r��i��upon the above-mentionproperty fork, spection purposes. 1, - Date: ��8ignature (Applicant or Agent . . Application Number . . . . . 08=00001243 Permit ELEC-SERVICE CHANGE Additional desc . Permit Fee . . . . •33.50 Plan Check Fee .00 Issue Date Valuation 0 Expiration Date 1/19/09 Qty Unit Charge Per Extension BASE FEE 15.00 1.100' - 18.5000 EA ELEC SVC <=600V/<=200A 18.50 ---------------------------------------------------------- Special Notes and Comments ELECTRICAL SERVICE CHANGE REPLACE BREAKERS & RECONNECT WIRES Fee summary Charged Paid Credited. Due --------- ---------- Permit Fee Total 33.50 ---------- .00 ---------- .00 33.50, Plan Check Total .00 .00 .00 .00 'Grand Total 33.50 .00. .00 33.50 LQPERMIT Bin # City of La Quints Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # 2 0 ll Project Address: q '� Ir,E Owner's Name: 7/r Wo S A. P. Number: Address: k Legal Description: Contractor: -ec City, ST, Zip: -/ 3b Telephone: b �+ Address: �j �q Project Description: / City, ST, Zip: ZZe� "3 Telephone:7W 5Cf 621 %G ' State Lic. # : -70 City Lic. #: Arch., Engr., Designer: - Address: City, ST, Zip: Telephone: tri- State Lic. #: Name of Contact Person: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: a e� Estimated Value of Project: b O APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '`" Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees