07-2718 (ELEC)P.O. BOX 1504
78-495 CALLE TAMPICO
7 LA QUINTA, CALIFORNIA 92253
Application Number: 07-00002718
Property Address: 51371 AVENIDA NAVARRO
APN: 773-103-008-2 . -000000-
Application description: ELECTRICAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 3400
Applicant: Architect or Engineer:
a N��
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LICENSED CONTRACTOR'S DECLARATION
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Proles 'onals Code, and my License is in full force and effect.
License Class: C10 License No.: 879507
Date: 1 of 0 'mil Contra r:
OWNER•BUILDER 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 exemptibn. 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).:
I _ 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 ISec.
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— 1 I am exempt under Sec. B.&P.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 ISec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
Owner: .
DOYLE RESIDENCE
51371 AVENIDA NAVARO
LA QUINTA, CA 92253
(
Contractor: .
LUERSEN, FRANKLIN
7350 ACOMA, 44
YUCCA_VALLEY, CA
(760)369-7002
Lic. No.: 879507
VOICE (760) 777-7012
FAX (760) 777-7011 .
INSPECTIONS (760) 777-7153
Date: 10/08/07
9228
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
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 proyisions.of Section
3700 of the Labor C , s all rthwco ply with those provisions. '
I Date: /o L4-07 Applica.
WARNING: FAILURE TO CU WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER Rim
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. -
APPLICANT ACKNOWLEDGEMENT -
IMPORTANT Application is hereby made to the Director of Building and Safety fora 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 cons ction, and hereby authorize representatives
of this county to enter upon the above-mentioned property f io purposes.
D tae f�/ Signature (Applicant or Agent): / .
LQPERMIT
Application Number 07-00002718
Permit . . . ELEC-.SERVICE.CHANGE
Additional desc .
°Permit Fee 33.50
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date 4/05/08
Qty Unit Charge, Per
Extension
BASE
FEE
15.00-
1.,00 „. 18.5000 EA ELEC
SVC <=600V/<=20.0A
18.50
---------------------------------------------------------
Special Notes and Comments .
--------------------
ELECTRICAL SERVICE CHANGE OUT 100
AMP
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
Bin #
—_
City of La Quinta
Building.0 Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701'2-
Building Permit Application and Tracking. Sheet
Permit # �M
('y
Project Address: 51371 AVtl.h I do%'. a J01. r
Owner's Name:
A. P. Number:
Address: Jt` ( 3 2 1 AvIe t VW D
Legal Description:
Ci ::
h', ST ZiP i! Ct u C 4
Contractor:
Telephone:
Address: SO 14-60M Sk T,r _
Project Description:
p�/
City, ST, Zip: lilC C �l C c, ' .
ClV co Q 1 yl
Telcphone: '7�OU" 6 — &O (i
"y-
u' ,:
'�. C-4 \–1 Qckt q e oit C/U0
State Lic. # : City Lic. #.-
Arch.,
:Arch., Engr., Designer:
j
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New .Add'n Alter . Repair Demo
Sq. Ft.: #Stories: # Units:
Name of Contact Person:
Telephone # of Contact Person:
Estimated Value of Project:*3 Lt 00
APPLICANT: DO NOT WRITE BELOW THIS LINE.
#.
Submittal
Req'd
Recd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
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