ELEC (001131),w.
PERMIT APPLICATION
City of La Ouinta
Department of Building and Safety
This permit becomes void if work not commenced within 180 days from date of issuance, OR, it work has been suspended or abandoned for period of 180 days.
Cavanauah Electric
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if
•" LICENSED' CONTRACTORS DECLARATION: I hereby affirm that I am'licensed under provisions of Chapter 9
the permit is for one hundred ($100) o. less. I certify that in the performance of the work for.which this permit is
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of
and effect. (j j — _
California.
License Class Lic: Numbert' I /s `•
Date Applicant
_
Date - / ^y `� � ''• ` Contractor •f ' -� `t ` •` -
NOTICE,TO APPUCANT::If, after making this Certificate of Exemption, you should become subject to•the Workers'
OWNER -BUILDER DECLARATION: I Hereby affirm that I am exempt from the Contractor's License Law for the
Compensation provisions of_the Labor Code, you must forthwith comply with such provisions or this permit shall
following reason (Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit to
be deemed revoked. ,
construct, alter, improve. demolish, or repair any structure, prior to its issuance, also requiies the applicant for
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
such permit tofile a signed statement that heis licensed pursuant to the provisions,of the Contractor's License Law
01 hereby certify that no exi:5vatibn five (5) o.r more feet in depth into which a person is required to descend, will be
(Chapter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code)or that he is exempt '-
made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or
therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by.any applicant for a.permit
demolition or•dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2; Grp 2, Art 2, Sec 341. Title 8,
subjects the applicant to a civil penalty of not more than five hundred dollars ($500.):
C.A.C.) '
0 I. as owner.of the property, or my employees with wages as their sole compensation, will do the work, and the •
0 As owner -builder, I will not employ anyone to di work which Would require a permit from the Division of
structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License
Industrial Safety, as noted above, unless such person has a permit to do such wdrk from that division.
Law does not apply to an owner of property who.builds, or improves thereon, and who does such work himself or
r
through his own employees, provided that such improvements are not intended or offered for sale. If, however, the .6
0 Division of Industrial Safety Permit No.
building or improvemnt is soldwithin oneyear of completion. theowner-builder will havethe burden of.proving that
Date Applicant
he,did not build or improve for the purpose of sale.).
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance .
• 0 I, as: owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec:
of the work for which this permit is issued (Sec. 3097: Civ. C.). .
7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who
Lender's Name
builds or improves thereon: and who contracts for such'projects with a contractor(s) licensed pursuant to the
SSB
Contractor's License Law.).
Lender's Address
0 l am exempt under Sec. . B. & P.C. (Attached Certificate).
I certify that I have read this application and state that the above information is correct. ) agree to comply with all
Date Owner' I
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of thiscouniy to enter upon the above-mentioned property for inspection purposes:
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure, or a
certificate of Workers' Compensation Insurance , or a certified copy thereof (Sec. 3800Aab. C.):
Policy No. Company
0 Certified copy is hereby furnished.
0 Certified copy is filed with the City Building Inspection Department or'City Department.
Date Applicant
APPLICANT NAME (L. F: MI) . r . •
Cavanauah Electric
ADDRESS ,
83-231 Hwy 111
CITY/COMMUNITY/STATE/ZIP
Indio, CA 92201
JOB SITE ADDRESS/SPACE
52-279 Avenida Navarro
CITY/COMMUNITY/STATE/ZIP
La Quinta, CA 92253
BOK
773
PAG'.PRC
27
012
C
Install a light switch in
TWN
PING '
SE '
S
TRACT
LOT
1
MOD
SB -
TRACT NAME
None
OWNER NAME (L, F, MI)-
Edward Sdarcy
CONTRACTOR -FIRM Applicint ` `
ADDRESS
Above
CITY/COMMUNITY/STATE/ZIP
Above
PHONE •
347-3608
LICNC
286936
ARC/ENG FIRM NAME '
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE .
{
17.50FEE
LICNC •
'
USE OF PERMIT
Zkomkm Electrical
BL
ZON
- FSB
SSB
SSB
RSB
OFC•
ZONE ORD 0. `
LOT SZ
, .END
SIDE
Signature of Applicant or Agent : Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this applieationand state that
the information given is correct 1I agree to comply with all state laws and county ordinances relating to buidling
construction, and authorize a representative of the City of La Ouinta Department of Building and Safety to enter
upon the property for which 1 have applied for this permit for the purpose of making inspections:
Signature of Applicant or Agent Date
Print Applicant/Agent Name
APPLJPRMT DATE
_ l12/11/84
Elect.
Permit to move meter and main to
fron of'property on N.W. corner of
garage.
To.install one 30 amp 240
V recep.
in garage., i
Install a light switch in
garage.
Elect. Fee 17.50
16
11wo-
TT
{
17.50FEE
BLDG. DEPT. VALUATION 1 800.00
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
34
Plenums & Ducts
2A
Slab Grade
35
Furnace Compart.
3
Steel
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
❑
43
Final
10A
Fireplace T. 0.
❑
NON
ADDITIONAL INFORMATION
i
SEWAGE SYSTEM SIZE &.LOCATION
11 Exterior Lath
12 Internal LathI8�1
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
128 Ceiling (Batts)
12C Ceiling (Blown)
147 Final
PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25 Final
Tank Pit L. Line
ELECTRIC APPROVALS
REAR OF PROPERTY LINE
p/L P/I
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
298 Bonding
30 Fixtures
31 Service
32 Final
STREET NAME