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07-2879 (ELEC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: t 0,7i -00.00T979 --\T Property Address: 52695 AVENTDA RUBIO APN: 773-282-022-9 -000000- Application.description: ELECTRICAL Property Zoning: COVE RESI-DENTIAL .. Application Valuation: 100 Applicant: Architect or Engineer: ----------------- LICENSED CONTRACTOR'SDECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of perjury that am licensed under provisions of Chapter;9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: License No.: Date: Contractor: OWNER -BUILDER DECLARATION I•heretiy affirm under penalty of perjury that I am exemptfrom the Contractor's State License Law for the following reason(Sec. 7031..5, Business and.Professioris 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 pplicant for permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001.: - (. 1 _ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and 00 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 thework.hlmself 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 forthe purpose of sale.). (_ 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 contractor(s) licensed pursuant io the Contractors' State License Law.). - 1 _ ) I am exempt under. Sec. B.&P.C. for this reason ate: / d ,(/ ner: 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: tt Lender's Address: n LQPERAIIT Owner: SOLIS MANUEL 52695 AVENIDA RUBIO ID LA QUINTA, CA 92253 ---------------------- VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/31/07 .. r 31 Contractor: ©� 1001 Owner ZP11V YDFPIr ---------------------------------- 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 ofthe.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 andpolicy number are: " Carrier �I Policy Number - 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 provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. icant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL 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, ANDATtORNEY'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 forthon 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 ab 'info r ation is correct..I agree to comply ' h all city and county ordinances and state laws relating to buildi constr ction, and hereby authorize represe a ' es of this coun y to ter upon the above-mentioned propert fo tion urposes. Gate:/� / Q 1 ' ature (Applicant or Agent): Application Number . . . . . 07-00002879 Permit . . . . . . ELEC-SERVICE CHANGE Additional desc . . Permit Fee 33.50 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 4/28/08 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 18.5000 EA ELEC SVC <=600V/<=200A 18.50 ---------------------------------------------------------------------------- Special Notes and Comments INSTALL NEW 125 AMP RESIDENTIAL PANEL 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 OWNER/BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted`in your namelisting yourself as the builder of the property improvements specified. For your protection you should,be aware that as "Owner/Builder" you, are the responsible, party of record on such a permit. Building permits -are not required to be sighed by property owners unless they are personally performing their own work. If your work is:being performed •by someone ;other than yourself,',you may protect yourself from possible liability if that person .applies for the proper permit -in his or her name. Contractors are required by law to be. licensed and bonded" by the State of California and to have a business license from the City or County'.' They are also required':by law, to, put their. lic'e'nse number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following 4riforination, for your benefit:and protection: If you employ or otherwise engage any persons other. than your immediate family, and the work (including materials and other costs) is $200:00 or more for the entire project; and such person's are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer, you must register with the State and Federal Government as an employer and you are subject to several obligations include State 'and Federal income tax withholding, federal social security taxes, worker's compensation insurance, disabiliy insurance costs and unemployment,compensation contributions. There may be financial risks for'you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. For more specific information about your. obligations under Federal Law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors,are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors' is to secure an "Owner/Builder" building permit, erroneously implying that the property owneris providing his or her `own labor and material personally. Building permits are not required to be signed;,by property owners unless, they are performing their 'own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N. Street, .Sacramento; California 95814:-'• Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of these matters. The building permit will not be,issued until the verification is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La Quinta, CA 92253 (760) 777-7012 FAX: (760) 777-7011 S0 s OWNER'S SIGNATURE/DATE PROPERTY ADDRESS D7- 04`79 PERMIT NUMBER(S) j Bin # ...City of La uinta Building U. Safety Division. P.O. Box` 1504,.78495 Calle Tampico La Quints, CA 92253 - (760),•777-7012 -Building Permit Application and Tracking Sheet Permit # ' Project Address: v_ .. Owner's Name:. - (/!`% . A. P. Number: Address: �Q z7 Legal Description: • City, ST, Zip: 4o�_ //✓�oQ CW Contractor: - : � / TelephoneQ ' 112 . Address: Project Description` City, ST, Zip: .Telephone: State Lic. # : City Lic. #: Arch., Engr., Designer: Address: l City, ST, Zip: Telephone: �s 4 oP T ;� Co'Tnstru..dE�-i ype: Occupancy: State Lic. #: "'Project+type (circle, one): New Add'n Alter Repair Demo Name of Contact Person: .Sq." Ft.: #Stories: #Units: Telephone# of Contact Person: Estimated Value of Project: APPLICANT:. DO NOT WRITE BELOW'THIS',LINE # Submittal Req'd '•Rec'd TRACKING PERMIT FEES Plan Sets -Plan Check submitted Item _ Amount Structural Calcs. Reviewed, ready for corrections E 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 Subcontactoe List Called Contact Person Plumbing Grant Deed Plans picked- no: `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 .