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08-0495 (ELEC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253. Application Number: 08=00&00495____1 Property Address: 53190 AVENIDA RUBIO APN: 774-043-010- - Application description: ELECTRICAL Property Zoning: COVE RESIDENTIAL Application valuation: 250 Tityl 4 4 Quum BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Applicant: Architect or Engineer: -------------------------------------------------- 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 Professionals Code, and my License is in full force and effect. License Class: C/ont 1►0 License No.: 3 76189 Date• — -{/ ractor: q 7 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 sheds 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 sheds 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).: (_) 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 contractors) licensed pursuant to the Contractors' State License Law.). 1 _ ) I am exempt under Sec. , BAP.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 (Sec. 3097, Civ. C.). - Lender's Name: Lender's Address: 1J t LQPER_N11T Owner: JOHN MOORE 53190 AVENIDA RUBIO LA QUINTA, CA 92253 Contractor: BRANNEN ELECTRIC 46324 ROUDEL LN LA QUINTA, CA 922c (760)347-3829 Lic. No.: 376189 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/25/08 ------------------ 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 STATE FUND Policy Number 3009487-2008 _ 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 sho d become subject to the workers' compensation provisions of Section 3700 of the Labor shall fort ith comply with those provisions. ate scant: WARNING: FAILURE TO SECURE WORK ' 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, 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 bove information is correct. 1 agree to comply with all city and county ordinances and to laws relating to bu' i construction, and hereby authorize representatives of this county to enter upop4ie above-mentioned prop rt r inspe' purposes. t ignature (Applicant or Agent): c• .n Application Number . . . . . 08-00000495 Permit . . . . . . ELEC-MISCELLANEOUS Additional desc . Permit Fee . . . . 22.50 Plan Check Fee 5.63 Issue Date Valuation . . . . 0 Expiration Date 9/21/08 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 7.5000 EA ELEC PWR APP >1 TO <=10 7.50 -------------------------------7-------------------------------------------- Special Notes and Comments SO L.F. CONDUIT FROM J -BOX TO POWER DRIVEWAY GATE. APPLICANT ADVISED TO GET FIRE APPROVAL. Fee summary Charged Paid Credited --------------------------------------------------------- Due Permit Fee Total 22.50 .00 .00 22.50 Plan Check Total 5.63 .00 .00 5.63 Grand Total 28.13 .00 .00_ 28.13 LQPERMIT `QN ASY3 - -- �— �= 1181HX3 . Grp tiZ 31x0 r. 1J.M HNA00 A8 03ANddll - - - N3tNliitld301N3V4'd013AN __- X "p s W V(� 1 rc 1I2^ /JJ n 2X �G 2. v o Bin # City-6f La.Quinta Building g Safety Division. Permit.# P.O. Box 1504, 78-495 Calle Tampico. Q �q La Q6inta, CA, 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet - -Proj� d_y dress:... S3 / 9p iAvtt A. P. Number: Legal Description: Owner's-Name' To V-" o o ✓`e_ dA dress:_i S3/ ,�• �LA 1 � "- -City; ST, Zip: 3 LC =-1- `Telephone:- — `-°•_• -Proje tDescription: Contractors 6 / l G Address: / C JJ - City, /.7 y Telephone:7�Q-� ' State Lie. # :3 7City Lic. #: - O � � -- Arch., Engr., Designer: Address: City, ST, Zip:. Telephone: Construc i n;-T Occu an p cy. _ State Lic. #: �= `Name.of-Contact-Person: ofnp ,_ Project type (circle-one): New Add'n Alter Repair Demo Sq. Ft : #Stories:. #Units: i Telephone-#_of-Contact-Person: �(�� _ rT Es-mated-Value-oftiProject: _�Q APPLICANT DO. NOTWRITE BELOW THIS LINE # Submittal Req'd Recd 'TRACKING . PERMIT FEES Plan Sets Plan Che&submitied Item Amount Reviewed, ready for corrections Plan Check Deposit Structural Calcs. 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'correctioni/issue'. Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked-up S.M.I. H.O.A. Approval Plans resubmitted Grading INHOUSE:- Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. ApprDate of permit issue School Fees . Total Permit Fees