06-0653 (ELEC)P.O. BOX 1504 VOICE (760);777=70.12 r
78-495 CALLE TAMPICO a _ . FAX (760) 777-7011
` +Y~ LA QUINTA, CALIFORNIA 92253 t BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777'7153
BUILDING PERMIT
' Date:. 2/13/06 _
• Application Number: ,06-00000653 Owner. 1
Property' Address: 525"6"0 AVENIDA RAMIREZ GARCIA ROBERTO
APN: -773-292-003-21 -000000- -,,.n 52560 'AVENIDA RAMIREZ
V� Application description: ELECTRICAL LA QUINTA, CA 92253
Property Zoning: COVE RESIDENTIAL ------------- ------------- ---,--
'Application valuation: 250 A 1
Y , .
Contractor:
EB 4 2006
Applicant: .r Architect or Engine'4:FOwner
t
CITY OF LA QUINTA - - - - - -
' FINANCE DEPT,
-- - - - - - -- - - -- - - - - -- ------- - - - - ------------------ - - - - -------------------- - - - - -—
x'
LICENSED CONTRACTOR'S DECLARATION - - WORKER'S COMPENSATION DECLARATION
hereby at under penalty. of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:.
Section 70001 ofDivision 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: - - License No.: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
' - issued.
Date: Contractor: - - 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 ,
' - OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier Policy Number -
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure,'prior to its issuance, also requires the applicant for the S person in any manner so as to become subject to the workers' compensation laws of California,
.permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State' + ;and agreethat, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of. the. Business and Professions Code) or 13700 of the Labor Code, I sh 1 orthw t comply, with jtho a provisions. - -
• • • . that he or she is exempt therefrom and the basis for the alleged exemptio. ny violation of Section 7031.5 by q •y �� - �•�,_ (��`��•V�— \,, 1� n ` r }-
• - any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: "Date: d� t <J—y6 ApplicanP5
I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and r - U
:'•.• the structure is not intended or offered for sale (Sec. 7044, Business and ProfessionsCode: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
fi? Contractors' State License Law does not apply to an owner of property who builds or improves thereon,' y SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUN DRED•THOUSAND
,and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN '
` improvements are not intended or offered for sale. If, however, the"building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
�J 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.). "' APPLICANT ACKNOWLEDGEMENT -
• 1, as owner of the property, am exclusively contracting with licensed contractors_ to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
_ 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). - - - whose benefit work is performed under or pursuant to any permit issued as a result of this application, •'
(_) I am exempt under Sec. = , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City.
of 02 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.
Date: - (, 1ti� Owner:— = _ _ - - : 2. Any permit issued as a result of this application becomes null and void if work isnot commenced -
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject '
CONSTRUCTION LENDING AGENCY - permit to cancellation.
'I hereby affirm under penalty of perjury that there is a construction lending agency for.the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building construction, and hereby authorize representatives _
of this county to enter upon the above-mentioned propertor inspecti purpo
Lender's Name: .r `— -
Dategnature (Applicant or Agent):
Lender's Address:.• -
LQPERMIT
u
LQPERMTT
Application Number . . . . 06-00000653
Permit ELEC-SERVICE CHANGE
Additional desc .
Permit Fee 52.50 Plan Check Fee
.00
Issue Date Valuation. . . .
0
Expiration Date 8/12/06
Qty Unit Charge Per
Extension
,
'
BASE FEE
15.00
1.00 37.5000 EA ELEC SVC <=600V/>200A/<=1000A
37.50
.
----------------------------------------------------
Special Notes and Comments
REMOVE EXISTING ELECTRICAL SERVICE &
REPLACE WITH 200 AMP ELECTRICAL SERVICE
Fee summary Charged Paid Credited
-----------------
Due
----------------------------------------
Permit Fee Total 52.50 .00 .00
52.50
Plan Check Total .00 00 .00
.00
Grand Total 52.50 .00 .00
52.50
u
LQPERMTT
Bin #
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012 J
Building Permit Application and Tracking Sheet
Permit #
Project Address:
Owner's Name:
A. P. Number:
Address: �c m` re cz- -
Legal Description:
g P
Contractor:
-
City, ST, Zip: p o % 3.
Telephone: — -
Address:
Project Description:
City, ST, Zip:
Telephone:
State Lie. # : City Lie. #:
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
Construction Type: Oocupancy:
State Lie. #:
Project type (circle one): New Add'rn Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project 5 0 m o
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACHING
3.
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
a
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 Permil Fees