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12-0535 (ELEC)tw P.O. • BOX 1504 78-495 CALLE TAMPICO ' LA QUINTA, CALIFORNIA 92253 Application Number: rc�1 535-. Property Address: 2_,__52900-AVENIDA-7:RAMIREZ APN: 773-323-008-19 -000000 Application description: ELECTRICAL Property Zoning: COVE RESIDENTIAL Application valuation: • 1000 Architect or Engineer: �lA ------------------ 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 Professionals C e, and my License is in full force and effect. License Class: CIO i nse No.: 597452 Dat�-ntractor: OWNER -BUILDER DECLARATION - I hereby affirm under penalty of peury 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 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).: (_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and -11 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 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 to the Contractors' State License Law.) (_) I am exempt under.Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY 1 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: 1 P LQPERMIT 'VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS• (760) 777-7153 Date: 5/14/12 Owner: YANDLE RESIDENCE 52900 AVENIDA RAMIREZ LA QUINTA, CA 92253 Contractor: U HOWELL'S ELECTRIC 78875 WAKEFIELD D MAY 14 2012. LA QUINTA, CA 922 (760)835- ' 3180 CITY OF, LA QUINTA Lic. No.:597452 GINANCEDEPT. ------------------- WORKER'S COMPENSATION DECLARATION 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 TRVLS INS Policy Number WKN1361553 _ 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 provisions of Section x/3700 o/the ab e, I shall orthw'th co ply ith those prate. I 't: _ WARNING: FAIL E TO SECU�R,W KERS' COMPENSATION COVERAGE IS LAWFUL, AND SHALL SUBJECT AN EMPLOYER TOC IMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN TION 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 t 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 160 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 an0 state laws relating to building. construction, and hereb authorize representatives of thiss,06unty to /enter up o he above-mentioned prope r inspecti s. ate:S- I -(/ gnature (Applicant or Agent): Application Number 12-00000535 Permit . . . ELEC-SERVICE CHANGE Additional desc . Permit Fee 33.50 Plan Check Fee .00 ' " Issue Date . . . Valuation . . . . 0 Expiration Date 11/10/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 18.5000 EA ELEC SVC <=600V/<=200A 18.50 ----------------------------------------------------------- Special Notes and Comments ------------- ---- EMERGENCY CHANGE OUT DUE TO A DAMAGED BUSS BAR ON MAIN SERVICE. --------------------------------------------------------------------- Other Fees . . . .. . BLDG STDS ADMIN (SB1473) ------ 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 33.50 .00 .00. 33.50 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 34.50 .'00 .00 34-50 Bin. # Oty of La Quin to Buliding 8t Safety Division P.O. Box 1304,78-495 Calle Tampico 1.a.Quinta, CA 92233 -:(760) 777-7012 Building Permit Application' and Tracking Sheet Permit # Project Address:, ©� V �N �lf I%%/lQQ Ownu's Name:. Ce— A. P. Number. Address: 5;t Ott) O 4 V SIV -z- Legal Legal Description: City. ST. Zip: V'1 N + A ( CO V I Contractor. (�-� (g C_ f L f� G= Telephone: as�i: :-... Address-.7$ %i .S w A k a --('e-U' c(e- Project Description: [C/` C-Y i City, sT, Zip:. L-,A,- a v 10" . CA 0 Telephone., ^—�1 35�-- 31$0 m �;.��x•" � CU� Cj fir 2 State Lia # : L'j i J City Lir #;t� ► �1 : M _1. i� S - Arch., Engr., Designer Address: City., ST, Zip: l f-s S G ( 8 /v , Telephone: Construction Type• Occuparcy: State Lic. #: _ b Project type (circle one): New Add'n Ater Repair Demo Name of Contact Person• b pt LS • � r2 1 Sq. Ft.: #Stories: #Unit;: Telephone # of Contact Person . d'' 33-- 3 1 26 Estimated Value of Project: OO APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Reed TRACENG PERMIT FEES Plan Sets Plan Check submitted Amount Structural Cafes.Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Called Contact Person Plan Check BalawA Mile 24 Cates. Pians picked up Construction Flood plain plan Plans resubmitted Mechanical Giading plan V Review, ready for corrections/issue Electrical Subeonteetor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading ' IN IIOUSE:- ''a Review, ready for correetionsfissne Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Feas