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05-4863 (ELEC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 05-00004863 Property Address: 81847 COUPLES CT APN: 764 -060 -042 - Application description: ELECTRICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 500 T,�df 4 4 Q" Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that) am licensed under provisions of Chapter9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License, Class: B License No.:. 760044 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..6, Business and Professions Code: Any city. or county that requires a permit to construct, alter, improve; demolish, or repair any structure, priorto 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 permit subjects the applicant to a civil penalty of not more than five hundred dollars ($600)•: (_) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not'Imended 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 bullding or improvernerd 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 ofaale.). (_ 11, 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 Lew does not apply twan 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. , 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 (Sec. 3097, Civ.. C.). Lender's -Name: Lender's Address: LQPER31IIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/01/05 Owner: BIRDIE HOMES, 300 E. STATE REDLANDS,, CA LLC ST. STE. 100 011'17'2 Contractor: FIRST PACIFICA DEV 300 EAST STATE.ST, REDLANDS, CA 92373. (909)7.98-3688 Lia.. No.: 760044 DLNOV11005 It OF LA QUINTA FINANCE DEPT. ------------------ 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:self4risure 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 BUND Policy Number W-5734291 _ I certify that, in.the,performance of the work,for which this permit is issued, 1 shall not employ any person imeny.mannerso:as to become subject to.the workers' compensation laws of California, nd.agree that, if I.should become subject.to the workers' compensation provisions of Section 3700 of the Labor ode, I shall forthwith comply with titQpejMovisions. 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 (9100;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 fora permit subject to the conditions,andrestrictions 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, andrthe applicant, each agrees to, and shall defend,Andemnify and hold harmless theCity of Le Ouirna,Jts 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 vokflf 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 above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of.t/hiss county to enter upon the ve=mentioned property for inspection purp 0991vi— `\ 1— ' nature (Applicant.or Agent Application Number . . . . . 05-0.0004863 Permit' . ELEC-MISCELLANEOUS al Additiondesc . Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date . . . Valuation . . . . 0 Expiration Date . . .4/30/06 Qty Unit Charge Per Extension BASE, FEE 15.0 0 1.00 15.0000 EA ELEC TEMPORARY POWER POLE 15,.00 Special Notes and ------------------------------------------------------ Comments TEMP 001-4 POLE' Fee summary Charged Paid Credited Due .Permit Fee Total ----------- ---------- 30.00 ---------- ---------- .00 .00 3,0.00 Plan Check Total .00 .00 .00 :00 Grand Total 30.00 .00 .00 30.00 LQPEBMIT rA do 4 70 Perndr # Project.Addrew. City of La Quinta eSafew Dwsw P.O .Bear 1504, 78-4PS Calk Tampico /a Qdntk CA 92253 - (760) 777-7012 BLiiding Permit Appiicadon and Tracking Sheet 's lame: �. A. P. Number !,So mon: Cita. ST. Zip: Catnact Addt= �� � Projetx Cm•. ST. Tip: - State Lie. p : Arch_ Engr Designer: Cita Lie. n: Addriess: Cit}. ST. Zip: Telephone Cot»ttetion T�•pe: Occuitaatn•: Project type icircle one): New Add'n Ater Repair Demo State Lic i=: Name of Cotttact Person:Sq..Ft.: x Sc Units Telephonef+ of Contact Person: imated Value of Pra" a Submittal Req'd .APPLICANT: DO NOT WRITE'SM.OW THIS UNE Reed TRACiatiC PERMIT FEES Plan Sets Pian Check submitted Item' Amount Structural Coles. Reviewed. ready for co.. eetioas Plan Cheek Deposit Truss Calix Called Contact Person Plan Check Balance Tide 2A CRIM Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan X" Review. ready for eorreetionsrissue Electrical Subeootstaor Lst Catled'Cootaet Person Plumbing Grant Deed Plans picked up Sma. H.O.A. Approval Mas resubmitted Grading M HOUSE:- s"' Review. ready for eorreetionsrissue Developer impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appy Date of permit issue School Fees Total'PermitFees