14-0342 (ELEC)P.O. BOX 1504 4 Qk VOICE (760) 777-7012
78-495 CALLE TAMPICOFAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/31/14
Application Number: 14-00000342 Owner:
Property Address: 49788 COACHELLA DR COMMON LOT/ISLAND HOA
APN: 646-240-017- - - LA QUINTA, CA 92253
Application description: ELECTRICAL (760) 346-1161
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 1200
Contractor:
Applicant: Architect or Engineer: JETSON CONSTRUCTION ECTR
4565 CAMINO PAROCELA
PALM SPRINGS, CA 922 a .c t
V� (760)641-4817 VAR 3 5 201;
Lic. No.: 898493
CITY OF LA QUhgTA
PIR�:�.hCE L1�'PT:
----------------------------------7--------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with 1 hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Bu ess 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: B -C10 C i ense No.: 898493 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date: T/?1/4 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 EXEMPT Policy Number EXEMPT
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to certify that, in the performance of the work for which this permit is issued, 1 shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the erson 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 agree that, if 1 sh Id bec mLo-hwith�
bject 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 3 00 of the Labor C e, I shy I ply with those provisions.
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).: Dater 3 Applicant: i
(_) 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 WARNING: AILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS 1$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.
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 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.).
1 _) I am exempt under Sec. - , B.&P.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:
LQPER ITT
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.
I . 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 above information is correct. I agree to comply with all
city and county ordinances and state laws relating to bui Ping construction, and hereby authorize representatives
of s c
thio ty to me, upon the above-mentioned pro :y for Ispecti;
n pu se .
Date. �/ / Signature (Applicant or Agent):
Application Number . . . . . 14-00000342
Permit . .
. ELECTRICAL 2013
Additional desc .
.
Permit Fee . . .
. 23.83
Plan Check Fee
.00
Issue Date . . .
.
Valuation . . .
. 0
Expiration Date
9/27/14
Qty Unit Charge Per
Extension
1.00 23.8300 EA ELEC POWER
APPARATUS
23.83
----------------------------------------------------------------------------
Special Notes and
Comments
ELECTRICAL - REPLACE 100 AMP POWER
PEDESTAL LIKE FOR
LIKE. 2013 CALIFORNIA
BUILDING CODES.
----------------------------------------------------------------------------
Other Fees .
. . . . . . PLAN CHECK,
ELECTRICAL
23.83
PERMIT
ISSUANCE M/P/E
90.57
Fee summary
Charged Paid
--------------------
Credited
--------------------
Due
-----------------
Permit Fee Total
23.83
.00 .00
23.83
Plan Check Total
.00
.00 .00
.00
Other Fee Total
114.40
.00 .00
114.40
Grand Total
138.23
.00 .00
138.23
LQPERMIT
C . I . T1( ®F LA �IpEPTA
BUILDING & SA
APPROVED
DATE "�Il Y
El w ` 12- 10
LZ 0 LF5 Tl� L
7S8
CCS
- e -t T7-171-Gt S
Bin #
City of .La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
�-• �-2-
Project Address: 11 - 7 8 LLA t
Owner's Name: L !U /-/OA
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractoc:E SVtJG
Telephone: i'J
Address:
Project Description: L? G C D
City, ST, Zip: 3i Sly /Jv
Telephone:
21;:<ts::::»::>::::;.::;>;�:>:;:<%><:::
«;
State Lic. # : g 3
City Lic. #.
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
State Lic. #:
>:;.;;.,,.;::;::;::;;;<::>;;;;;;:: .:::>:: :>:;
..........................
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Z t G
Sq. Ft.:
# Stories:
#Units:
Telephone # ofContact Person: 766 6ql 41217
Estimated Value of Project:, , •�
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
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
Title 24 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
IN HOUSE:-
U4 Review, ready for correctionsCssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P-
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees