08-1883 (ELEC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 08-00001883
Property Address: 4-97'90--C-OACH'ELLA DR
APN: . 646-240-005- -
Application description: ELECTRICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: —A—•
T,iht 4 4a Qu&&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
LYONS RESIDENCE�ff��
49-790 COACHELLA DRIV�E'�
LA QUINTA, CA 92253
Contractor:
Applicant: Architect or Engineer: PARKER LIGHTING AND_E
76719 KENTUCKY AVENUE
PALM DESERT, CA 92211
(760)345-8840
Lic. No.: 553706
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 Gass: C10 License No.: 553706
Date:)6 i d� Contractor:
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 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
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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_) I am exempt under Seca , 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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/21/08
LA�U A
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 EXEMPT Policy Number EXEMPT
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 1 should become subject to the workers' compensation provisions of Section
700 -of -the -Labor -Code, I shall forthwith cor ply with those provisions.
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 ($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 above inform"
q� is correct. I agree to comply with all
city and county ordinances and state laws relating to building cRnstrt Ind hereby authorize representatives
of this co4nty fjo enter upon the above-mentioned pro rty�for specti n poses.
Application Number . . . . . 08-00001883
Permit . . . ELEC-SERVICE
CHANGE
Additional desc .
Permit Fee . . . . 33.50
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date 5/20/09
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 18.5000 EA ELEC
SVC <=600V/<=200A
18.50
----------------------------------------------------------------------------
Special Notes and Comments
MAIN ELECTRICAL PANEL CHANGE OUT
REMOVE
'ZINSCO' 125 AMP & REPLACE WITH CUTLER
HAMMER 200 AMP
Fee summary Charged
-------------------------------------
Paid Credited
--------------------
Due
Permit Fee Total 33.50
.00
.00
33.50
Plan Check Total .00"'
.00
.00
.00
Grand Total 33.50
.00
.00
33.50
LQPERMIT
Bin #
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
(� r
Project Address: /V 7 Q (fd t" Owner's Name: G
A. P. Number: Address: _ Q
Legal Description: City, ST, Zip: (�
Contractor. - k4 `i < LcC• Telephone: Nil - 111111
Address: Project Description: _ 7� L
City, ST, Zip: s Q �—
Telephoner _-�24s _1�4P5cIG
tiL Z / n SCO ' l
State Lic. # : C— I0 7 cCe City Lic. #: _
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
State Lic. #:
Name of Contact Person: Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: Estimated Value of Project:'
APPLICANT: DO NOT WRITE BELOW THIS LINE
q
Submittal
Plan Sets
Req'd
Rec'd TRACKING. PERMIT FEES
Plan Check submitted Item Amount
Structural Calks.
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 correctionsfissue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN I-IOUSE:-
M Review, ready for correctionstissue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks, Appr
Date of permit issue
School Fees
Total Permit Fees