06-2095 (ELEC)P.O. BOX 1504 VOICE (7 60) 777-7012
78-495 CALLE TAMPICO FAX (76101777-7011.
LA QUINTA, CALIFORNIA 92253UILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
G)'j� •. BUILDING PERMIT
Date: _ 5/19/06
Application Number: 0.6-000020.95 Owner:
Property'Address: 91 R'79 IN SHEA LA QUINTA
APN: 764-280-999-L -300235- C/O JEFF MCQUEEN
Application description: ELECTRICAL 8800 N GAINEY CENTER
Property Zoning: MEDIUM HIGH DENSITY RES SCOTTSDALE,, AZ 85258
Application valuation: 120.0
Applicant: Architect or Engineer:
a1�
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LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm.under penalty of perjury that am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of f_ the Business and Professionals Code, and my License is in full force and effect.
License Class: C7 License No.: 178543 `
/ate 5-w ontractor-
OWN ILDER'DECLARATION
I hereby affirm under penalty of perjury that l 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, after, improve, demolish, or repair any structure, prior:to Its issuance, also requires theapplicantfor the
permit -to file,a signed statement that he or she is licensed pursuant to the provlsione 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 ($600).:
(_ 1 1, 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 forsale (Sec: 7044, Business and Professions Code: The
Contractors' State Licensi 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 notintanded or offered for sale. If, however, the building, or improvement is sold within
one yea? of�complstion, the owner -builder will have the burden of proving that he or she did not, build or
improve for the'purpose of sale.).
(_)
1, as owner of the property, am exclusively contracting with licensed contractors toconstructthe.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 coritrector(s) licensed
pursuant to the Contractors' State License Law.).
Tam exemptunder Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm,under penalty ofperjury that there is a construction lending agency for the performance of the
work for which this=permivis issued (Sec. 3097, Civ. C.).
Lender's Name::
Lender's Address:
LQPEXWT
Contractor:
COCHRAN COMMUNCATION
36630 CATHEDRAL CYN L
CATHEDRAL CITY, CA 92
(760)328-6778
Lic. No.: 478543
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WORKER'S COMPENSATION DECLARATION
1 heraby-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
Coda, for the performance of the work for which this permit is issued. My workers' compensation
insurance owder and,policynumberare:
Carrier STATE -FUND. Policy Number. 0460008625
_ 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
3900 of the Labor Code, l s rthwi comply with those -provisions; .
te�?-`�
WARNING: F TO SECURE WORKERS' CO PENSATIDN COVERAGE IS UNLAWFUL AND SHALL
ECT
AN'EMPLOYER TO CRIMINAL.PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 0100,0001. IN ADDITION TO'THE COST OF COMPENSATION, DAMAGES AS.PROVIDED FOR IN
SECTION, 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'SFEES.
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 benerit 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, indemnffy and hold'harmless the City
of La Quints, its officers, agents and employees for any act or ornission 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 isnot commenced
within 180 days from date of issuance of such permit, or cessation of work for 186 days will subject
permit to cancellation.
I certify that I have read this application and state that the above informationis correct. I agree to comply with all
cil�nd cou rdinances.and state laws relating to building construction, and hereby. authorize representatives
aOftis oo to enter upon the -above-mentioned. prope fo,inspection purp
D' zZ��°$IgnIApplicent or Agent):
Application Number . . . . . 06-000.02095
Permit ELEC.-MISCELLANEOUS
Additional desc . .
Permit Fee 33.5.0
Plan Check
Fee
.00
Issue Date
Valuation
0
Expiration Date 11/15/06
Qty Unit Charge Per
Extension
BASE.FEE
15.00
1.00 18.5000 EA ELEC
SVC <=600V/<=200A
18.50
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Special Notes and Comments
-
100 AMP METER PEDESTAL
Fee summary Charged
Paid Credited
Due
Permit Fee T=tal 33.50
.00
.00
33.50
Plan Check Total .00
.00
.00
.00
Grand Total 33.50
.00
.00
33.50
LQPEMT
I BM
City of La Quinta
Building ax Safety Division
P.O. Box 1.504
78-49S Calle Tampico
La Quinta, CA 92253
Building Permit Application and Tracking Sheet
Owner's Nam: TIME WARIM R CAOM
Address: q172S C 0 0 /f 3 T
City,ST.-zip:P,4L/V DF,5fF7' 92ZeO
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Telephone: 2 �0 — 49 z
Project Description:
:700 AMP METE)f PE9fST,4L
9.
Construction Typo AM Occupancy: IVA
Project type (circle ,one).CNejw Add'u Alter Repair - Dem
Sq. Ft.. # Stories:
Units:
Estimated Value of Project:
Carson Box
80'-3" Condui
Carson Box
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(not to. scale
Thomas Guide
5590-B-1
COCHRAN COMMUNICATIONS CONSTRUCTION
36-630 Cathedral Canyon Drive
Cathedral City, CA 92234
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