10-1261 (ELEC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 10-00001261
Property Address: 48721 SAN ISIDRO ST
APN: 646 -130 -023 -
Application description: ELECTRICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 1500
Applicant:
T A •ht 4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
Owner:
MICHAEL PHEIL
48-721' SAN IS
LA QUINTA, CA
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VOICE (766).777-7012
'FAX (760) 777-7011
INSPECTIONS (760) 777-7153
--Noy �3zo;o- ID,
Contractor: aTF711y=,V�0,4C
QUPWA
Owner EPT.
Date: 11/17/10
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• 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 I I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business 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: License No.:. for by Section,3700 of the Labor Code, for the performance of the work for which this permit is
Date: 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
a yy
pplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars IS5001.:
() 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. It, 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 .l.
(_ 1 I am exempt under Sec. , B.&P.C. for this r on oe
Date: f(P tOnen
CONSTRUCTION LENDING A ENCY
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 Addresss�
LQPERMIT
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 V Policy Number
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 becomesubject to workers' com nsation provisions of Section
/—?700 of the L or Code, I shall forthwith co ly with those r visions.
**&0kd�
a� te:Applicant:
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 information is correct. ree to comply with all
city and county ordinances and state laws relating to building construction, and hereby orize representatives
of thisWttr upon the above-mentioned property for inspection purposes.Spplicant or Agent):
r
Application Number 10-00001261
Permit . . . ELEC-SERVICE CHANGE
Additional desc
Permit Fee . . . . 33.50 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 5/16/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 18.5000 EA ELEC SVC <=600V/<=200A
18.50
Special Notes and Comments
MOVE METER FROM CURRENT LOCATION TO
OUTSIDE WALL OF GARAGE, PER REQUIREMENTS
FROM IID. APPROVAL BY KK. 2007 CODES.
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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
LQPERMIT
Request to move electrical meter
Michael & Zsuzsanna Pheil
48721 San Isidro
La Quinta, CA 92253
760-20371590
APN:646130023 t
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P.O. BOX 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMP[CO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
PROPERTY OWNER'S PAC
RAGE
(760) 777-7012
FAX (760) 777-7011
Disclosures.& F6rms for Owner-B.uil¢ers A*pl�ag for Construction Permits
l MANT1 NO. gyp
Dear Ft eperty Owner.
Ari. application for a building permit has been submitted in your name listing yourself as the builder of the .property
impvowments specified at ! 'n2. l S PYQ
: W�e are ponding you with an Owner -Budder AcknoWledgment and Information Veri&eatkm Form to matte you awaea.of your
responsibilities and possr'ble tisk you may incur by having thispermit.issued in yournamme as the
Owner -Builder. We wW not issue a bWtdt g pem& uwtft yeWhave read, itll ded your undentaading of each:vrw ision,
signed, and returned this form to as at our offldal address indicated. An agent of the owner cannot execute this.•notice
Unless you, the property owner, obtain the prior approval of the permitting authority.
#M%-V11"iW1MVr,*A. ttsff.%V.T Aft" VWTIMOUNWRa•rL gKWO Y
iF71ltH4CY1s0111S Read `iyatiat eachstateimeret &etbw tt� sj&* you rrru#nrstaad`orVe�r{�y Ms b#brnnadom '
40WI understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owwr-Builder'
building permit that erroneously implies that the property owner is providing his. or her own labor and. material petsori0Y.1, as
an Owner -Builder, maybe held liable and subject to serious. financial risk for any injuries sustained by an unlicensed person
and his or her employees while working on my Property. 'My homeowner's insurance may not provide coverage for those
injuries. I am willfully acting as -an Owner -Builder and am aware of the limits of my insurance -coverage for injuries to workers
on my. property.
22. 1 understand building permits are not required to be signed by property owners unless they are responsible for the
construction and are. not hiring a licensed Contractor to assume this responsibility..
4�123. I understand as an "Owner -Builder" I am the responsible. party of mord on the permit. I understand that I may protect
myself from potential financial risk by hiring at licensed Contractor and having the permit filed in his or her name instead of my
own.(�24
I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
permits and contracts.
�5. I understand if I employ or otherwise engage any persons; other than California licensed Contractors, and the total value
of my construction is at least five hundred dollars ($500), including labor and materials. I may be considered an "employer"
under state and federal law.
<�26. t understand if I am considered an "employer" under state and federal law, I must register with lite grate and federal
government, withhold payroll taxes, provide workers' coinpei�sat. disability insurance, and' -contribute to u utployment
compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial
risk.
I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
tures cannot .legally build them with the .intent to offer them for sale unless all work iserformed b licensed
P Y
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed
under contract with a licensed general building Contractor.
understand as an Owner -Builder if I .sell the property for which this Y
4ganciall
P perty permit is issued, I may be held liable for an or personal. bouries susgahted by.any subsequent owner(s) that result from any latent constriction defects in the
workmanship or materials.
I understand I may obtain more information regarding my obligations as an "employer" from the Interrml ROMMu®
ervice, the United States Small Business. Administration, the California Department of Benefit Payments. and the California
Division of Industrial Accidents. i also understand I may contact the California Contractors' State License Board (CSI.B) at 1-
800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
0. I am aware of and consent to an. Owner -Builder building permit applied for in my name, and understand that I am the
01
Pte' 1e8allY and financially rwporxsible for
proposed construction activity at. the following address:
' ) t S ti�n1 tC
-- $ 1 l.dam- wii J;Y -- - -- --
l. I agree that, as the party legally and financially responsible for this proposed.construction. activity, I will abide by all
cable laws and requirements that goveia Owner -Builders as well as emP to Yers.
1 2. 1 agree to notify the issuer of this form immediately of any additions; deletions, br c6�ge8 to �y of the i ti I
have provided on this foam. Licensed contractors are regulated by laws designed to protect the public. If you Contract with
-someone who does not have a license, ft Contractors, State License Board rutty be unable to as�t'you with any financial loss
you may sustain as a result of a complaint.. Your only remedy against unlicensed Contractors may be i4°civil court: It is also
important for Yost to understand tbat-if an ualic eased Contractor or employee of that individual -or firra is injured while woddng
on .your Property, you may be held HM6 for damages: If you obtain a permit as Owrner-Builder and wish to hire ConUavtors,
you wrdl be zesponsrblo for v%*ing mer or not those Contractorsarel%ense�d and the status of thois _ waiters'
Coon insurance oovetuge. t�PY'
Before a building permit can be issued,, this .form must be completed and signed by the property owner and returned to
the agency responsible for isst t n t. Vlore: A copy of *e: properV owner's war's e, fem nota eep dor
other verification aceep#abte, to the tjoAvy is . r q w be p whentits pgai& is issued to verify the pwperV
owner's signature.
Signature of property owner Date:
Note:' The following Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to apply for a construction permit for the Owner. Builder.
Excluding.the Notice to Property Owner, .the execution of which I understand is my persomal reapoasibilitY, I hts*Y authorize
die follow t% persons} to act as my agents) to apply for, sign; and file'the documents necessary. to obtain an Owns -Builder
_ Permit for my Project...._ _
Scope of Construction Project(orDescription of Work): ��� rZ�T2�C►�-�, N E f� 2
Project location or Address: , �- 1 S (Dy L 0
Name of Authorized Agent:. Tel No _
Address of Authorized Agent:
I declare under penalty of perjury that i am the property owner for the address listed above and I personally filled out the above
information and certify its accuraey.lVote: A copy of the owner's driver's license, form notarisation, or other verification
acceptable: to the agency is required to be presented when the permit is issued to verify the property owner's signature..
Property Owner's Signature: Date:
Bin #
Qty Of La QUIZ?to
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
-Building Permit Application and Tracking Sheet
Permit #
Project Address: 8872 1 SA-#,) IS f ()12D
Owner's Name: N �� ZSU Z$W)Vtr1 L-
A.
A. P. Number: I Soo2Z
Address: 43724 SAS ISI 0124D. '
Legal Description: S ma Lg I L r E
Contractor:
°
City, ST, Zip: L,4-&) j N r. .C4- 9 Z 2.53
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Telephone: & � <$: ,: .::;: ,.; :. y.$ ryi45':
Address:
Project Description: y Q_IAJ 6 W67 6"6
City, ST, Zip:
►•it �i2OK t T. GU/1,aemr Loc4norj,
Telephone:
{:,i:{.%:;{'+ j•�>:'{{'�titi {ti Ffr v'{l!?ti;� i:;N: r•.{;r �?
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THE fs to E W t_ OF 1-t4 r5AQNL 6 .
State Lie. # :
City Lie. #:
WE: RA -D A-. A- .. 9 VQA Gly WQE a T 46FLI
Arch., Engr., Designer:
IZEt=VSc' TO P -U0 yT rU TO COLD LOCArl0.-,)
Address:
BeL4uSE IF DoES tel! me -e -T EIQ,� rvab
City., ST, Zip:
"�?v4 v�{{':}^':4±`µ4'j>�`.vt h$,'4xri. ns:,v,:^': ; �}
Telephone:`;;v''•.;<:s::y..y`.<;:ty`:`Vsv y.•;;.
State Lie. #: ''''!'?:{>:< 'r^''{'"'"'{' "'" ~;;.
'y{+.
Name of Contact Person:
ConstructionType: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:#Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG
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
21° 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:-
Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees