12-0138 (ELEC)P.O: BOX 1504
78-495 CALLE TAMPICO .
LA QUINTA, CALIFORNIA 92253
Application Number: 12-00000138
Property Address: 48801 SAN LUCAS ST
APN: 658-310-001- -
Application description: ELECTRICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 300
T-itvl 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
PAGE TOBY C
C/O CANTOR & FITZGERALD
3811 TUTLE CREEK DR NO 16
DALLAS, TX 75219
Contractor:
Applicant: Architect or Engineer: FRAZIER ELEC I
PO BOX 96 �I�U
LA QUINTA, CA 92247 (J�
(760)772-5830 f
1 Lic. No.: 938762 I
-------------------------------------------------------------------�
LICENSED CONTRACTOR'S DECLARATION WORE
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury ori.Id
Section 7000) of Division 3 of the Business and Profess iqj6Is Code, nd my License is in full force and effect. I _ I have and will maintain a cernfu
License Class: C10 l LL o.: 938762 for by.Section 3700 of that
i
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.l.
(_ 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 _ 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: e
Lender's Address: f
LQPERMIT
VOICE (760)777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/15/12
�cSNT,
:R'S COMPENSATION DECLARATION
the following declarations:
to of consent to self -insure for workers' compensation, as provided
or Code, for the performance of the work for which this permit is
issued. J
_ I have and will maintain workers'i 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 i Policy Number EXEMPT
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 subje i td the work rs' compensation provisions of Section
3700 of the Labor Call forthw' i co y t those provisions.
k�— `� plicant:
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. I agree to comply with all
city and county ordinances and state laws relating to building construction, and Areby au Re representatives
of this countytoenter upon the above-mentioned propett inspection s.
s�Z L5ure (Applicant or Agent):
Application Number . . . . . 12-00000138
Permit . .
. ELEC-TEMPORARY POWER
Additional desc .
Permit Fee . . .
. 30.00 Plan Check Fee
.00
Issue Date .
. Valuation
0
Expiration Date
8/13/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 15.0000 EA ELEC TEMPORARY POWER POLE
15.00
----------------------------------------------------------------------------
Special Notes and
Comments
TEMP POWER PEDESTAL FOR REMODEL OF SFD.
2010 CODES.
----------------------------------------------------------------------------
Other Fees . .
. . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary
Charged Paid Credited
Due
-----------------
Permit Fee Total
----------------------------------------
30.00 .00 .00
30.00
Plan Check Total
.00 .00 .00
.00 .
Other Fee Total
1.00 .00 .00
1.00
Grand Total
31.00 .00 .00
31.00
LQPERMIT
—tt � 125 AMP=.MOBILE HOME METERED PEDESTAL—HARDW-IREO-120/240 HVAC C: f
arr>rh:atM�tkX � ilw.'�AMtld„�ws�]•Ij49',,q:s•�Y!°it"b•• ^-' A�F'.'fh� a'tr�tC'?,i`Y9'74�:1C�.AtiwitelCa.Ci .a.r•L' .^.s3 .r 4 �:uw-..rte
1".'1.3.;11:- r+�r�=� 'vrtcnatt�fi•�n•^,�n.ro.mr� yy lsr� ^ywt� _Mff-y,_
STANDARD CONFIGURATIONS
�s►t� °'� BLANK 50 I 10010� OMB
1 -50A/125 -250V 100A, 2Pole CB 100A, 2Pole Main CB
►t�• � ago -� ria �! m� •
!l ' m m
{ '%•t g?•►, f I SII \i '� iF I -Tl -i--
_ _ I
503020GR 11 00-20GR � 1 � L�
t
1-50A/125V-250V 100A, 2Pole CB
1-30A/125V 1-20A/125V I
MPRV-100-MB-78
1-20A/125V
I
A G N B
SPECIFICATIONS
I CATALOG NUMBER
DESCRIPTION
MPRV-BLANK-78
Ring type, parallel wired
MPRV-13LANK-78-R-5T
Rinnless, horn bypass '
MPRV-100-78
Ring type, parallel wired
MPRV-100-MB-78
Ring type, series wired
J MPRVA00-20GR-78
Rin type, parallel wired 9 YP
MPRV-50-78
Ring type
J MPRV-503020GR-78
I Ring type
4” k
49-1/2"
24"
t
>I
SINGLE
8"
• UL Listed 100 amp continuous duty meter socket.
120/240 volt single phase service.
•
Twin line termination lugs #6-350 kemil CU/AL per phase
for looping.
• Space for four (4) single, or one double (240V C/13 center -
positions cnly) and two (2) single pole universal style,
plug-in circuit breakers.
• Ringless version equipped with horn bypass as standard.
• For fifth terminal field installed order kit 105J in the
3 o'clock or 9 o'clock position.
• Direct rear feed kit PF -KR included.
• Specify MPRV-10048 for 100 amp service pedestal with
direct feed kit and 100 amp CB wired in parallel. Space
for two additional single pole CBs provided. Series wiring
available; specify MPRV-100-MB-78.
• MR -2 sealing ring standard with ring type cover.
•
No -knockouts.
(llilil)' requirements Jirr Nri; rquijimenl may vary. Ahvive coiisJdl !hr• sorvhkg Wilily for (heir rc-quirenrenic bvllorr nrde'i•in,; cir
irr+l.rllilig equiplijeW in this I-A.dn•4. �\
Bin. # 1
QEZ ® ujh �a
Bltilding'8t Safety Division .... ..
P.Q. Box 1504,"78-495 Calle Tarhplco '
La.Quinta, CA 92253 - (760)" 777-7012
Building Permit Application and Tracking Sheet
Permit �
Project Address: Q
Owner's Name:
A. P. Number.
Address: Q
D—m .
City, ST, Zip: C
t
Telephone:
Legal Description: '
Contractor. ���`
Address: 1 – C ro� �C Z�
Project Description: � '1
City, ST, Zip: Q
O ✓K C
Telephone: %C.0"-ra c -0C;: 1 \?v
4`�� .
State Lic. # : S 4 2-- City Lie'.
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone: "Y' : `�� ::'
State Lic. #: .f ;~
Name of Contact Person:Sq.
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACKING
PERMrT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Pian Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mecharitcal
Grading plan
V Review, ready for correctiionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O A. Approval
Plans resubmitted
Grading
IN HOUSE:=
3a Review; ready for correctionsfissue
Developer Impact Fee
Planning Approval-
Called Contact Person
AJ.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees