13-0377 (ELEC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 'BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
13-00000377
Property Address:
78810 SANITA DR
APN:
604-163-00.6-106 -23269.-
Application description:
ELECTRICAL
Property Zoning: •
LOW DENSITY RESIDENTIAL
Application valuation:
550
Applicant: Architect or Engineer:
------------------
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 Class: C10/ License No.: 397002
�T -*�13 Contractor-."trr �r
v
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 (Chapter9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or sheds exempt therefrom andthe 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).:
(_ 11, 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 chat 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.).
(_ 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 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: _
LQPERMIT
Owner:
JOHNSON BRADLEY
LA QUINTA, CA 92253
(760)464-3165
IN
Contractor:
COVE ELECTRIC, INC. f
77824 WILDCAT DRIVE li
PALM DESERT, CA 9221
(760)360-0036
Lic. No.: 397.002
VOICE (760) 777-7012
FAX (760) 777-7011_
INSPECTIONS (760) 777-7153
Date: 3/28/13
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';cornpensation, as provided
for by Section 3700 of the Labor -Code, for the performance of the work for which this permit is
issued.
�• ;gl?have and, will maintain workers' compensation insurance, as required by. Section. 3700 of the Labor
Code, for the performa3•ce of the work4-or which this permit is issued My workers' compensation
insurance carrier and policy number are: 3. `
Carrier INS..CO OF WEST Policy'Number WSD5005043.02
I.certify that, in the performance of the work for which this permit is issued,,) shall not employ any
person in any manner so as to become subject to the workeis' compensation laws of*California
and agree that, if I. should beco" subject to the workeis'.compensation provisions of Section
3700 of the Labo�r.C,ode, L- f thwith` mp)y with those provisions:"
/Date: O . �-,+TApplicant.', r
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, DAMAGE_ S 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 86ildingand Safety for a permit subject.to the.
conditions and restrictions set forth on this applicauon.
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.iesult `of This application,
the owner, and the applicant, each agrees to, and shall defend, indemnify antl 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 isnotcommenced
within 180 days from data 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 .hereby authorize representatives
of this
county to enter upon the above-mentioned property f p ctior//v/��)urrposes.
Date:'• - •+Signature (Applicant or Aggeri 1: �./�fi
Application Number . . . . . 13-00.000377
Permit . . . ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . . 26.00
Plan Check
Fee
6.50
Issue Date . . . .
Valuation
. . .
.
0
Expiration Date . . 9/24/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 11.0000 EA ELEC MISC
11.00
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Special Notes and Comments
ELECTRICAL - REPLACE ONE MAIN BREAKER.
2010 CODES.
Fee summary Charged Paid
Credited
--------------------
Due
-------------------------------------
Permit Fee Total 26.00
.00
.00
26.00
Plan Check Total 6.50
.00
.00
6.50
Grand Total 32.50
.00
.00
32.50
LQPERMIT
B,n.l#
Cl y-- f .LaQurnta
Bu11d1rig S- ;feiy: Division
P O Boz' f 504, X78-495 blip'Tamplco.
to Quints; CA 92253 -:(760)1777-7012
Permit. Application and TrackingSheet
Permit #
�1
i
I.
Owner's Naive: � rw • o a
A, P. Number.
B,n.l#
Cl y-- f .LaQurnta
Bu11d1rig S- ;feiy: Division
P O Boz' f 504, X78-495 blip'Tamplco.
to Quints; CA 92253 -:(760)1777-7012
Permit. Application and TrackingSheet
Permit #
�1
Project Address: I d / G� D /'.
Owner's Naive: � rw • o a
A, P. Number.
Address: aA
Legs[ Description:
City. ST, Zip
Contractor. e e,c C/1- C
Telephone:
Address: �'a!ZY CG /�.
Project Description:
City, ST, Zip: 11 ..
Telephon �) O d f
Q
State Lia 4: 3 % po 2' City Lc #, 4
Arch., Engr., Designer
.
Address:
City., ST, Zip:
Telephone:
State Lie. #:
` .Const tscdon Type: Oc«dpaacy:
"Project We (curie one): ,New Add'n Alter epair .Demo
Name of Contact, Person:
Sq: Ft:
#Stories: # Units:.
Telephone # of Contact Person:..
Estimated Value of Project Q ,
APPLICANT: DO NOT WRITE'BELOW"THIS UNE . •.,
N
Sabm[ttal
Req'd,
Reed-
TRACICTNG :
PERMITFFM-
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed; ready, for correction
Plan Check Deposit. .
Truss talcs.
galled Contact Person
'Plan Check Balance.
'Inde 24 Calci.
Pians picked up
Construction
Rood plain plan
Pians resubmitted; .
Mecharilcal
Grading plea
Z'j Review, ready for correcdonsfissue
Electrical
Subcoutactor List
Called Contact Person
Plumbing
Grant Deed
Plass picked up
S.KL
ILO' -A- Approval
Plass resubmitted .
Grading
IN HOUSE-..
'' 6 Review; ready for eorrecdons/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr "
Date of permit issue
School Fees.
i
Total Permit Fees