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12-1216 (ELEC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Z-12-_000012Z673 Property Address: 78620 SANITA DR APN: 604-174-014-179 -23269 - Application description: ELECTRICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 600 Tiht Q." BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: POST JUSTIN 78620 SANITA DRIVE LA QUINTA, CA 92253 VOICE'(760) 777-7� FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/11/12 Contractor: Applicant:. Architect or Engineer: SO CAL ELECTRIC D U 20164 SKY RIDGE ROAD DESERT HOT SPRINGS, CA 9 Ilk (760) 992-4047 . l LiC. No.: 900403 f�Q�l�� CIF NA�CEDE�• LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I icenseduh rovisions of Chapter 9 (commencing with Section 7000) of Division of the Busine Professio ode, and my License is in full force and effect. License Class: CIO icense No.: 900403 ate:. //�)Z tractor. -BUILDER DECLARATION I hereby affirm under penalty of p�erjuTy 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'bxempt therefrom and the basis foi'the alleged exemption. Any.violation of Saction•7031 .5 by any applicant fora'permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 1 _ 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 for sale (Sec: 704, Business and'Professions Code: The .Contractors'. State License Law,does not apply to:amownerof property who builds or improves thereon, and whodoes the work himself or herself throughhis or herawn employees, provided that the improvements aie.not intended or offered forsale. if, however, the building or improvement is sold within one: year -of completion; the owner -builder will have the burden of,proving;that he of she did not build or improve for the purpose of sale.). - (_ 1 1, 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 Lawdoes 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 Sec. , B.&P.C.-for this reason Date: Owner:, CONSTRUCTION LENDING AGENCY. I hereby affirm under penalty of perjury that there isa 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 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 HARTFORD UNDER Policy Number '57WECEP1226 I certify that, in -the performance.of the work for which this,periiit: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 3700 of the labor Code, I shall forthwithcomply with those provisions. D a:(9IyAn licant': � it t �r'�•� �/ L� WARNING: FAIL R10 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 A a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Ouinta, 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 1 B days from date of issuance of such permit, cessation of ork for 180 days will subject permit to cancellation. I certify that I have.read this application and state that themation ' orrect. I agree to comply with all city and county ordinances and state laws relatingion;' ereby authorize representatives of this county to enter uponthe above-mentionedon es.ture (Applicant or Agen Application Number . . . . . 12-00001216 Permit . . . ELEC-MISCELLANEOUS Additional desc . . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 4/09/13 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 EA ELEC MISC 11.00 ---------------------------------------------------------------------------- Special Notes and Comments REPLACE 100 AMP MAIN 2 POLE BREAKER & BUS -BARS, 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 26.00 .00 .00 26.00 Plan Check Total 6.50 .00 .00 6.50 Other Fee.Total 1.00 .00 .00 1.00 Grand Total 33.50 .00 .00 33.50 LQPERMIT Bin.# Cray. 0f Ld Qutntd r Building tai Safety Division Permit # P.O. Box 1504,-78-495 Calle Tampico ' i4.Quinta, CA 92253 - (760) 777-7012 'Building Permit Application and Tracking Sheet Project Address: Owner's Name:. A P. Number. Address: i j Legal Description:City, i ST, Zip: /t 2 Z�j i Contractor:- C1 Telephone: Address: Project Description: �Y City, ST, Zip: L i Ctrl''n z 1 Oa, gg6ex i(? t -'OK Telephone:-24 : Q State Lic. # : City Lia #.: Arch., Engr., Designer Address: City., ST, Zip: Construction Type: G Occupancy: Telephone: l State Lic. 9: Project Project type (circle one): New Add'n Al Repair o Name of Contact Person: Sq. Ft: #Stories: tuts: Telephone # of Contact Person:Estimated Value of Project: t� APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKNG PERMIT FEES Plan Sets Plan Check submitted Item Amount . Structure! Cates. Reviewed, ready for corrections Plan Check Deposit- . Truss Cates. Called Contact Person Plan Check Balance_ Title 24 Cates. PEansrcked u P p Construction --------- _Flood Pain lau_ -- -- - Mechanical --- - Grading plan 2af Review, ready for correctionstissue Electrical Subcoatector List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. LLO.A. Approval Plans resubmitted Grading IN HOUSE:- '^` Review; ready for correctionsfissue Developer Impact Fee Planning Approval.Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees