07-2358 (ELEC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
07-00002358
Property Address:
48955 AVENIDA EL NIDO
APN:
658 -310 -011 -
Application description:
ELECTRICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
2000
Applicant:
W. 001"
T4'yl 4 4 Qgm&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MICHAEL WALES
48955 AVENIDA EL NIDO
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
Architect or Engineer: MIRAGE ELECTRIC
19400 FORD AVENUE O
DESERT HOT SPRINGS, CA 92241
IV"(760)40
Lic. No..::536 536093
--------------------- ---- -----------------------
LICENSE CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am nsed under provisions of Chapter 9 Icommencing with
Section 7000) of Division 3 of the Business and fessionals Code, and my License is in full force and effect.
Lic s ass: C10 License No.: 536093
at ontractor:
Fam
NER-BUILDER DECLARATION
I hereby affirm under penalty of perjury thatxempt from the Contractor's State License Law for the
following reason ISec. 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 155001:
(_ 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.).
I _ I 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 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
Date: 8/22/07
_ _02 �-- ----
WORKER'S COMPENSATION DEC R',
I hereby affirm under penalty of perjury one of the following declarations: \C��,Ia O®,
I have and will maintain a certificate of consent to self -insure for wor'e,'soo enation, as p Jd
for by Section 3700 of the Labor Code, for the performance of the Sr(6o hi this it
issued.
I have and will maintain workers' compensation insurance, as required by Sectoon 3 - of the.L or
Code, for the performance of the work for which this permit is issued. M workers' co pensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 1744970
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 becosubject to the workers' compensation laws of California,
and agree that, if I should become s lett to the workers' compensation provisions of Section
3700 of the Labor Code,,I�Ilfo ith comply with those provisions.
4ee.: 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 f$1 00,000). 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 ce ify that I have read this application and state that the above information is rect. I agree to comply with all
city n county ordinances and state laws relating to building co�tio reby authorize representatives
of c my to enter upon the bove-mentioned property for inas.
Dat ature (Applicant or Agent): i
Application Number . . . . 07-00002358
Permit . . . ELEt-SERVICE
CHANGE
Additional desc .
Permit Fee . . 33.50
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date 2/18/08
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 18.5000 EA ELEC
SVC <=600V/<=200A
18.50
----------------------------------------------------------------------------
Special Notes and Comments
CHANGE OUT 200 AMP E -PANEL
Fee summary Charged
---------------------------
Paid Credited
Due
----------
Permit Fee Total 33.50
----------
.00
----------
.00
33.50
Plan Check Total .00
.00
.00
.00
Grand. -Total 33.50
.00
.00
33.50
LQPERMIT
Bin #
City of La Quinta
Building 81 Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
X358
Project Address.
Owner's Name Cr � _
�S
A. P. Number:
Address: ZEZ6-5--�40
/
Legal Description:
Contractor: 11Z (
C
City, ST, Zip:
Telephone:
Address:
�—
Project Description:
City, ST, Zip:
Telephonez. CD
State Lic. # : C5�
City Lic. #:
Arch., Engn, Designer: !
Address:
(�
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: L
Sq. Ft.:
# Stories:#Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE.
#
Submittal
Req'd
Rec'd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"" 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 correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees