06-0556 (ELEC)P.O. BOX 1504
78-495 CALLE TAMPICO -
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LA QUINTA,-CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 06-00000556 Owner:
Property Address: 53.860—A-VEN-IDA NARO' CHARLIE LOWRY
APN: 774-175-006-17 -000000- 53860 AVENIDA NAVARRO
Application description: ELECTRICAL LA QUINTA, CA 92253 D
Property Zoning: COVE RESIDENTIAL
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Application. valuation: 2000
Contractor:
Applicant: Architect or Engineer: DSD ELECTRIC
P.O. BOX 408
LA QUINTA, CA 92247
(760)777-8771
Lic. No.: 792057
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/07/06
LQPERMIT
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LICENSED CONTRACTOR'S DECLARATION
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- WORKER'S COMPENSATION DECLARATION
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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 one of the following declarations:
Section 7000) of Division 3 of the Business and tiple5pionals 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
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License Class: C10 License No.: 792057 -
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for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
ssued.
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Dated.—✓ Contr� _
_ 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
- OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier STATE FUND Policy Number 1705915
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a"permit to
_ I certify that, in the performance of the work for which this permit is, issued, I shall not employ any. "
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
.person in any manner so as to become subject to the workers' compensation lawsofCalifornia,-
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permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become sub' ct to the workers' compensation provisions of Section
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License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor�e�l-shat - ith comply with those provisions. -
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that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
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any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
D5ter Applicant:
( 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
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the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
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Contractors' State license Law does not apply to an owner. of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and•who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
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improve for the purpose of sale.).
- APPLICANT ACKNOWLEDGEMENT
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
' property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed;
. 1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
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(_) Lam exempt under Sec. , B.&P.C. for this reason -
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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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. '
Date: Owner:
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
CONSTRUCTION LENDING AGENCY
permit to cancellation. -
1 hereby affirm under penalty of perjury that there is -a construction lending agency for the performance of the
I certify that I have read this application and state that the aboveinformation is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.).
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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 purposes. -
Lender's Name: - _ . .
�T.,� / ,
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OateL- Signature (Applicant or Agent):/!I
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Lender's Address:
LQPERMIT
Application Number . . . . . 06-00000556
Permit ELEC-SERVICE CHANGE
Additional desc .
Permit Fee 33.50 Plan Check Fee
00
Issue Date . . . . Valuation . .
0 .
Expiration Date 8/06/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 18.5000 EA ELEC .SVC <=600V/<=200A-R..So.__..
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Special Notes and Comments
REMOVE EXISTING ELECTRICAL
SERVICE/REPLACE WITH 200 AMP SERVICE
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
Bin #
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City of La Quetta .....___.
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico r
�. La Quinta, CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet,
Permit # ;
'Project Address' `r /
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-fOwner's Name:
G�1,/A�L /E L:9 w1, -v
A. P. Number: •
_Address: S��!�.�-'•,/1.�4 �I�i4��/r9�2G�
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Legal Description: C
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Contra �� 1
City, ST, Zip x �i2.1�
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Telephone: -y
Address: Box o
Project Description: E�c��t[_
City, ST, Zip. LA 06 1 JV -J, 4 0 C4 ZZ
t_/PCr R4b (v FZpy-k; 00R ✓nYo ZOo/J/'J!�
Telephone:
,state Lic. #�:.7�Z0 % j
City Lic.
Arch., Engr.,.Designer:
Address:
City, ST, Zip:
.Telephone: '
p
State Lic. #: -
Name_of C.ontact.P_ersod��V� 7YTi
Construction Type: Occupancy:
Project type (circle one): New Add'm Alter ,Repair Demo
Sq. Ft.:# Stories: #Units:
_Estimated_Value_ofP_roject:_ L.. _._
Telephone`#'of Contact Person: ' 1
/Gc2_ .1,_-�- _ _
APPLICANT: DO NOT:WRITE BELOW THIS LINE
! #
Submittal'
Req'd
Recd
TRACKING
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
Energy Calcs.
Plans picked up
Constructioa
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 corrections/issue
Developer Impact Fee
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Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees