06-1273 (ELEC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06-00001273
Property Address: 48786 CLASSIC DR
APN: 658-130-011-18 -31379'-
Application description: ELECTRICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 1000
Applicant:
44w
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I
Architect or Enginee
MAR n2006
CITY OFLA QUINTA
Owner:
CENTEX HOMES
2275 CORPORATE CIR #230
HENDERSON, NV 89074
Contractor:
CENTEX HOMES
41865 BOARDWALK, STE 101
PALM DESERT, CA 92211
(720)862-1030
Lica No.: 825943
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/29/06
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. LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury
1 am licen ed - er provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Gsirt ss and Prof nals Code, an my License is in full force and effect.
License Class: At_ , L' ense . 825943
M. Dat
94? `"tip '� o
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. 70 1. , Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, olish, 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.:
(_) 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.).
(_ 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 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:
�1
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.
,/( 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Z� Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier LOCKTON CO Policy Number WC832209709
I certify that, in the perform ce of the work for which this permit is issued, I shall not employ any
person in any man so a to beco subject to the workers' compensation laws of California,
and agree that, if ould come s bject t e workers' c pensation provisions of Section
3700 of the L Code, I shat o hwit comply with se rovisions.
Date Ap lic n
WARNING: FAILURE O S URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLO E 0 CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000 N 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 p it, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that above infor ation ' co rect. I agre comply with all
city and county ordinances and state laws relating to 'ding cons tion, tion, nd h7preby au3pdr2e representatives
of this county to enter upon. the above-mentioned o rty for n (S tion urpos.
_ i
Dat Signa ure (Applicant or g
r�
IR
LQPERMIT
Application Number . . . . . 06-00001273
Permit . . . ELEC-TEMPORARY POWER
Additional desc . .
Permit Fee . . . . 30.00
Plan Check Fee
..00
Issue -Date . . . .
Valuation . . .
. 0
Expiration Date 9/25/06
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 15.0000 EA ELEC
TEMPORARY POWER POLE
.15.00
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Special Notes and Comments
200 AMP TEMP POWER POLE
Fee summary Charged
-------------------------------------
Paid Credited
Due
Permit Fee Total 30.00
--------------------
.00 .00
30.00
Plan Check Total .00
.00 .00
.-00
Grand Total 30.00
.00 .00
30.00
Bin # City Of La QUitlta
Building U Safety Division
Permit # P.O. Box 1504,78-495 Calle Tampico
La Quinta, CA92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address.` �id ►� lbov* LAO
Owner's Name:
A. P. Number: ,,30 -- 0 t
Address: ytf((.-6'
Legal Description:
City, ST, Zip: � Qosi:�—TL 41
Contractor:
Telephoner -
Address-
Project Description:
City, ST, Zip:
Item Amount
Telephone:in
RIM
State Lic. # :
CityLic. #:
Arch., Engr., Designer:.
Address:
City, ST, Zip:
Called Contact Person
Telephone:.
State Lic. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person:'760- - (fie Z- s ) 03 0
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG .
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
Construction.
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
2q° 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:-
?'d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person'
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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