12-0813 (ELEC). P.O. BOX 1504
78-495 CALLE TAMPICO •
LA QUINTA, CALIFORNIA 92253
414 0 VOICE (760) 777-7012 .
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/23/12
Owner.
BOLES BURTON M
78860 SONESTA WAY' D Q 0
LA'QUINTA, CA'92253
JUL 2 3 1012
Contractor: CITY
Application Number:
f12.-0000-0813- Y�
Property Address:
78860 SONESTA WY
APN:
604-151-020-31 -23269 -
Application description:
ELECTRICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
1200
414 0 VOICE (760) 777-7012 .
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/23/12
Owner.
BOLES BURTON M
78860 SONESTA WAY' D Q 0
LA'QUINTA, CA'92253
JUL 2 3 1012
one year of completion, the owner -builder will have the burden of proving that he or she didnot 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 •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
4
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
performedunderor 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 certify that I have read this application and state that 4theabove information is �.,rebt
ec. I agree to comply with all
city and county ordinances and state laws relating to bconstruction, a d thorize representatives
of this countyto enter upon the above-mentioned propr ins -ec '
Date: 7 Signature (Applicant or Agent):
Contractor: CITY
Applicant: Architect or Engineer:
OF �q
HILL ELECTRIC INCORPO FZff QU/M7q
C DEP7.
42335 WASHINGTON ST, #F405 -
PALM DESERT, CA 92211
(760)772-1770
LiC. No.: 717777
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
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 Professionals 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
Li ense Class: C10 - License / o.: 717777
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
j1_4Issued.
Date: / ? 3� �2 ontractor:
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 HARTFORD UNDER Policy Number 72WECDF5680
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 laws of California,
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 subject to the wort rs' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code I s a_II fort w' h amply h those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by7'Z3•�2
} I
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
Date: S Applicant:
(_ 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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
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 didnot 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 •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
4
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
performedunderor 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 certify that I have read this application and state that 4theabove information is �.,rebt
ec. I agree to comply with all
city and county ordinances and state laws relating to bconstruction, a d thorize representatives
of this countyto enter upon the above-mentioned propr ins -ec '
Date: 7 Signature (Applicant or Agent):
Application Number . . . 12-00000813
-
Permit ELEC-SERVICE
CHANGE
- Additional desc .
Permit Fee 33.50
Plan Check
Fee..
.00
Issue Date . . .
Valuation
0
Expiration Date.. 1/19/13
Qty Unit Charge Per
Extension
BASE .FEE
15.00
1.00'.. 18.5000 EA ELEC
SVC <=600V/5=200A
18.50
Special Notes and 'Comments
PANEL UPGRADE FROM 125 AMPS .TO 250
AMPS.
2010 CODES.
-----------------_----------------------------------------------------------
'Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
Paid Credited
Due
Permit Fee Total 33.50
.00
00
3.3.50
Plan Check Total .00
.00.
.00
.00
Other Fee Total 1.00
.00
.00
1.00
Grand Total 34.50
.00
.00
.34.50
LQPERMIT
lain.#
City of La Qui : to
:Bulldtn- 8r Safety Di06r;
P.O. Box 1504,78-495 Calle Tampico
1.4.Qutnta, CA 92253.-:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: j�
Owner's Name:. u e
A. P. Number.
Address: a (a n
Legal Description:
Contactor. e?aim�:s'
1 I C`rir I C
City, ST, Zip.
Telephone ^ :"a;r`
:........
1 1
Address: � 335 W t AF' IY OS
Project Description:
City, ST, Zip:NZZ' /
C...
t�C 1 iAICF
Telephone:
Q�
lrrl e-0 Ybja AY -
State Lica #2
City Lic. #;
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lic. #:� r" "
Name of Contacx Person: �� t) I
Construction type: . Occupancy:
Project type (circle one): New Add, n Alter Repair Demo
Sq. Ft,:#Stories:
#Units:
Telephone # of Contact Person: V>17,21 b
Estimated Value of Project ' 0 v
APPLICANT: DO NOT WRITE BELOW THIS UNE f
M Submittal Req'd Recd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales..
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance
Titre 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted.'a
Mechariical
Grading plan
2•' Review, ready for correctioastiissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M,L
H-O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review; ready for correctionstissue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees