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12-1381 (ELEC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number. 12-00001381 �. Property Address: 77753 TRADITION DR APN: 658-130-011-14 -31379 - Application description: ELECTRICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1700 Applicant: Architect or Engineer: f BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: ' DALE WILSON 77753 TRADITION DRIVE LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Contractor: P ESQUIBEL ELECTRIC, FRANK Date: 11%26/12 43922 PACIFIC AVENUE c INDIO, CA 92201 NOV� 2 V 2012 �� (760) 347-5470 Lic. No.: 870269 CITY OF LAQUIhi' - ------------------------------------------------------------------------------------------------ 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 License Class: C10 'cense No.: 870269 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ntractor: _ 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 -B LDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt om the Contractor's State License Law for the Carrier EXEMPT Policy Number EXEMPT following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to I c=at, 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 sh Id become subject to the workers' 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 Labo C d , I shall forthwith.eoSTfi>ly vii those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by ��J�� C any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: e: f--r--r� icant: 111/// 1 11, 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' COM PENS A N 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 IVIL 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).; N 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. oneyear of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purposeofsale.). APPLICANT ACKNOWLEDGEMENT 1 _ 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, (_) I am 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 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 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 certify that 1 have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to buildi g construction, an b a orize representatives of this county to enter upon the above-mentioned pr art for inspection urp ses Date:IL ySig ure (Applicant or Agent): ter' r - Application Number 12-00001381 Permit -ELEC-MISCELLANEOUS Additional desc _. Permit Fee . . . 21.00 Plan Check Fee 5.25 Issue Date Valuation . . . . 0 Expiration Date 7 5/25/13 Qty Unit Charge Pe'r Extension BASE FEE 15.00 2.00, 3.0000 EA ELEC-APPLIANCES 6.00 Special Notes and Comments, INSTALL INFRATECH HEATERS UNDER PATIO . COVER. MODEL W.D .4024585. 2010 CODES. -------------------_---------------------------------------- Other Fees . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid' Credited. Due -----------.------------- - Peimit Fee Total 21.00 ._00 -.00 21.00 Plan Check Total 5.25 .00 .00 5.25 Other. Fee Total 1.00 .00 .00 1.00 Grand Total 27.25 .00 .00 27.25 LQPERMIT c op�era{.e �ea��vS - CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVE® FOR CONSTRUCTION DATE" BY �� i C�l -4z a3 � � o o ell f a3 � � o o ell f • t8 Speed Limit SLOW is MPH NO PARKING In front of garages or driveways Tradition Drive Legacy Drive Classic Drive Hentage Drive JK.. LEGACY VILLAS- , a- 05 Bin.# Qty 0F.La Qulhtd Bullding 8r Safety Division P.O. Box 1504,78-495 Calle Tampico ta.Qulnta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # ` 1 Project Address: Owner's Name:. w C C A. P. Number. Address: -7 Legal Description: C Contractor � City, ST, Zip: ` i '',�,��;rg?�•'. ryes. Telephone:. Address:z L e Project Description: City, ST, Zip: Telephone: 60 T"c:> City Lic #; MD �'6 Z1155 State Lie. # : b Arch., Engr., Designer: Address: City., ST, Zip: Telephone: State Lic. #: ' '�;;'"��..':»,iu ..<� Construction Type: P� Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.:#Stories: # Unit$: Name of Contact Person: S . Telephone # of Contact Person: '7z Estimated Value of Project: (�(j APPLICANT: DO NOT WRITE BELOW THIS UNE it Submittal Req'd ' Rec'd TRACKING PERMIT FEES Plan Sets Pian Check submitted Item Amount Structural Calm Reviewed, ready for corrections Plan Check Deposit. . Truss Cales. Called Contact Person Plan Check Balance Title 24 Calm, Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan r4 Review, ready for corrections issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN ROUSE:- '"' 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