08-0935 (ELEC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA. 92253
Application Number: 4 ,-08-00000935
Property Address:
78130 CALLE TAMPICO
APN:
770-020-012- -
Application description:
ELECTRICAL
Property Zoning:
VILLAGECOMMERCIAL
Application valuation:
2000
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION ,
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professals Code, and my License is in full force and effect.
_License Class: 13 i License No.: 808029
te: S L Og Co ractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that:l am exempt from the Contractor's State License Law for the '
following reason (Sec. 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 ($500).:
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, 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.).
( ) I am exempt under. Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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: Pic'
LQPERMIT
Owner:
HIGHLAND LA QUINTA
80 S LAKE AVE STE
PASADENA, CA 91101
Contractor:
PATTERSON BUILDER
13057 VICTORY BLV
NORTH HOLLYWOOD,
(818)762-5.795
Lic. No.: 808029
VOICE (760) 777-7012
. FAX (760) 777-7011.
INSPECTIONS (760) 777-7153
Date: 5/29/08
II LLC
660
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.
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
` insurance carrier and policy number are:.
Carrier STATE FUND Policy Number 1763924-2008
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 become subject to the workers' compensation laws of California,
and agree that, if 1 s, ould become s ject to the workers' compensation provisions of Section
3700 of the Lab Co , 1 hal or; ith comply with those provisions.
atD e: o Od- AM'(ic/ant: /
WARNING: FAIL REO TO SECURE RKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). 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 certify that I have read this application and state that the above itcti
ation i orrect. I agree to comply with.all
city and county ordinances and state laws relating t u 'ng con , an ereby authorize representatives
of this�co/1u�ntytorenter upon the above-mentioned p opensn rpo s.
9�ef;7 nature (Applicant or Agentl:
Application Number . . . . . 08-00000935
Permit ELEC-TEMPORARY POWER
Additional desc,.
Permit -Fee 30.00 Plan Check Fee
00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 11/25/08
Qty' Unit Charge Per
Extension
BASE FEE
15.00
1.00 15.0000 EA ELEC TEMPORARY POWER POLE
15.00
--------------------------------- ---------------------
Special Notes and Comments
1 TEMP POWER POLE AND 5 SPAN POLES
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.
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- City, of. La .Quints
Building U Safety Division
P.O. Box 1504, 78 -495 -Calle Tampico "
I a Quinta,,CA 92253 - (76.0) 777-7012
Building Permit A.pplication and Tracking Sheet .
Permit # �. •
Project Address:' _ I . -�Cn [
Owner's Name:. l m(
A. P. Number:
Address ,
Legal Description:
Contractor:
City, ST, Zip;
Telephone:
Project Description:
Address: • . + S ? L% ' &Ur-)
City, ST, Zip: C Ql
Telephoner
State Lic. #.q02(0 Z City Lic. #:j
�'A_ C
VV
E
1 lam]
Arch.; Engr., Designer: ` -
:
AM
,Address:
City, ST; Zip: 'E
Telephone:
State Lic. #:
w
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n` Alter Repair Demo
Sq. Ft.:
#'Stories: '
#Units:
Telephone # of Contact Person: p,
3 _ l ��S
Estimated Value of Project
APPLICANT: DO NOT WRITE BELOW THIS LINE b
#
Submittal
Req'd
Recd
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 a
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.0 A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
.�
School Fees
Total Permit Fees
t