11-1269 (ELEC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 11-000012 69,—. -
Property Address: 44965 TORTOLA CIR
APN: 604-274-002-89 -23913
Application description: ELECTRICAL.
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 50 0
Applicant:
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
TAFFOLLA ROBERT
44965 TORTOLA CIRCLE
LA QUINTA, CA 92253
Contractor:.
IST ATRIUM INC
VOICE (760) 777-7012
FAX (760).777-7011
INSPECTIONS (760) 777-7153
Date: 11/23/11 '
i t�: i� �• � t �
20i, 1
Gl'Nr;c.
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 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. , BAP.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
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 160 days from date of issuance of su per it, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state t the above formation is correct. I agree to comply with all
city and county ordinances a d state laws relating.1 building co uction, and hereby authorize representatives
of/t/1�s county t7o enter upo the above -menti ned p pe y for.in ection purposes.
Date: �� 3 gnature (Applicant or gent):
P.O. BOX 3882 -
PALM DESERT, CA 92261
Y`
(760)880-6606
LiC. No.: 836088
LICENSED NTRACTOR'S DECLARATION
-------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I a I' ense 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 an o ssio Is 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: B C53 C10 License No.: 836088
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
te: ntractor:_71
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
NE ER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that am exempt from the Contractor's State License Law for the
Carrier STATE FUND Policy Number 0028277008
•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 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 ha if I shout c e 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 oft abor Code al forcomply with those provisions.
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).:
Date: " 1 pplicant:
1—) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
I
the structure is not intended or offered for sale .(Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE KERS' 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 did not 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.).
(_) I am exempt under Sec. , BAP.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
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 160 days from date of issuance of su per it, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state t the above formation is correct. I agree to comply with all
city and county ordinances a d state laws relating.1 building co uction, and hereby authorize representatives
of/t/1�s county t7o enter upo the above -menti ned p pe y for.in ection purposes.
Date: �� 3 gnature (Applicant or gent):
Application Number 11-00001269
Permit'ELEC-SERVICE CHANGE
Additional•desc .
Permit Fee 33.50 Plan Check Feb
00
Issue Date Valuation . . .
. 0
Expiration Date.... 5/21/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 18.5000 EA ELEC SVC <=600V/<=200A
18.50
Special Notes and Comments
PANEL UPGRADE FROM 125 AMPS TO 200 AMPS.
2010 CODES..
-----------------_--------------------------------------.------
. Other Fees ... . . .- BLDG STDS ADMIN (SB1473)
-----------
1.00
Fee summary Charged Paid 'Credited
Due „
Permit Fee Total 33.50 .00 .00
33.50
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
.
Bin
.0 of�f�d .Q uinta
: -Building & Wei Division
P.O. Box 1504 78-495 Calle. Tampico
' ' : .. � p� .. :. . .
• La Quinta, CA 92253 - (760) 777-7012
- Building Permit Application and Tracking Sheet,.
.
Permit #. jp
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Project. Address: � 0'l/ Ca v
Owner's Name: Q (�a Ro lQ�d�
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A. P. Number: ..
Address:
Legal Description:
City, ST, Zip:
Contractor:_
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Telephone: fi;>.;d'
Address:
Project Description:
City, ST, Zip:
Telephone: 0 ///(/�//(j06
State Lic.'# : 3 (+'
City Lie. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:'
State Lie. #::}\'"'"
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Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Name of Contact Person:
Telephone # of Contact Person:
Estimated Value of Project: 570a
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Pian Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked upConstruction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°' Review, ready for correctionsfrssue
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 correctionsfissue
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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