05-3276 (ELEC)P.O. BOX 1504,
78-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
Application Number: .
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
05-00003276
79675 -PARKWAY ESPLA14ADE N ' .
609-380-998-A -293232- .
ELECTRICAL
LOW DENSITY RESIDENTIAL
0.
U itect or Engineer:
JUL 2 9 2005
1A
CIN F,LA
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
LENNAR HOMES OF CALIFORNIA
78401 HIGHWAY 111, STE C
LA QUINTA, CA
LA QUINTA, CA 92253.
Contractor:
LENNAR HOMES OF CALIFORNIA INC
40004 COOK ST.
PALM DESERT, CA 92211
(951)817-3600
Lic. No.: 728102
Date: 7/29/05 '
- LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I arr 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: B License No.: 728102
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
/Date: Contractor:
issuedd .
1 have anwill 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 AON RISK SRVC Policy Number MWC11114500 . '
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 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 L ot'Code, I shall forthwith cam I 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 1$5001.:
Date: 'S ppligant:
(_ 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
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 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
I hereby affirm under, penalty of perjury that there is a construction lending agency for the performance of they.
work for which"this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERAIIT
WARNING: FAILURE TO SECURE WORKERS'. 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. y
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 information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon th bove-mentioned property for inspection purpo .
atFT e:7 -.Z1% ignature (Applicant or Agent):
Application Number . . . . . 05-00003276
Permit . . . . ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . . 33.50. Plan Check
Fee
.00
Issue Date . . . Valuation
0
Expiration.Date 1/25/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 18.5000 EA ELEC.SVC <=600V/<=200A
18.50•• .
Special Notes and Comments
LANDSCAPE IRRIGATION PEDESTAL
Fee. summary Charged Paid Credited
Due
Permit Fee Total 33.50 .00
.00
33.50
Plan•Check Total .00 .00
.00
.00
Grand Total 33.50 .00
.00
33.50
Bin
City of LaQuit] td.
Building U Safety Division
Permit �` P.O. Box 1504, 78-495 Calle Tampico
La Quinti, CA 92253 - (760) 777.7012
Building Permit Application and Tracking: Sheet
Project Address: �cao
Owner's Name:
A. P: Nurnber: .
Legal
lD
e
scription:
Address:
Contractor: City, .ST,
Zip:
Address': Project Description:
'
City, ST, Zip:
Telephone:
State Lic. #
City Lic. #:
Arch., Engr-, Designer: .
Address:
Citv,.ST, Zip:
Telephone:
Construction Type:
State Lic. #• Cccu ancv:
• p
Project t} pe (circle one):. New
Add' -x Altcr Repair Demo .
Name of Contact Person:
Sq. Ft.: # Stories: N Units- .
Telephone. # of Contact Person: r
Estimated Value of Project -
APPLICANT: DO 'NOT WRITE BELOW THIS LINE
# Submittal
Req'd Rec'd TRACl:1NC
Plan SetsPERMIT FEES
'Plan mit
Check subted ' g
J Z/ Item
Structural Calcs. Amount
Reviewed, read}- for corrections
Truss Calcs. Plan Check --Deposit
-Called Contact Person
Title 24 Cala: Plan Check Balance
Plans Picked 'up
Flood plain plan Construction
Plans resubmitted
Grading plan Mechanicals
2" Ra ieN, ready for corrections/issue
Subcontactor List Electrical
Called Contact Person
Grant Deed Plumbing
Plans picked up
ILO:A. A S.M.1.
pp�oral Plans -resubmitted
IN HOUSE:- Grading
Review ' eadr for corrections/issue
Plannin A Developer Impact Fee
g Approval Called Contact Person
Pub. INT 's. Appr A.LP.P.
Date of permit issue
School Fees
}
Total Permit Fees
15 14 64 65 66 67 68 69 70 71 72 73 8 7 6 5 4 Z 2
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