06-1621 (ELEC)0
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
06-00001621
81787 IL SERENATA DR
764-010-011-53 -30092
ELECTRICAL
LOW DENSITY RESIDENTIAL
0
& SAFETY DEPARTMENT
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed r provisi s of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busi rofe �onaIs Code, nd my License is in full force and effect.
License Class: C10 No.: 61DI4187
k Date: _�� ntractor:
I TT OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury th I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business d 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).:
(_ 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.).
(_) 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 the
work for which this permit is issued (Sec. 3097, Civ. C.). .
Lender's Name:
Lender's Address:
LQPERMIT
IT
Owner:
STARKWEATHER RESIDENCE.
81787 IL SERENATA
LA QUINTA, CA 92253
Contractor:
CUSTOM QUALITY ELECTRIC INC
1722 S. GRAND AVENUE
SANTA ANA, CA 92705
(714)541-0404
Lic. No.: 605287
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/21/06
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 REDLAND INS Policy Number RPSI1142201
Icertify 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 I should become subject to the workers' compensation provisions of Section
3700 of the Lab2f2'66e1'SI all forthwith com h those provisions.
Date: %Z�-0 `replicant:
WARNING: FAILURE TO SECURE WORKER ' 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. ^s
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 Ouinta, 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 ove in nation ct. I reel ree to a ly with all
city and county ordinances and state laws In to building c tructi , by auth ' e repres mauves
of this county to enter upon the above -me ed propert pection purposes.
Date: 7�j. natur�icant or Agent):
�—
- LQPERMIT.
Application Number . . . . . 06-00001621
Permit . . . ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . . 39.00 Plan Check Fee
9.75
Issue Date . . . . Valuation . . .
. 0
Expiration Date 10/18/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
20.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
15.00
20.00 .4500 EA ELEC DEVICE/FIXTURE >20
9.00
----------------------------------------------------------------------------
Special Notes and Comments
ADDITION OF NEW LIGHTING TO MASTER
B-R/FAMILY ROOM/LIVING ROOM/DINING ROOM
& TWO BEDROOMS.ENEGY/ELECTRICAL CODE
COMPLIANCE ACHIEVED BY HIGH EFFICACY
LIGHTING -ALL OTHER LIGHTING MUST BE
MOTION SENSOR OR DIMMER SWITCHES.2004
CA ELEC/2005'CA ENERGY CODES.
Fee summary Charged Paid Credited
-----------------
Due
------------------------------'----------
Permit Fee Total 39.00 .00 .00.
39.00
Plan Check Total 9.75 .00 .00
9.75
Grand Total 48.75 .00 .00
48.75
A RE -INSPECTION FEE OF- Ap30
WILL BE CHARGED IF THE APPROVED
PLANS AND JOB CARD ARE NOT ON
THE SITE FOR. A .SCHEDULED
INSPECTION.
NO EXCEPTNS! �kvry
' e
�• m a m m o q�
IF LA
- & SAF
APPROI
FOR CONSTRI
DATE �C% BY
U.
INTA
DEPT.
D
�. �..1
�
r
f. 1
d
c
i
IF LA
- & SAF
APPROI
FOR CONSTRI
DATE �C% BY
U.
INTA
DEPT.
D
Bin #
Permit #
Project Address:' 8 _
A. P. Number:
Legal Description: S
Contractor: (A
Address: S�
City, ST, Zip:.
Telephone: � � -, O
State Lic. #
Arch., Engr., Designer:
Address:
City,.ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person:
# 1 Submittal
Plan Sets
Structural Calcs.
Truss Calcs.
Energy Calcs.
Flood plain plan
Grading. plan'
Subcontactor List
Grant Deed
R.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
City of. La Quinta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinti, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
5;Te4 rA, Owner's ame:
Address: '
7�h> G> City, ST, Zip:
�1�705
Lic. #:
Project Description:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Estimated Value of Projec
APPLICANT: DO NOT WRITE BELOW THIS LINE
Recd TRACING
Plan.Check submitted
Reviewed; ready for corrections
Called Coutact Person
Plans picked up
Plans resubmitted
2~ Review, ready for correctionsrissue
Called Contact Person
]Plans picked up
Plans resubmitted
Review, ready for corrections/issue
Called Contact Person
Date of permit issue
PERMIT FEES
Item Amount
Plan Check Deposit
Plan Check Balance
Construction
Mechanical
Electrical
Plumbing
S.M.L
Grading
Developer Impact Fee
A.I.P.P.
Total Permit Fees