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04-8358 (ELEC)P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760)777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Fee summary Charged Paid ----------------- ---------- ---------- Permit Fee Total 33.50 .00 Plan Check Total .00 .00 Grand Total 33.50 .00 Credited Due ---------- ---------- .00 33.50 .00 .00 .00 33.50 t tAP!Ro 5 Z00 clTYoFLAQUuNT'. F�aa ,CE Application Number ;04-00008358 7 Date 3/29/05 Property Address F. . . . 48657 LEGACY DR APN: 658-130-011-8 -31379 - Application description . . . ELECTRICAL Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . 0 Owner Contractor ------------------------ CENTEX HOMES ------------------------ CENTEX HOMES 2275 CORPORATE CIR 4230 901 N. GREEN VALLEY PKWY, 140 HENDERSON NV 89074 HENERSON LA QUINTA CA 92253 (702) 990-0800 WCC: ZURICH AMER INS WC: 832209708 10/01/05 CSLB: 825943 10/31/05 ' ---------------------------------------------------------------------------- CCC: A -B Permit . . . . . . ELEC-MISCELLANEOUS Additional desc Permit Fee. 33.50 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE: FEE 15.00 1.00 18.5000 EA' ------------7--------------------------------------------------------------- ELEC SVC'<=600V/<=200A 18.50 ' Special Notes and Comments ADDITIONAL ELECTRICAL METER Fee summary Charged Paid ----------------- ---------- ---------- Permit Fee Total 33.50 .00 Plan Check Total .00 .00 Grand Total 33.50 .00 Credited Due ---------- ---------- .00 33.50 .00 .00 .00 33.50 t tAP!Ro 5 Z00 clTYoFLAQUuNT'. F�aa ,CE P.O. Box 1504 •/�/ VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 0 S-!05 8 Date: Li/• �• OS Applicant: Architect or � E,%gineer: Applicant's Mailing Address: t4v Architect or Engineer's Address: r !A Lic. No.: -e ' %97e BUILDING PERMIT DECLARATIONS 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 Professionals Code, and my License in ful rce and effect. ense Class' cense No. 2 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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 or 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.). U 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.). L) I am exempt under Sec. BA P.C. for this reason Date WORKERS' 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. J 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 mer nix, wr>�rs' compensation in nce carrier a cy.gypyber�r14 7Dv J(L [T �PfiGcy Number <L CJ is 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 at, if I ould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthw1h comply with those provisions. -o' I WARNING: FAILURE TO SECURE WORKERS' CIPENSWION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND LLARS ($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. 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 Lenders Address 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 employeesfor any act or omission related to the work being perforned 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 inf ation i orect. I agree to comply with all city and county ordinances and state laws relating to building construction, and her by authorize representatives of this count en r u n the above-mentioned property for inspection purposes. ate nature (Applicant or Agent):