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07-2222 (ELEC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 07-00002222 Property Address: 81830 EAGLE CLAW DR APN: 764-280-999-35 -300235- Application description: ELECTRICAL Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 200 Applicant: Architect or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION I BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penattyof perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals'Code, and my License is in full force,and effect. LicenseClass: License No.: Date:, Contractor: OWNER -BUILDER DECLARATION 1 hereby -affirm under penalty°oUperjury that I -am exempt from the Contractor's State: License Law for the following reason (Sec. 7631 .5, Business and Professions. Code: Any city or county that requiresea permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicantfor the permit to file.a signed statement that he or she is licensed.pursuant to theprovisions of the Contractor's State LicenseLaw(Chapter 9 (commencing with Section 7000) of Division 3 of the. Business and Professions Code) or that he or she is exempt therefromand the basis:for the alleged exemption. Any violation of'Section 7031.5 by _ any applicant for a permit subjects.theapplicant,to a civil penalty of not more than five hundred dollars ($500)•: (_) 1, 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 buildsorimproves 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. improvernent'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 ) 1, asowner of the property, am exclusively contracting with licensed contractors to. construct the project (Sec. 7044, Business'and Professions Code: The Contractors' State License Lew does not apply to are owner of property who builds or improves thereon, and who contracts for the.projects with a contractor(s) licensed purivant to the Contractors' State License Law:). a (_ 1 I am,exempt under Sec. ,'B.&P.C. for this reason 'Il Date: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury thatthere is a construction lendingagencyfor theperformance of the work for which this permit is issued (Sec. '3097, Civ. C':). Lender's Name: Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/02/07 Owner: PAUL & MARY KROLL W::AU6 81830 EAGLE CLAW D LA QUINTA, CA 9225( 02'e�00� Contractor: CI OF LA Owner FINANCE ------------ 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 forwhich this permit is issued. My workers' compensation insuranceXarrier and policy number..are: Carrier - - - - - - -- - - - - - - - - =- - - - -- Policy Number Icertifythat; in the performance of the work for which thispermitis-issued,I shall not employ any person in any mannerso as to become subject to the workers' compensation laws of California, and agree that, if I should.become.subje the workers' compensation provisions:of Section 3700 of the Labor Co I shall forthw' omply'with those. provisions.. Date: 2 Applics WARNING: FAILURE To SECURE WORKERS' COMPENSATION RAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINALPENALTIES 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 Ibehalf this application is made; each person,at'whose request and for whose benefit work is performed�underor 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 Quina, 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 isnot 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 thisapplicationand state that the above information is correct. I.agree to comply with all city and county ordinances and•state laws relating to building construction, aN hereby authorize. representatives of this county to enter upon the above-mentioned pro�y�forriinspe p byes. Date:,, �6� Signature (Applicant or Ageek/,j4_ Application Number . . . . . 07-00002222 Permit . . . ELEC-MISCELLANEOUS Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation_ . . . . 200 Expiration Date 1/29/08 Qty Unit. Charge Per Extension BASE FEE 15.00 1.00 11.0000 EA ELEC MISC 11.00 ----- ----"- ----------------------------- Special Notes and Comments --------------- ---- - - -- ADDING 220 AC CRKT FOR FUTURE SPA INSTALL Fee summary Charged Paid Credited Due ------------------ Permit Fee Total ---------- -- -- 26.00 - ---------- .00 ---------- .00 26.00 Plan Check Total 6.50 .00 00 6.50 Grand Total 32.50 .00 .00 32.50 LQrERMrr Bi" # City of La Quinta Building a Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking, Sheet p g Permit # Project Address: 0 "' ^� �p Owner's Name: a, A. P. Number: Address: b2 Legal Description: Contractor: dh2�'r Address: City, ST,,Zip:LA Q(41AJ(^� f ZZ Y3 Telephone: Project Description: stao -n_ City, ST, Zip: m 514— Telephone: State Lic. # : City Lic.. #: -- Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # St , es: # Units: Telephone# of Contact Person.: Estimated Value of Project:. APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACK NG . PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance. Energy C.alcs. Plans ticked up Construction Flood plain plan Plans resubmitted 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.O.A. Approval Plans resubmitted Grading IN HOUSE: ''" Review, ready -for correctionsrssue Developer Impact.Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit'issue School Fees Total Permit Fees Irc _54 14r� A RE -INSPECTION FEE OF $30 WILL BE CHARGED IF THE APPROVED PLANS AND JOB CARD ARE NOI u H--r—�OR A SCHEDULED INSPEC ON. EXCEPTIONS! CITY OF LA QUINTA BUILDING & SAFETY DEPT, S Lp"5 FORr-- : d Construction is t�C M ( .�—Ne,�s a .� Dr. Martin Luther Ding Jr. Day V 1y, v0 - CITY OF LA QUINTA BUILDING & SAFETY DEPT, S Lp"5 FORr-- : d Construction is t�C on the following de Holidays: .�—Ne,�s a .� Dr. Martin Luther Ding Jr. Day President's Day v0 - Memorial Day Independence Day Labor DaY Q, Veteran's DaY ThanksgiVing Day Christmas Day t,IVT' TELEPHONE (760) 777-7012 FAX (760) 777-7011 OWNER/BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "Owner/Builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the City or County. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit. and protection. If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you maybe an employer. If you are an employer, you must. register with the State and Federal Government as an employer and you are subject to several obligations include State and Federal income tax withholding, federal social security taxes, worker's compensation insurance, disability insurance costs and unemployment compensation contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance.. For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions.. A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N. Street, Sacramento, California95814. Please complete and return the enclosed owner -builder verification form so that we can confirm that -you, are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La Quinta, CA 92253 (760) 777-7012 FAX: (760) 777-7011. R'S SIG /DATE ,k� /fir �' i�►2 i? q , CA Q 22s'3 PERTY ADDRESS PERMIT NUMBER(S)