08-1454 (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:
---7)
108=00001454,__
'--46152.WASHINGTON ST .
604-050-033-19 -000000-
ELECTRICAL
REGIONAL COMMERCIALt -
5000
Architect or Engineer:
VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/21/08
Owner: '
ATLANTIC RICHFIELD CO
C/O PROP TAX DEPT t
P O BOX 512485
LOS ANGELES, CA 90051 '
Contractor:
ORANGE ELECTRICAL CONTR I
488 MONTGOMERY WAY U AUG 2 1 2006 U
• ORANGE,' CA 92868-
i (714)771'-2814
LiC- No.: 834083 CITY OF LAQWNTA
FINANCE DEPT
C7
LICENSED -CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am 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 Busin s 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: C10 License No.: 834083 ` for by Section 3700. of the Labor Code, for the performance of the work for which this permit is
issued.
/Date: %,—?.A ntractor: + 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 workerscompensation
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 ENDURANCE WC .Policy Number WEN003702001
following reason ISec. 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 erson 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 ag2pplicant:
if I shou 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 bor Code sha fo with comply 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).: ate: �
(_ 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 '� WARNING:, FAILURE TO SECURE WORKERS' 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.UPTO 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.). APPLICANT ACKNOWLEDGEMENT'
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby -made to the Director of Building and Safety for a permit subject to the '
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, ,
1 _) I am exempt under Sec. B.&P.C. for this reason 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.
" Date: Owner: _ 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
CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty. of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and unty ordinances and st laws relating to building onstructio and hereby authorize representatives
' of thi ounty toenter upon th bove-mentioned property fo spe n uses. -
Lender's Name:
Ir Vure e: Sign (Applicant or Agent):
Lender's Address: � at� -
r'
LQPERMIT
Application Number 08-00001454 -
Permit . . . ELEC-MISCELLANEOUS
-
Additional desc .
Permit Fee . . . 33.50 Plan Check
Fee
.00
Issue Date . . . . Valuation
0
Expiration Date 2/17/09
Qty Unit Charge Per
Extension
BASE FEE
15.00
1..00 18.5000 EA ELEC SVC <=600V/<=200A
18.50
Special Notes and Comments
200 AMP METER PEDESTAL FOR VERIZON
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.
LQPERMIT ..
.
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Jul 2006
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DATE
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DATE
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104
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58
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Bin #
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # I'
�j
l
Project Address:
Owner's Name: .t w% Ao*m Ne
Address: L UL0 eAeo�ta 4 G I #�D�
A. P. Number: 60 + X50 + 0.37
Legal Description:
Contractor: ORAWfaACLO
City, ST, Zip: ?A1 -'1% 245"T C 4
r Telephone: ks
Project Description: 2c
Address: Lt % T
City, ST, Zip:Q
?OJDV r Al kD e.
Telephone: 71LA- t +75-0 I
State Lic. # : 9311109S
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: S QIO►
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: ( Li•2311_71b
Estimated Value of Project: '5.0&0*
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked 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 corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.1.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
,,
Total Permit Fees