06-2441 (ELEC)P.O. BOX 1504: ^' VOICE (760) 777-7012
78-495.CALLE TAMPICO FAX (760) 777-7011
" LA QUINTA, CALIFORNIA 92253: BUILDING & SAFETY DEPARTMENT " INSPECTIONS (760) 777-7153'
BUILDING PERMIT
Date: /
D e: 6 19/06
Application Number: C 06-00002441 J� ' Owner:
Property Address: `52790 AVENIDA VILLA OOwner:ARAMBULA MARTIN
APN: 773-334-002-25 '-000.000- 52790 AVENIDA VILLA _
Application description: ELECTRICAL LA QUINTA, CA 92253 _
Property Zoning:' COVE RESIDENTIAL ------ ------------
Application
---..-•—Application valuation: 900 D Li I
Contractor: 9 2UU6-
Applicant: Architect or Engineer. Owner JUN 1
-„-------.---- ---- --- DEPT.
-----A�
CITY OF LA
FINANCE
1
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that 1 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 Business and Professionals.Code,,and my License is in full force and effect._ I have and will maintain certificate of consent to self -insure for workers' compensation, as provided
�t License Class: License No.: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date: Contractor: _ 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
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 Policy Number -
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to y 1 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 Labor Co e, I shall for ith com ly wit se ovisions.
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 ($5006: Date: -C -P Applicant:
1 j91 1, as owner of the property, or my employees with wages as their sale compensation, will do the work, and r
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 UP TO 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.L - - APPLICANT ACKNOWLEDGEMENT
-- "1 - 1 1, 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 permitsubject 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.
/!.`v/ - --- ' - - M: performed under or following issuance of this permit.
Date (` D Z fi Own_e_r: 2. Any permit issued as a result of this application becomes null and void if work is not commenced
r 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
,F. 1, work for which this permit is issued (Sec. 3097, Civ..C.l. = - city and county ordinances and state laws relating to building construction, and hereby authorize representatives,
` •--' �'^' ' `^. .- of this county to enter upon the above-mentioned property for inspe - n purposes.
•' Lender's Name:. - - - / _ -
Date: Signature (Applicant or Agent): C�
Lender's Address:
LQPERMIT
Application Number 06-00002441
.
•
Permit- ELEC=SERVICE
CHANGE
_
Additional desc`.
Permit Fee 33.50
Plan Check
Fee
.00
Issue Date
? Valuation
0
Expiration Date 12/16/06
y
Qty Unit Charge Per
Extens 'ion' G,
BASE
FEE
15:00
1.00 18.5000 EA ELEC
SVC.<=600V/<=200A
18.50
------------------------
Special Notes and Comments ,
---
-
200 AMP SERVICE UPGRADE.
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-
.
y .
Bin #
City- � Q of Lapinta -
Building & Safety Division
P-0; Box 1504, 78-495 Calle Tampico.
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # I j(
�� I
Project Address:'
Owner's Name:
c �
A P. Number:
Address: _ 7 L,All
Legal Description:
City., ST, Zip:
Contractor:
Telephone: %G(' —
Project Description: .
Address:
'City; ST, Zip:
v' 90 A
Telephone:
ten
State Lic.
City Lica#:
Arch., Engn, Designer:
Address: .
City,'ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction. Type: Occupancy:
ProjecCtype (circle one): New Ad 'n Alter : Repair Demo
Sq. Ft.: .
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:'-
rojectr D �=
APPLICANT:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections:
Plan Check Deposit
Truss Cafes.
Called .Contact Person
Plan Cheek Balance
Energy Calcs.
Plans picked.up I
Construc:lon
Flood plain plan.
Plans resubmitted
Mechanical''
Grading plan
20 Review, ready for eorrections/issue
Electrical
Subcontactor.List
Called Contact Person
Plumbing
Grant Deed'
Plans picked up
S.M.I.
H.O.A.. Approval '
Plans resubmitted
Grading .
INHOUSE:-
Review, ready for corrections/issue
Developer Impact Fee.
Planning Approval
Called Contact Person
A.LP.P.
Pub: Wks. Appr
Date of permit issue:
School Fees
Total Permit Fees