07-1936 (ELEC)•fir .. 7` •. - .., • �� .
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: 7/03/07.
Application Number: 07-00001-936- Owner:
Property Address: <f 53.650 AVENIDA VILLA BARRY MOLNAA
APN:= 774-134-008-17 -000000- 53650 AVENIDA VILLA
Application description: ELECTRICAL LA QUINTA, CA' 92253
Property Zoning: COVE RESIDENTIAL
Application valuation: 1800
- - .' • Contractor: /''•f�i ��„i-`'P9•
Applicant: Architect or Engineer: BRANNEN ELECTRIC W �i
46324 ROUDEL LN 0`
LA QUINTA, CA. 92253 1 `) v �O .
(76.0)347-3829
I A,—
Lic- .No.: 376189 0¢ CEO•.
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 Busines 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.: 376189 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
> issued.
te:
a- 3Q / 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 workers' compensation'
OWNER -BUILDER DECLARATION - insurance carrier and policy Aumber are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 0014396`2007
following reason (Sec. 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 person in any manner s s 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 thv (:nntrar,.tor's State and agree that, if I sh I come 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 C e shall fort h 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: -v A scant:
(_ 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: FAIL E TO SECURE WORK R 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 ALTIES 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 sh6 did not build or - -
improve for the purpose of sale.l. '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 _ 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 Ouinta, 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 ur der 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 county ordinances and state laws relating to buildi nstruction, and hereby authorize representatives -
i - of this county to enter upon the above-mentioned prope f inspects urposes.
Lender's Name:-
_,rate: I gnature (Applicant or Agentl: .
'Lender's Address: -
+4 N
LQPERMIT f '
Application Number .07-00001936
`
Permit ELEC-SERVICE CHANGE
. Additional desc
y
Permit Fee . . . . 335.0 Plan Check Fee
.00 -
Issue Date Valuation
0
Expiration Date-. 12/30/07
Qty_ UnitChargePer
Extension "
BASE FEE
15.00
1.00 18:5000 EA. ELEC SVC <=600V/<=200A
18.50
---------------------------------------`------------------------------------------------------
Special Notes and Comments
.
SERVICE CHANGE 200'AMP OVERHEAT TO. .200
AMP UNDERGROUND
Fe`e summary, Charged Paid Credited
Due
Permit Fee Total •33.5,0 .00 ..00
33.50
Y Plan Check Total 00., 00 '.00
00
Grand Total 33.50 .00 .00
33.50'
LQPERMTT - .- -
Bin #
. 1
City 6f La -Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tamp:Ko
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Trarkitig Sheet
'Permit #
Project Address: -53- �b �
Owner's Name: p„V,d,,,, *&1n acW
A. P. Number: �.;
Address: — 66 t% a,, G
Legal Description:
Contractor: r
Address:[L — r14 v . tA go
City, ST, Zip:
. et u - ,a
Telephone:
Project Description:
City, ST, Zip: U ✓l,.
Qd h'l V2�-�t. a e
Telephone., tWE
State Lic: #%" City Lic. #:
Arch., Engr., Designer:
d
Address: .
City, ST; Zip:
Teleph ne:
State Lica #:
P
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person:
%1
Estimated Value of Project: �+ QQ QQ
APPLICANT: DO NOT. WRITE BELOW THIS LINE
#
Submittal
Req'd
"Reed
TRACKING .
PERMIT FEES
Plan Sets
Plan Check submitted
'Item
Amount
Structural Cates.
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
2nd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plum-ging
Grant Deed
Plans picked up
S.M.E.
H.O.A. Approval
Plans resubmitted
Grad_ng
IN HOUSE:-
''d Review, ready for corrections/issue
Develbper Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue :.
School Fees
Total [Permit Fees
r