11-0733 (ELEC)P.O. BOX 1504
78495 CALLE TAMPICO
LA Q.UINTA, CALIFORNIA 92253
Application Number:
11-00000733
Property Address:
78285 HACIENDA LA QUINTA
APN:
646-280-021- - -
Application description:
ELECTRICAL
.Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation: •
500
T4tyl
VOICE (760) 777-7012.
FAX (760) 7774011.
BUILDING & .SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/06/11
Owner:
WEAVER GARY & GAYLE
78285 HACIENDA LA QUINTA
LA QUINTA, CA 92253�n� nm
Applicant: Architect Or Engineer:
UCED CONTRACTOR'S DECLARATION.
:1 hereby affirm,under pens ty of perjury at I licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division of the BuS•r a Professionals Code, and my License is in:full force -end effect.
U lass:. B License No.: 743377_
Dat Contractor: V -
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury thatfem exempt' *from the Contracior's:State License Law for the:
tollowing'reason (Sec: 7031,.6,:Bushisss and Professions -Coded Any city orcountv4hat requires a permit -to .
construct, alfer, improve,;demolish, orrepalr any structure, prior [oats Issuance, also requires the applioantfor the
perrhit to file's signed: statement thathe or she is licensedpursuant twthe,provislons of -the Contractor's State
License Law (Chapter 9 (commencing -with Section 7000)'of Division 3 of the Business,and Professions Code),or
that he:or'she Wexempt therefrom and the basis for the alleged, exemption. Any violation of Section 7031.5, by
any.applicantfor a permit subjects'the,applicam to a -civil penalty of notmore than five hundred dollars 10600).;
(_) I, as owner of the.property„ormy employees with wages as their sole compensation, will do the work, and
the structure.is not intende'd or offered for.eale (Sec. 7044, Business and ProfessiorWCode: The
Contractors' State.Ucelse,Law does not;apply'to an;ownerof property who builds or improves thereon,
and who; does the work himself or herself through his or her own employees, provided that the.
improvements,
mprovements are noOntanded 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.).
(_ l I,as owner of the property, am exclusively gontracting with licensed contractorato construct the project:(Sec.:
7044, Business and Profession& Code: The Contractors' State License Law does not apply to an owner of
property who buildaor, improves thereon, and who contractsdorthe projects with a contractors) licensed
pursuantto the Contractors' StatedUcense Lew.).
(—) I am exempt'underSee. . B.&P:C.;for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I,hereby affirm, under penalty of perjury that thewis'a,construction lending agency for the, performance of the:
work for which this permit Is Issued (Sec. 3097, div. - C.). '
Lender's Name:
Lender's Address:,
•LQPERMIT
I. !'`” 2011
Contractor: b " `
t
PERRI CONSTR A PARTNERSHIP-
7226.3,DESERT DRIVE GlT1rOF LA QUINTA
RANCHO MIRAGE, CA 92270 F"�ji.a�'^j; FPTi-
(760;)3;40-58.88'
Lic. No.: 743377
WORKER'S COMPENSATION DECLARATION
I hereby affirm under, psnaltyotperjury one of the following declarations:
_ 1 have and -will maintain a certificate of consencto self -insure for workers' compensation, as provided
for by,Section 3700 of the Labor Code, for the, 'performancs of the,work for which this permit is
Issued.
_ I have and will marttain,workers' compensation Insurance, as, required by Section 3700 of the, Labor
Code, for the performance of the work for which this permitis.issued. My workers' compensation
insurance carrier and policy num are:
Carrier, EXEMPT. P I Number EXEMPT
_ I cartity that; in the perfonman of work for which this permit is issued, I'shall not employ any
person In any mannerlso a subjec fto the workers' compensation laws of :California,
and agree that,,if'l should o e ubject to -the workers'.compensation provisions okSection
3700 of the e,.l allrthwhh complymAth those provisions.
Date: 4 z.11ppheant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE'IS'UNLAWFUL,.AND SHALL
SUBJECT AN EMPLOYER TO, CRIMINAL,PENALTIES AND, CIVIL FINES UP TO.ONE HUNDRED THOUSAND
DOLLARS 101;00,0001• IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS, PROVID_ ED.FOR IN
SECTION $708' OF THE LABOR CODE,INTEREST, AND ATTORNEYS FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT .Application is hereby made to the Director of Building and Safety for a permits_ ubjectto-the
cond_itions:and restrictionset forth on this: application.
1. Each person,upon whose behalf this application is made, each person st.whose request'and'for
whose'benefit work is performed under'orpursuant to any permit Issued as a result of this application,
the owner, and the applicant, each agrees to, and ahaltdefend. Indemnify and hold harmless the City
of La Oulms,' Its officers, agents and emp oyess.for any act or omissiomrelated to the work, being,
performed under or following issuance of this permit;
2. Any permit issued as a resuWpf this application,becomes null and; void, if work s not'commenced.
within ISO days; from, date of' Issuance of such pe or tion of work'for 180 days•will subject
permit to. cancellation.
I certify that l have read this application and state that the a_ nt - ion is correct. I agree to.cornply with all
cityand county ordinances and ststdlaws,relating to building sti ion, and hereby authorize representatives
oftfiIs ty to tteerr ualpon the above -mentions riy f nsp Ion purposes.
Data ` 1lognature (Applicant or Agent):- _ _ _
Application Number . . . . . 11-00000733
Permit. . . ELEC-SERVICE
CHANGE
Additionaldesc .
Permit Fee .. 33.56
Plan Check Fee
.00
Issue Date-
Valuation . . .
. 0
Expiration Date 1/02/12
Qty Unit Charge Per
Extension
BASE
FEE:
15.00
1.00 18.5000:EA ELEC
SVC <=600V/c=200A
18.50
Special Notes and Comments
200AMP METER/PANEL CHANGE OUT - 2010
CALIFORNIA ELECTRICAL CODE'.
July 6, 2011' 11:13x52 AM AORTEGA
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
!_T.�I�liul
Bin!#
City of La Quints
Building er Safety D1WWon
P.O. Box, 1504,,78-495 Calle Tampico
Lx Qutnta, CA 92253 _ (760) 777-7012
Building Permit Application and'Tracking Sheet
Pennit #
t 1.0'133
Project Address: 7,41Gly
A
Owner's None:
A. P. Nitmber.
Address: �¢
Legal Description:
City; ST, Zip: V
Contractor.
,-,
Telephone:
Project _Descripdon:.
Address:
City; ST, Zip::
'Telephone: . �5
State Iic.4 :
City Lie. #:
Arch., &W., Designer.
Address:
City., ST, Zip:,
Telephone:
State.Lic. #:
Neme:of Contact Persons�i.
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo.
Sq. FL:
# Stories:
#Units:
Telephone # of Contact Person:
Estimated' Value of Proj 42&
APPLICANT: DO NOT. WRITE BELOW THIS LINE
N
Submittal
Req'd
Reed.
TRACING'
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Strnttnrai'Cales.
Reviewed, ready for corrections
Plan Check Deposit
'Truss Cares.
Called Contact Person
Plan Check Balance
Titie'24 Calcs.
Plans picked up
Construction
Flood plain pian
Plans resubmitted
Mechanical
Grading plan
20";Review, ready.for eorrections/issue
Electrieal
Subeontactor List
Called' Contact Person
Plumbing
Grant Deed
Plans, picked up
S.MJL
H.0AA..Approval
Plans resubmitted
Gradbrg
WHOM-,
3" Review, ready for. eorrectlgaNssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
sunni