06-2512 (ELEC)P.O. SOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING: & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 06-00;0.02512 Owner:
Property Address: 78410 HERITAGE WY PH RANCH LLC
APN: 643-1.70-999-34 -31348' - 783'70. -HIGHWAY 11=1 STE
Application description( ELECTRICAL LA QUINTA, CA 92.253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 1500
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S:DECLARATION
I ,hereby affirm under penalty ofperjury that 1.;am licensed under, provisions of Chapter 9 (commencing with
Section 7000(of Division 3 of:the Business.a4i rofassienals Code„and myticense�is in full forceiand effect..
License/Class: C/10 Li 37
Date: v"�-v contractor - -
OW DER DECLARATION
I hereby affirm, under',penelty of perjury that L_am exempt from.the Contractor's State Uoense1aw fouthe
following reason.(See. 7031,.5i.6usiness and Professions Code: Any city orcounty.thet requires,a permit to
construct, alter; improve, demolish; or repair anystructure„prior to its:fssuance; also requires,the,applicant for the
parmitto file a signed ;statement that'he or she is licensed pursuant to the,provisions ofathe Contractor's State
License Law (Chapter9'(commencing with Sectfon.7000) of. Division 3 of the Business and Professions CodeFor
thathe or she "is exempt:therefrom and the basis forthe,alleged exemption. Any violation of'Section 7031:5 by
anyapplicant fora permit subjects the applicantto a civil penalty of not:more,than#ive hundred dollars (8500).:
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 Prpfiiwions Code; The
Contractors" State License,Law does not apply.to an owner,of property'who bull ds or Improves thereon,
and who does the,work himself or herself through his or herown employees, provided that the
improvements are not intended or offered for sale. if, however, the°building.or'improvement,is;sold within
one year of completion,.the owner -builder wil(have,the burden of proving that'he or she did'not build or
improve for ths'purpose of sale.).
J_) I, as owner of the. propsrty,.am exclusively.contracting with licensed contractors:to construct the project=(Sec.
7044,, Business and ProfessionslCodet The•.Contractors' State'License Law does not apply to an owner
property who builds or improves thereon, and Who, contracts,fonthe projects with 7a. contractor(s) licensed
pursuant to the, Contractors' State License -Law.).
1 _ 1 I am exempt under Sec. ,.8:&P:C. for this reason
Data: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm'under penalty of perjury that there is a.construction lending agency for the performance_ of the
work for which this,perrrirt`is issued (Sec. 3097, Civ. C.).
Lander.'s `Name:
LQPERbIIT
Contractor:
DESERT POWER
1999 S NAVAJO DRIVE
PALM SPRINGS, CA 92264
(760')327=8851
Lic. No.: 824337
VOICE (760) 777-7012
FAX (760)'777-7011
INSPECTIONS (760) 777-7153
Date: 6/26/06
WORKER'S COMPENSATION DECLARATION
I hereby affirm under'penalty0 perjury one of the following declarations:
t._have and ,will maintain'.a certificate of consent to self-insureforworkees' compensetion;,es'provided
for by Section 3700 of the Labor Code , ,for the performance of the work for which this permivis
Issued.
I'have and will maintain' workers' compensation insurance; as required b"y Section 3700,6f the Labor
Code, for ttWperformance of the work for which this permit is issued. My workers' c_ompensi i_on
insurance, carrier and.policy numberare:
Carrier.ZXEMPT. Pollcy:Nuniber EXEMPT
_ I,certifyihet, in the performance of the, .work -for which this -
permit is'issued;.l shall not employ any
persomin any manner so as to become subject to the workers' compensation. laws of California,
and agree that, if l shouldbecome,subject;te the workers' compensation provisions of Section
3706 of the Labor Code;,l'sh hwith p1mly wittfthose,provisions.
Date:` Applicant: -
WARNING:_ FAILURE SECU S' COMPENII ON COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN, EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (8100,000). IN ADDITION.TO THE COST'OF'COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 370&OF THE, LABOR CODE, INTEREST, AND ATTORNEY'SFEES.
APPLICANT ACKNOWLEDGEMENT'
IMPORTANT Application s; hereby made:to the: Director of Building and Safety for a permit subject to the.
conditions and,restrictions:set forth on this application:
1. Eachperson upon whose'behalf this application4s,made,.,each persom:at-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 shall defend, indemnify and hold harmless the City
of La 0uiinta, its officers, agents and,employess.forany act or omission related to the work being
performed under or. following issuance of this permit.
2. Any,permit issued as a.resuh of'this�application_becomes null and void if work is not commenced
within 180 days from date of:issuanoe of such _permit,_ or cessation of work for 180. days will subject
permk.'fo caneelletion.
I certify that.I have read this application and state that;the above information is correct. I'agree to comply with all
city and.county ordinances: and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the,above-mentioned propertyfor” se ` n purp s -
Date: Signature (Applicant or Agentl,
Application Number . . . . . 06-00002512
Permit . . . ELEC-TEMPORARY POWER
Additional desc .
Permit Fee 30.00 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date . : 12/23/0.6
Qty Unit Charge Per
Extension
BASE FEE-
15.00
1.00 15.0000 EA ELEC TEMPORARY POWER POLE
15.00
---------------------------------'------------------------------
Special Notes and Comments
200'AMP TEMP POWER POLE-NOTE.:PREV.IOUS
POWER TO PERMITTED SALES TRAILER IS
BEING RELOCATED TO ALLOW FOR REMOVAL OF
EXISTING TEMP POWER POLE.
Fee summary Charged Paid Credited
---------------
Due
----------------------------------------
Permit Fee Total 3.0.00 .00 .00
30.00
Plan Check.Total .00 .00 .00
.00
Grand Total 30.00 .00 .00
.30.00
IV
LQPERMff.
Bin #
City of La Quinta
Building at Safety Division
P.O. Box 1504,78-495 Calle. Talnpito
La Quinta,-CA 92253 - (760) 777-70.12
-Building Permit Application and. Tracking Sheet
Permit #
Project Address:
Owner's Name:
Address:
Legal Description:
City, ST, Zip:
Contractor:
Address:
O e, J—
Telephone- _ S-'
Project Description:
City, ST, Zip:
Telephone (0 a
State Lic: # :
O
�-
City Lic. #:
G
Arch., Engr., Designer:
Address:
City, ST,.Zip:
Telephone:
State Lic. #:
Name of Contact Person:
C mstructionType: Oocupancy:
Project'type (circle One)' New Add'n Alter Repair Demo
Sq -Ft.: # Stories: #Units:
Telephone* of Contact Person:
i Estimated Value of Project: C)
APPUCANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Reed
TRACH NG .
PERMIT FEES
PlanSets
Plan:Check submitted
Item
Amount'
Structural.Cales.
Reviewed, ready for corrections,
Plan Check Deposit
Truss Cala.
Called ContactPerson
Plan Check Balance
Energy Cales.
Pians picked up
Construction.
Floodplain plan ,
Plans resubmitted
Mechanical
Grading pian
2" Review, ready for coerectionslissue
Electrical
Subcontactor:List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
SILL
ILO,A. Approval
Plans resubmitted.
Grading .
WHOM:-
'Review, ready for correctionstissue.
Developer Impact Fee
Planning Approval
Called•Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees