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09-1127 (ELEC)P.O. BOX 1504 78-495 .CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 09-00001127 Property Address: 53145 AVENIDA HERRERA APN: 774-053-019-7 -000000- Application description: ELECTRICAL Property Zoning: COVE RESIDENTIAL Application valuation: 200 Tityl 4 4v Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner:. TORRES 53145 AVENIDA MORENO VALLEY, Contractor: Applicant: Architect or Engineer: BRADLEY ELECTRIC INC. 42335 WASHINGTON ST, PALM DESERT, CA 92211 (760)360-0944 - /� Lic. No.: -275466 VOICE (7.60) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/26/09 530"1 gy��tq 04: oG a STEA / -------------------------�----1------------------------------------------------------------------- LICENSED CONTRA TOR'S DECLAMATION 1 hereby affirm under penalty of perjury that I am licensed unde rovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busin s an Professionals Ole, and my License is in full _ nd effect. Licens Cass: CIO Lic, nse o.: 2�466 Date i ctor: OWNER -BUILDER DEC�couD I hereby affirm under penalty of perjury tha I am exempt from the Conthe following reason (Sec. 7031.5, Business aid Professions Code: Any cirmit to construct, alter, improve, demolish, or repai any structure, prior t 'ts iss at> nce, also requires the applicant for the permit to file a signed statement that he or sh�fs4ieensed-pursuant to the provisions 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 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 (5500).: (_) 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 Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own 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 will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed . pursuant to the Contractors' State License Law.). 1 1 I am exempt under Sec. , BAP.C. for this reason Date: 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 permit is issued (Sec. 3097, Civ. C.). Lender's Name:. Lender's Address: LQPERMIT WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insura ce, as required by Section 3700 of the Labor Code, for the performance of the work for w ch�this pe - is is issued. My workers' compensation insurance carrier and policy number are: Carrier ENDURANCE WC Policy Num er WEN0035,743-02 _ I certify that, in the performance of the work fo which this permit�Ls issued, Ishall-nn�em,,loy anyperson in any manner so as to become subjec to the workers' co`npensatio a lifoiniaand agree that, if I sho Idn`(�o�wc_�ome subject to th war ion pro sio ection _ IXi700 of the La� Cot�ltd9l�ll forthwith�au+ ith those olovi ion WARNING: FAILURE TO SECURE PORKERS' COMPENSA��I�AGE ISILQLe�WOI�,WD SHALL OUSANO DEMPLOYERSUBJECT AN OLLARS $100,000). IN ADDITO RTIONAL -T4-PENL ( I ST OF COMPENSATION, DAMAGES AS L FINES UP TO ONE HUMMED VIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant 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 Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null a -vdt- if worlds of commenced within 180 days from date of issuance of such permit, essation o work for 1 days w' sul permit to cancellation. I certify that I have read this application and state that the atjove information is torr I. I agree to co y with a city and county ordinances and state laws relating to builf=mi��nstruction, a�Qhereb authorize rep a ti of this-ounty to -enter upon the -above-mentioned orooeftv`idliFfsoection oie anBes. J (Applicant or Application Number . . . . . 09-00001127 -Permit . . . ELEC-SERVICE CHANGE -Additional desc . Permit Fee . . . . 33.50 Plan Check Fee .00 Issue.Date . . . . Valuation . . . . 0 Expiration Date . . 4/24/10 Qty Unit Charge Per Extension BASE FEE 15.00 1.00- 18.5000 EA ELEC SVC <=600V/<=200A 18.50 ---------------------------------------------------------------------------- Special Notes and Comments REPAIR 200 AMP METER SOCKET. 2007 CODES --------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 • ,� Fee summary Charged Paid Credited Due -----------------F ---------- ---------- Permit Fee Total 33.50 ---------- ----------- .00 .00 33.50 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 34.50 .00 .00 34.50 13 LQPERMIT I Bin # Qty Of La Quinta Building 8i Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # d� Project Address: ?� �, Owner's Name: a �� A. P. Number: Address: -� Legal Description: City, ST, Zip: , , tr ct Con r: a o0&10,V eleP hone: ' Address:-,/ 33.5 N Project Description: City, ST, Zi Tele ho n P State Lic. # : '< City Lic. #•: Arch., Engr., Designer: Address: City, ST, Zip: ne: Telephone:ho €State Lic. #: Name of Contact Person: Construction onTY • Pe: Occupancy: ProJ'ecttYP (circlea one): New Add'n Alter Repair Demo Sq. Ft.: # Stories:#Units: Telephone # of Contact Person: Estimated Value of Project: 02L�D 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 Calcs. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2nd 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:- 3rd Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees