10-0368 (ELEC)P.O. BOX 1504
78-495 CALLETAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 10-00000368
Property Address: 78730 W HARLAND DR
APN: 604-222-002-32 -23268
Application description: ELECTRICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 200
Ta�/444"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty'of<perjury that I sm.licensed under, provisions of Chapter 9 (commencing with
Section 7000) of,Division 3 of the Business and, Professionals Code, and my License Is In fulfforce and effect.
License Class: CIO Q /Licenseho.: 917978
ate: 7 /2 I ltd ontraaor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 am exempt from the Contractor's State License Lew for the
following reason (Sec. 7031.5, Business; and Professions Code: Any city or -county that requires epermit to.
construct; alter, improve, demolish, or repair any structure, prior to its Issuance, also.requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant,to the provisions.of the Contractor's State
License Law (Chapter 9 (commencing wkh Sectio_n.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'civit penalty ofnot more than five hundred' dollars (8500).:
(_) as ownerof the property, or my employees with .Wages ,as their sole, compensation, will do the work', and
the structure Is not; intended'or'offereid for,iw!wfSeo• 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of propertywho'builds or improves thereon,
and who doesthe work himself or, -herself through his or her own employees, provided that the
improvements are notintended or offered for sale. If; however, the building,or Improvement issold within
one year, oCcompletion, the owner builder will have thepurden,of proving that he or she did not, build or
improve for 'the -purpose. of,sals.).
(_) j,.as owner oftheproperty, am exclusivelycontracting 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
Oroperty,who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to,the Contractors' State License Low.).
(__ ► I am exempt under Sec. , B.&P:C. for this reason
.Date: Owner.
CONSTRUCTION. L ENDING, AGENCY
I hereby affirm, under penalty of perjury that therwis a construction lending agency for the performance of the,
'work forwhich.this-permit'is Issued (Sec. 3097; Civ. C.).
Lender's. Name:
Lender's Address:
I:QPSRMIT
Owner:
SOPHIA PERRONE
7873'0 W. HARLAND'DR_IVE
'LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/28/10
D e U i
Contractor: i
VEITH ELECTRIC
P.O. BOX 752 APR 2 8 2010 j
,
, 10
INDIA, CA 92202
(760) 834-9012 07Y OF LA QUINTA
LiC. No.: 917978 FINARCE'DEPT. _.
--------------------------------------
WORKER'S'COMPERSATION `DECLARATION
I.hereby affirm under penalty of perjury, one of the foilowing,declarations:
_ I have and will maintain a.certificate of,consem toaelf 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 insurance, as required by Section 3700'ofthe Labor
Code, for the perforniance-of the work for which this, permit is Issued. My workers' compensation
insurance carrier and policy number -are:
Cartier EXEMPT Policy Numbei EXEMPT --
1 certify that, in the performance of.the work.for which -this permitlsiissued, I shall not employ any
'person in any manner -so as to become. subject to the workers' compensetlon,lawe of Cal(fomia,
and agree that; if I should becoe subject,to tl workers' -.compensation provisions of Section
�[ 3700 of tm
he Labor sfsll'forthwi em Iy with those,piovisions.
e: 7 'Lf/tV plicent: - �
WARNING: FAILURE TO SECURE' WORKERS' COMPENSATION'COVERAGE'IS UNLAWFUL,.AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL, PENALTIES AND CIVIL FINES UP TO'ONE'HUNDRE6THOU3Arm
DOLLARS (8100;000). IN ADDITION'TO THE COST'OF COMPENSATION, DAMAGES.AS PROVIDED FOR,IN
SECTION 3708 OF THE1ABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby;made.to the'Director of Building and Safety,fora permit subject -to the
conditionsand restrictions set forth on this application:
1. Each person upon whose, behalf this application'is made, each,person at whose request and,for
whosebenefit ,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
ity
of La'Ouinta, Its officers, agents and employees"forany-aci 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 and void if work isnot commenced
within 1a0'days, from date of issuance of such permit, or cessation of work for 180 days will subject.
permitto cancellation.
I certify that l 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' construction, and hereby authorize representatives
of this cou to,e/nter upon the -above-mentioned prop y f inspection pun es
ate:YI/v Si re (Applicantior Agent) -ti`"�
Application Number . . . . . 10.-00000368
Permit . . . ELEC-SERVICE CHANGE
Additional hese
Permit Fee . . . . 33.50 Plan Check Fee
.00
Issue Date Valuation . . .
. 0
Expiration Date 10/25,/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 18,5000 EA ELEC SVC <=60OV/<=200A
18:50
--------------------- •---------
Special Notes and Comments
REPLACE MAIN BREAKER ON SERVICE PANEL
125 AMP- 2007 CODES.
-------_----------_----------------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee: summary Charged. Paid Credited
------------- ------ -
Due-
----------
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
LQPERMIT
Bin #
City of La Quinta
Bullding alt Safety Dhldon •
P.O. Box 1504, 78 495 Calle Tampko
La Quinta, CA 92253 - (760) 7777012 '
Building Permit Application and Tracking.Sheet R
.
Permit fi
Project Address: % e-7-30 W tar l aJ
Owner's Name:
A. P. Number:'Z Z'Z - �Z
. a� -
Address: 3o w ted. I,�...,(
Legal Description:
City, STT, Zip: G1 a, -; N GEL -12, 2,f
Contractor: Gi 4w^
Address: a 13,),- S Z
Telephone:
Project Description:resiCe�-
City. ST, Zip: wO�,d Z ZO Z-
Telephone: T 3 4/-90 L
State Lic. # : Cfj ] CityLic. #: ? 2
(L S ,
Arch., Engr., Designer.
Address:
City,, ,ST,2ip:
Telephone:
Lic. #:
Name of Contact Person:
Co» struction Type: Occupancy:State
Project type (circle one): New Add'n. Alta Repair Demo
Sq. Ft.:
CStories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project -2-0o .
APPUCANT:.Do NOT WRITE BELOW THIS UNE
#
Submittal
Plaa.Sets
Req'd
Recd
TRACMG
Plan Cheek submitted
PERMIT FEES
Item Amount
Structural Cala.
Reviewed, ready for correetioat
Plan Cbeek Deposit
Truss Coln.
Called Contact Peon
Plan Cheek Balance.
Title 14 Cala.
Plana picked up
Construction "
Flood plain plan
Plans resubmttied
Mechanical
Grading plan
2" Review, ready for correelionsAsfue
Electrical
Subcontactor Ust
Called Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H:O,A. Approval
Plans resubmitted
Grading
IN HOUSE-
r'' Review, ready for correction iwne
Developer Impact Fee
Plauning-Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of per®It lane.
School Fees
Total Permit`Fees