04-3665 (ELEC)ice
BUILDING & SAFETY DEPARTMENT
P.O. BOX 1504 (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
- BUILDING PERMIT
Application Number . . . . •04=00003665 Date 4/23/04
Property Address . . . X77911 DESERT DR -
APN: 658-140-999-141 -29436 -
Appld cation description . . . ELECTRI.CAL
Property Zoning LOW DENSITY RESIDENTIAL
.Application valuation.. 250
Owner
------------------------
IVANHOE LA QUINTA .COVE
C/O R BARRY MCCOMIC
7979 IVANHOE-AVE STE.550
LA JOLLA CA 9.2 0 3 7
Contractor'
TRANS WEST HOUSING, INC.
9968 HIBERT STREET, STE #102
SAN DIEGO CA 9213.1
(858) 653=3003
! : WCC: STATE FUND
WC: 1648813 10/01/04
CSLB: 701039: 01/31/05
_..�
CCC: B
------------------------
-----------------------------------------------------
Permit . . . . ELEC-MISCELLANEOUS
Additional desc
Permit Fee 30.00_ Plan Check Fee •3.75
Issue Date Valuation . . . . 0
Qty Unit Charge Per, Extension
BASE FEE 15.00
1.00.. 15.0000 EA. ELEC TEMPORARY POWER POLE 15.00
.00 18.5000 EA' ELEC SVC <=60OV/<=200A .00
-----------------------------------------------------------------------------
Special Notes and Comments
200 AMP TEMPORARY POWER PEDESTAL ON LOT
141.
Fee summary Charged Paid Credited Due \j
----------------- ---------- ---------- ----------r.- =`-'-----
Permit Fee , Total 30.00 00 �0 ,�3'0�00
CheckPlan Total
Grand Total 33.75 .00 0�0 ��3375�
P.O. BOX 1504
QUMAJ
VOICE (760) 777-7012
78-495 CALLE TAmrico FAX (760) 777-7011
LA QUINTA. CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: OrY - 3 6 -r , Date: �? 'Z 3 - 0-,0
Applicant:
C- ff
Applicant's Mailing Address:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
1 hereby affrm under penalty of perjury let 1 am icensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Prolessionals
Code. and ry7�cd
is in lull force and effect
L cwm Class / License No. 7z, 1 05 T
Dab Contractor !9�'
OVMIER-6ULDER DECLARATION
1 hereby affirm under penalty of perjury that I am exerrpt from the contractors, Stab License Law for the folowbV reason (Sec. 7031.5. Business and Professions Code: Any
city a county that terauires a pentmk b construct, alter, improve. denaistty or repair any structure. prior b its issw wo. also requires the applicant ter the pared b W a signed
statement frost he or she is licensed Pursuant to to provisions of the Cw acWV Stab Lioenae Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or fret he or she is exempt terotrom and the bash for fe staged exerroon. Any violation of Section 7031.5 by any appica it for a pent subjects
the applicant to a dvt penalty of not more than five hundred dolars (M).r.
U 1. as owner of the property. or my empioyees with wages as their sob cormpermMon wi do fro worth ad the structure Is not IrhbMaed or offered for sale (Sec 7044.
Business and Professions Code: The Contractors stab License Law does not appy ho an owner of property who builds or improves thereol . and who does the work
himself or herself or through his or her own enpbyees, provided that the irpnwements are not intended or dieted ter sale. if. however. the buid'i+g or improvement is
sold within one year of completion. the owner4bmider will have fine burden of provirp fat he or she did not build or improve ter the purpose of sob.).
U 1, as owner of the property. am exclusively on 'k -chi with',armsed contractors b construct ft project (Sec 7044. Business and Pidossions Code: The Cormack*
State License Law does not appy to an owner of property who builds or improves thereort, and who contracts for the projects with a contracto(s) %licensed pursuantb
the ContractoW Stab license Law.).
U I am exempt under Sec . BA P.C. for this reason
Dab Owner
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penafly of perjury one of the following declarations:
_ I have and will maintain a certificate of consent to self4nsure for workers' compensation, as provided for by Section 3700 of the labor Code. for the performance
of the work for which this pemnit isissued.
_ I have eaddnd will maintain workers' compensation insurance. ass required
1 certify that, in the performance of the work ter which this permit is ' 1 strati not employ any person in any manner so as to became subject to the workers
oortper - lion laws of Caifomia. and. agree that, III should beco ne subject b fro workers' compensation provisions d Serbon 3700 of the Labor Code. l shell
bftvM comply wtth fuse provisions.
Date Applicant
W : F URE TO SECURE WORKERS COMPENSATION COVERAGE S UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (3100.000). IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN
SECTION 3106 OF THE LABOR CODE, INTEREST. AND ATTORNEYS FEES. .
CONSTRUCTION LENDING AGENCY
1 hereby affirm under �0( perjury ifat faro is a oomstru lion lerxirp agency for the performance of the work for which this permit is issued (Sec 3097. Civ. C.).
Lender's Name
Lender's Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Appicatim Is hereby made b the Director of Building and Safety for a permit subject to the conditions and restrictions set IDM on this appicaion.
1. Each person upon whose behalf this application is made, each person at whose request end for whose benefd work is pedor ed under or pursuant b any prem*
Issued as a result of this application, the owner, and the applicant, each agrees b, and that. defend. Indemnify and hold harmless the City of La Quirts. its
df vers, agents and employees for any aro or omission rotated to the work being performed under or following Issuance of this pemmiL
2. Any permit issued n a result of this application becomes nut and void if work is not commenced within Iso days from date of issuance of such Pa., or
cessation of work fa 160 days will subject permit b cancellation.
1 certify that 1 have read this application and state that the above information is correct 1 agree b comply with at city and county ordinances end state Was relatirg to buldkv
comstruction, and hereby authorize represeNatives of this county to enter ypon the above-mentioned property for inspection purposes.
i
Dake�_#W,fi(;_S9-wh"(App6c"orAQenQ: