06-1865 (ELEC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application. Number:
06-00001865
Property Address:
49251 EISENHOWER DR
APN:
658-170.-005- -
Application description:
ELECTRICAL
Property Zoning:
TOURIST COMMERCIAL •
Application valuation:
2000
Ta�v 4 4 Qum&
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with
Section 7000)of Division.3 of the Business and Professionals Code, and my License is in -full force and effect.
UceenseClasjs: C10 -D28 (! LicemNo.: 418433
/uatev
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that 1 am exempt from the Contractor'sState License Law for the
following reason (Sec. 7031.5,.Business and Professions Code: Any city or county that requires a permit to
construct, alter,,improve, demolish; or repaiFany,structure, prior to its issuance, also requiresthe 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 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.parmit subjects the applicantto a civil penalty of not more than five hundred dollars (9500)•:
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 License1aw does nob 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 contractors4o construct the.pro)eet (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 contractors) licensed
pursuant to the Contractors' State License Law.).
( ) I am exempt under Sec. , B.&P.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: Wl
LQPERMIT
Owner:
LANDAQ INC
C/O LEGAL DEPARTMENT
56,140 PGA BL
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/09/06
Contractor: / �1
LA SALLE ELECTRIC INC.,.A .^
P.O. BOX 2859
CATHEDRAL CIT`r, CA 92235 �Nf i 206
(760)328-1.088 LI
Lic. No.: 418433
ct�G Oce+� J__t
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,insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance:carrier and policy number are:
Carrier STATE FUND Policy Number 15766712005
_ I -certify that, inuthe performance of the :work for which this -permit is issued, I shall not employ'any
person in any manner so asto.become subject to the workers' compensation laws of California;
and agree that, if 1 should become subject to the workers' compensation provisions of Section
3700 of the Labor Code; I shall forthwith ply with those provisions..
� �3, 0
pplicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE E IS UNLAWFUL, AND SHALL
SUBJECT AN -EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (81,00,000). IN ADDITION TO THE COST OF'COMPENSATION,.DAMAGES AS PROVIDED 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 restrictionSaut 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 Quints, 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 awa result,of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have+read this: applicationandstate -that the above information is correct. I agreeto comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
Of this county tp enter upo the above-mentioned pr(o'�P�vrt r mope con poses..
Y �V ignature (Applicant or Agent):y�+` .
Application Number . . . . . 06-00001865
Permit ELEC-MISCELLANEOUS
Additional desc . .
Permit Fee . . . 3.3.50
Plan Check Fee
.00
Issue. Date . . .
Valuation
0
Expiration Date . . 11/05/06
Qty Unit Charge Per
Extension
BASE
FEE
15.0.0
1.00 18.5000 EA ELEC
SVC <=600V/<=200A
18.50
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Special Notes and Comments
Spe
-----------------------------
200 AMP METER PEDESTAL FOR LIGHTING AND
IRRIGATION
Fee summary Charged
Paid Credited
Due
------------------ ---------- ---------
Permit Fee Total 3.3.50
---------- ----------
.00 .00
3.3.50
Plan Check Total .00
.00 .00
.00
Grand Total 33.50
.00 .00
33.50
LQPERMPP