05-2460 (ELEC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05-00002460
Property Address: 51605 EISENHOWER DR
APN: 773-134-016-4 -000000-
Application description: ELECTRICAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 400
Applicant:
T4ht 4 4 Q"
/ Architect or Engineer
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION .
I hereby affirm under penalty of perjury thatI a 'can d u der provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business a P ofe lona Code, and my License is in full force and effect.
License Class: C10 ense No.: 387369
/ Da ontractor.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State 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 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 with Section 70001 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 ($500).:
(_ I 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 I, 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.).
(_) 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 peimit is issued (Sec. 3097, Civ. C:).
Lender's Name: , l
Lender's Address: Iy
LQPERMIT
Owner:
BARBARA LEAKE
51605 EISENHOWER DRIVE
LA QUINTA, CA 92253
Contractor:
WYNDHAM ELECTRIC
44486 ACACIA DRIVE
PALM DESERT, CA 92260
(760)220-9442
Lic. No.: 387369
VOICE (760) 777-7012
. FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/20/05
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 EXEMPT Policy Number EXEMPT
'I'certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to b c m subject to the workers' compensation laws of California,
and agree that, if I s c e u ect to he workers' compensation provisions of Section
3700 of the Lab
Code, I s I f t it y with those provisions.
pplicant:
WARNING: FAILURE TO SECURE WORKERS' COM EN A I COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CI L FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). 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 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 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 application and state tnve ' mo n is c «act. I agree to comply with all
city and county ordinances and state laws'relating tc stru do and by authorize representatives
of this county to enter upon eabove-mentioned p spec o urpo
(Applicant or Agent)
Application Number . . 05-00002460
Permit . . .
ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . .
15.75
Plan Check Fee
.00
Issue Date . . . .
Valuation
0
Expiration Date
12/17/05
Qty Unit Charge
Per
Extension
BASE
FEE"
15.00
1.00 .7500
PER ELEC.DEVICE/FIXTURE
1ST 20
.75
Fee"summary. Charged
----------
Paid Credited
--------------------
Due
---------------------------
Permit Fee Total
15.75
.00 .00
15.75
Plan Check Total
.00
.00 .00
.00
Grand Total
15.75
.00 .00
15.75
LQPERAIIT
Bin #
City of La Quinta
Building sz Safety. Division
Pennit # P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and7racking Sheet
IProject Address: Owner's Name:
A. P. Number:- " Address:
.Legal,Description: City, ST, Zip:
Contractor: Telephone:
Address: T k Project Description:
City, ST,ZipeV,Jm1, /.his ( -- ,i a h1-7
Telephone:
State Lic. # : qlm
Arch., Engr., Designer:
Address: "
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Telephone # of Contact I
�r 16 I City Lic. #:
Z—O
Construction Type: Occupancy:
Project type (circle one): New. Add'n Alter Repair Demo
Sq; Fl.: #Stories: # Units:
Estimated Value of Project:
APPLICANT:
# Submittal Rtq'd Rec'd
DO NOT WRITE BELOW THIS LINE
TRACKING PERMIT VEES
Plait Sets
Plan Check submitted Item Amount
Structuril Calcs.
Reviewed, ready for corrections Plan Check Deposit
Truss'Calcs.
Called Contact Person Plan Check Balance
Title 24 Calcs: ,
Plans picked "up Construction
Flood plain -plan
Plans resubmitted )Mechanical
Grading plan
2"' Review, ready for corrections/issue Electrical
Subcontactor List '
Called Contact Person Plumbing
Grant Deed
Plans picked up S.t\l.l.
1I.O.A. Approval
Plans. resubmitted Grading
IN IIOUSE:-
Review, ready for corrcetionslissue' Developer Impact Fee
Planning Approval
Called Contac( Person AJ.P.P.
Pub. Wks. Appr
Date of permit -issue
School Fees
-
Total Permit Fees
• Y _
RE00R0INO RI:GUEV EO BY
Recording requested by e A
UNION LAND TITLE COMPANY ' t�
az v
AND e,Maw neaoeoeo 11e1L To
M.�. r Ned Zubic self
1171 Cherry Apt E
sedoreM Glendale, Ca. 91202
rr a
L J
wa Tex WAnMt*U to•
r �
Same as above '*'
Nwn +
Sans@
i"wa
L J aaos isw a roe um @sus ssoomm use
s rant a e.
FIM%ersigned grantors) declare(sk
tary transfer tax Is S
puted on full value of property conveyed, or
Q( ) computed on full value lose value of liens and encumbrancep remandU at time of sale.
( ) Unincorporated area: (X) City of
FOR A VALUAl1L8 CONSWERAIRON, trsoeipt of which b baeby'acksw+rl dSvi,
Jay Trubee and June Trubee, husband and wife
hereby GRANT(S) to '
Ned Zubeic, a married man as his sole and separate property and Jadranka
Borqudan, a single woman as joint tenants
the following described real property in the e. � k ' C� �� �`^•"��
County of Riverside , State of California:
Lots 3 and 4, in Block 115 of Santa Carmelite at vale La Quinta Unit No. 12
as per map recorded in Book pages 79-80 of taps in the office of'the
County Recorder of said Cc un y \
Dated: September 22,p_1989
STATE Or CALIFORNIA �
cou or f{Lu-0e Id -e 11S
On 0=3640ba; C11
before me, a Notary Public
RU.for u State personally appeared
611A�Q•�
'T u
(known to me) (or
proved tome on the bash of atisfsetM evide-±) to beft parson
whose name IS - subscribed to the
within ieutrument ant acknowiedpd that — -
executed the same.
WITNESS my hs .int oflic al.
i 1
NOW fhs@a a sw1wl
_ Jay T ube
TITrubee'
rr@@r@rnrnxss@.@ss
pIIOMC SIX
J NIE HARDING
� rlaNctrva CtorrE tN
Att7EtI11Dt OOteltr
lily 600011@11160 ttP 91K 1,1"1
IVM am M drAm "WW No
6
Title Order No. Escrow or Loan No,