9705-063 (ELEC)s� LICENSED CONTRACTOR DECLARATION
toI hereby affirm under penalty of perjury that I am licensed under provisions of
1 o° Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
c� w Professionals Code, and my License is in full force and effect.
O 0 Cr) ^--Licens'a # Lic. Class Exp. Date
d
CC by
Z r- Date Signature of Contractor
T O 1
OWNER -BUILDER DECLARATION
�\I� reby affirm under penalty of perjury that I am exempt from the Contractor's
~ d 'L(icense Law for the following reason:
Z_ ) I, as owner of the property, or my employees with wages as theirsole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
cr) () I am exempt under Section B&P.C. for this reason
LO
N Date Signature of Owner
ON
Q WORKER'S COMPENSATION DECLARATION
2 Z I. hereby affirm under penalty of perjury one of the following declarations:
p () 1 have and will maintain a certificate of consent to self -insure for workers'
K W Y= compensation, as provided for by Section 3700 of the Labor Code, for the
D � Q performance of the work for which this permit is issued.
Q .CJ ( ) I have and will maintain workers' compensation insurance, as required by
U
Section 3700 of the Labor Code, for the performance of the work for which this
L.M Z permit is issued. My workers' compensation insurance carrier & policy no. are:
Cartier Policy No.
C)
J�(Tih$1
ls-section need not be completed if the permit valuation is for 00.00 or less).
!O l 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 become subject to the
workers' compensation laws of California, and agree that if I should become
3 subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
Date: Applicant '
b Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the'Director of Building and Safety
for a permit subject to the conditions. and restrictions set forth on his
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 applicaton agrees to,-& shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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 that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon.
the above-mentioned property fo inspection purposes.
Signatu a (Owner/Ageni ' "' """` Date�-
BUILDINGPERMIT PERMIT" CONTROL#
97 0.5-06 5114
TRACT
DATE 5112M7 VALUATION S.5110,00
i,Q� LOT
JOB SITE
ADDRESS 553-61 1lt.l� `Jltil>Fl�%� .7'r�t
APN
OWNER
CONTRACTOR / DESIGNER / ENGINEER
LOUIS DEIMARLTR40
OWNER BUILDER
LIV i' UINTAr CA 92253
USE OF PERMIT
cit>uttre esEen:l suai•ic;a .
&STIMS1113) CONT Of, WINSTRUCTION
500.01.1
.�D�,i�i1�t�'a ��i`+,���.►ti��!S��"aft'
i�sf,Es�"t'�r�°�11.. Ft�ls lG1Kt3t)il-�#ZtkE2c)tt �, g3:i.a?�
>,
t
,r
A
stfs-rt:xrim. r'ow-r1`IZF.tr;'3"1t1w AND E tAW CHECK
$13.50
't(YYA:#.t)()C NOW
RECEIPT
DATEBY
DATE FINALED
INSPECTOR
y INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING` APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wail Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final .
POOLS
- SPAS
BLOCKWALL APPROVALS
Steel.
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
v
COMMENTS:
�v
.1A 1-1114P7..
Final
Utility Notice (Gas) .
'ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring'
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
6
CITY Qu'
BUILDING & SAFETY
ET > "- It;Atom,.
coNDMONALLY
ACCEPTED FORZONSTRUCMD��.q
SUBjECT ,,
INSTW'nON AS PF
I
r
Residence at 53612 Eisenhower r
Louis DeMartino: (
ELECTRICAL PANEL
200 Amp 10 120/240 with 200 amp. Main
CIRCUIT
I.D.
BREAKER
A WATTAGE
B WATTAGE
1.
BATHROOM G.F.I.
20 IP.
1500
2.
BEDROOM RECEPTACLES
20 IP.
1500
3.
LIVING ROOM RECEPTACLES
20 IP.
1500
4.
DINING ROOM RECEPTACLES
20 IP.
1500
5. & 6
HOT WATER HEATER
30 213.
3000
3000
7. & 8.
3 T. AIR CONDITIONING
40 2P.
3000
3000
9.
GUEST ROOM
20 IP.
1500
10.
GUEST ROOM
20 IP.
1500
11. & 12.
WALL HEATER
20 2P.
2000
2000
13.
EXTERIOR LIGHTS
1000
14. & 15
AIR HANDLER
20 2P
1200
1200
16. & 17
STOVE/OVEN
502P
5000
5000
18.
GARBAGE DISPOSAL
20 1 P
700
19.
UTILITY OUTLET
20 1 P
1500
20.
UTILITY OUTLET
20 1 P
1500
21.
EXHAUST FAN
20 1 P
500
22.
LIGHTING
1 P
1000
23.
UTILITY
1 P
1000
TOTAL WATTAGE
22,400
22,200
CONNECTED LOAD = 44,600 WATTS C 240 v. = 185.83 amps