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13-0098 (ELEC)P.O. BOX 1504 r 787495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number:13=0000009.83 Property Address: 44355 VIA CORONADO APN: 6'04-211-015-36 -23971 - Application description: ELECTRICAL I. Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 200 Applicant: Architect or Engineer: s 14� BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: JOEY ARSANTO 44355 VIA CORONADO LA QUINTA,CA 92253 (760)619-7611 Contractor:. JMK ELECTRIC 44451 CAMBRIDGE AVE BERMUDA DUNES, CA 9 (760)218-1172 Lic. No.: 962833 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777=7153 Date:' 2/19/13 D), Lmi ��U- 0 . p 0 4 i� 2013 CITY OF IA Q ' RNAUINTA NCE - DEPT---------------------------------- ' r LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION • I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: - Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. - _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: C10 License No.: 962833 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is r _ r issued. 3 -:Y-/3 ' r• -Date: Contractor. _ 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 • OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the - Carrier EXEMPT Policy Number EXEMPT - _ following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, 1 shall not employ any construct, alter, improve demolish, or repair any structure, prior to its issuance, also requires the applicant for the - person in any manner so as to become subject to the workers' compensation laws of California,. permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State . and agree that, if I should become subject to the workers' compensation provisions of Section • License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I If ith comply with those provisions. _ 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).: Date: 7.Applicant:- - (_) 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 WARNING: FAILURE TO SECUR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL - Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND • and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN - • improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. • . 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.). - APPLICANT ACKNOWLEDGEMENT - - - (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the , .. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. -,- property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed , 1 . Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, .. (_ ) I am exempt under Sec. _ , BAP.C. for this reason - 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 t_he work being ' - - - - - performed under or following issuance of this permit. _ • Date: - Owner: 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 CONSTRUCTION LENDING AGENCY - - - permit to cancellation. - - • I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the - I certify that I have read this application and state that the above information is correct. I -agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). ` _ city and county ordinances and state laws relating to•building construction, and hereby authorize representatives , . - - of this county toenterupon the above-mentioned property for. i p as. - Lender's Name: _ • 3�y�3 .. - . • Date: Signature (Applicant or Agent): - Lender's Address: LQPERMIT - Application .Number . . . . 13-00.000098 Permit ELEC-MISCELLANEOUS Additional desc . Permit Fee 15.75 Plan Check Fee 3.94 Issue Date . . . . Valuation 0 Expiration Date 8/18/13 Qty Unit Charge Per Extension BASE FEE •15.00 1.00 .7500 PER ELEC DEVLCE/FIXTURE 1ST 20 .75 ----- Special Notes ' and Comments BRING BBQ UP TO CODE REMOVE GAS LINE AND SINK CODE CASE 10-4453.ADD 12 ELECTRCAL OUTLETS APPROVED PER AJ. 2010 CODES. ------------------_----------------- Other Fees .. . . . . .. . BLDG STDS ADMIN ASB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 15.75 .00 .00 15.75 Plan Check Total 3.94 .00 .00 3.94. Other•Fee Total 1.00. .00 _ .00 1.00 Grand Total 20.69 .00 ,.00 20.69 Bin. r# City 0(La Quints -Btdidhtg a Safety Div& w Perink # P.O. Box 1504, *78-495 Gane Tampico 4.Quinta, CA 92255 • (760) 777-7012 Building Permit •Application -and Tracking Sheet Pro;ectAddress �y3 65- r �^//.. I.0 Ownees Namc:. �Il.� Ae � j j.- A P. Number Address: L1.3 t� 5 C r Legal Description: Gy City, ST, Zip: ZQ 00)' i 4Gt_ 4a- Contractor 6 Contractor. I� �� C. Telephone: % — — Address: 1 is (� ' i - (1 {� , Project Description: f P City, ST, Zip: Telephone:i %� to Plitn F� State Lia fi : � lO�. City Lic. �: �j t �/ e •C>tiY../ � Arch., Bag, Designer. Address: rJA City, ST. Zip: Telesphoae: Construdion Type:. Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Coma Person: el 4" Sq. nes Telephone # of Contact Person:%2. Value of Project , APPUCAhtT: DO NO BELOW THIS LINE N Submittal Req'd Reed , - T�C� P rr FE Plan Sett Plan Geek submitted ` Amon' t* Structural Cases.i Reviewed, ready for corrections Plan Cbeck Deposit. Truss Cala. i . Called Contact Person Plan Geek Balance Tide 24 Calces. Plans picked up Construction Flood plain plau Plant resubmitted. . Mecharilw Grading plan Z'! Review, ready for correcdoWmue Electrical Subeostector List Called Contact Person Plumbing Grant Deed Plans picked up SALL H.O.A. Approval Plans resubmitted Grading IN HOUSE-, ''' Review; ready for correcdons/issuc Devdoper Impact Fee Planning Approval Called Contsct Person Pub. Wks. Appr ' Date of permit issue Sebool Fees Total Permit Fees a �I (FGA G�FU G FLZ - Lqj �l 42ZA-+� .Job Y OF LA S/ t-rgy "NIS t RUCT N ZADAT �U/ sI 7� � BY ',�