04-3687 (ELEC)P.O. BOX 1504U %y<� 0 4 2004
78-495 CALLS A PILO
LA QUINTA, C �LIFOAAT, #C92������y��
BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760).777-7011
SPECTION REQUESTS (760) 777-7153
Application Number . . . . 04-00003687 Date 4/26/04
Property Address . . 05185T�VIA_SQRRENTO
APN: 772-250-999-198 -30357 -
Application description ELECTRICAL
Property Zoning LOW DENSITY RESIDENTIAL
..Application valuation. 500
Owner Contractor
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TOLL CA V TOLL BROS, INC.
C/O KEVIN D DUERMIT 73121 FRED WARING DRIVE, #100
8.901 E MOUNTAIN VIEW 2.00 PALM.DESERT CA 92260
SCOTTSDALE AZ 85258
WCC: ROGAL & HAMILTO
WC:. WA264DO0472301 09/01/04
CSLB: 777699'. 04/30/06
CCC: B
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Permit ELEC-MISCELLANEOUS
Additional desc
Permit Fee 33.50 Plan Check Fee .00
Issue Date Valuation 0
Expiration Date 10/26/04.
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00' 18.5000 EA ELEC SVC <=600V/<=200A 18.50
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Special Notes and Comments
100 AMP IRRIGATION PEDESTAL LOCATED IN.
COMMON AREA SOUTH OF LOT 70 ON VIA
SORRENTO (WELL SITE)..
.Fee summary, Charged.
Permit Fee Total 33.50
Plan Check Total .00
Grand Total 33.50
'Paid Credited Due
.00 00 33.50
.00 .00 .00
.00 .00 33.50
P.O. BOX 1504 ��
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 44a
INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: Q�-%�7 Date:
Applicant:
Applicant's Mailing
Architect or Engineer.
Architect or Eng'ineer's Address:
Lic. No.
BUILDING PERMIT DECLARATIONS
I�-
LICENSED CONTRACTOR'S DECLARATION
1 odeby alfrm under Jp In A of tome a that 1 am Wonsed under Provisions of Ctapbr 9 (OOmmerhMV with Sidon 7000) of Division 3 of to Business and Piolesswaft
Code. and my licenses in luta brei and etfexx
l c 0 �Licerse No.—Z 776 9 9
rosea o � T c�,aacb►1�%'-� G�-�-- .
1 hereby alum under OWNER$UILDER DECLARATION
pe�Y of ply tmi I am a mho tom the Conhackn, stale License Law for the following reason (Sec. 703,.6. Business and Piolessions Code: Any
cky or county eat mquwu a Pw"* b +ct. stW. ioprore, demolish, or repea any st uMm priorlo is ksewncx, also requires to applicant br to phnmitb the &.-,g A
stMernw
tat he or she k licensed punRm t to the provisions of to Controcbrs' State License law (Chopbr 9 (consrencing with section 7000) of Division 3 of to Business
and Professions Code) or tat he or she k exempt rimwahon and the basis for ria alleged exemption. Any viclabon of section 7031.5 by any applicant bra permit subjects
the applicant too civil patty of not mare tan the hundred dollars
U 1. as owner of the property. ar my WrIP10 es with wages as their sob oomhpensatioh will do the work and the structure is nol intended or oeered for sale (Sec. 7044.
Business and Professions Code. The Cortracbrs' stab License Low does not appy to an owns of property who builds or improves thereon, and who does the work
hirnself or
A or trough his or her own empbyees, provided that the i npro ernenls aro not inlended or offered for sale. If. however. to building or improvement is
am One ) of °D^pletion• t1e owner -builder wnf have to burden of paving tat he or she did not build or improve for to purpose of sale.).
U L es Owner of to property. sm exdusively contracting with ioensed contractors to construct to project (See. 7044, Business and Professions Code: The Contraclors'
Stab License Law does not appy ban owner of properly who builds or improves toieoo, and who contracts for the projects with a cw*acbr(s) ioensed prnwant b
the Contractors• Stab License Law.).
U I am exempt under Sec . BA P.C. for this reason
Dale Owner
1 hereby affirm under WORKERS' COMPENSATION DECLARATION
DAY of ply one of the following declarations:
_ I have and win maintain a Certificate of consent b se114nsune for workers' oampensation, as provided for by Section 3700 of the Labor Code, for the peAorrranoe
of the work for which Itis p n, k issued
1 hImmelave and will maintain workers' Compensation insurance. Section r�egyuired by Section 3700 of the Labor Code. for the performance of the work for wrffhicth Itis permit is
f , Tr,, 7 Ni.ih mr W d[� a Y7d3o/
_ I city tat, in the performance of to work for which this pe... 4 is, not employ any person in any simmer so as to become subject b the workers'
laws of C800mla. and agree that, t I d%PA become subject b to wakens' Compensation Provisions of section 3700 of the labor Code. l Compforthwith ly with with erose provisions.
WARNING FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE FIINMED THOUSAND DOLLARS (i1>ID.000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE• INIVIEST. AND ATTORNEYS FEES.
1 hereby affirm under CONSTRUCTION LENDING AGENCY
Ply d pe+ju!y that there k a COnSbuciim landing agency for the performance of the work for which itis pet.. k issued (Sec. 3097. Civ. C.).
Lenders Name
Lenders Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application Is hereby made b the Director of
Building and safety for a permit subject to the conditions and restrictions set forth on this appicstim
1. Each person upon whose behalf this application is made, each at wtxm
PP�tiom the Owner. and the applicant, each green nNcan and dor end. i benefitnit work k hold
harmless
cinder a any permlp
Issued as s neserel of this s sprees b. and sfhael, defesnd, indemnify and (hold larmmtiess tie City of�La�tGuihh. its
officers, agents and emPlOyees for any ail or omission related to the work being Performed under or following issuance Of Otis permit.
2. MY permit Issued as are" of this application becomes rw4 and void t work is not commenced within 150 d4ys from date of issuance of such penmhil or
Cessation of work for 160 days well subject permit to cormliation.
L certify that I have hereby �authorize P �ate a an above information is Cored 1 agree b Comply with eel city and county ordinances and state laws relating b building
county to enter upon the above-mentioned property for inspection purposes.
/� a �(AW�cw or Agent ,