07-1445 (ELEC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
07-00001445
Property Address:
80204 VIA TESORO
APN:
772-250-018-10 -31349
Application description:
ELECTRICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
1500
Applicant: Architect or Engineer:
Vtlolbv
------------------
LICENSED CONTRACTOIa S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under prolrisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Businend Professionals Code, nd my License is in full force and effect.
ss
License Class: B Lic nse 777699
Date&.2 Contractor:
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 ISec. 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 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 permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_ 1 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.).
(_) 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.).
1 _ I I am exempt under Sec. , BAP.C. for this reason
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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:
LQPERMIT
Owner:
TOLL CA V
14350 N 87TH ST #310
SCOTTSDALE, AZ 85260
(480)951-0782
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/15/07
Contractor: KITy
TOLL BROS, INC.
14350 NORTH 87TH ST,SCOTTSDALE, AZ 85260 2001
(760)674-9699
Lic. No.: 777699QUINTA
WORKER'S COMPENSATION DECLARATION
1 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 ZURICH AMERICAN Policy Number WC387821301
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 become subject to the workers' compensation laws of California,
and agree that, if 1 should become subject to the w rkers' compensation provisions of Section
3700 of the Labor Code, I hall forthwith c mply ith those provisions.
Datq&y� Applicant: ��—
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 1OVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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 that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building c nstruction, and hereby horize representatives
of this county to enter upon the above-mentioned property for spection purpo
Dat AL2.. Tgnature lApplicant or Agent):
Application Number . . . . . 07-00001445
Permit . . .
ELEC-MISCELLANEOUS
Additional desc .
Permit Fee
33.50
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
11/11/07
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 18.5000
EA ELEC
SVC <=600V/<=200A
18.50
Fee summary Charged
----------
----------
Paid Credited
----------
Due
-----------------
Permit Fee Total
33.50
.00
----------
.00
33.50
Plan Check Total
.00
.00
.00
.00
Grand.Total
33.50
.00
.00
33.50
LQPERMIT
Bin #
City of La Quinta '
Building ix Safety Division
Permit ,
(
P.O. Box 1504, 78.495 Calle Tampico
_ qq1 La Quints, CA 92253. (760) 777-7012
/
Building Permit Application and Tracking Sheet
Project Address: eo _ q
•
et.V GJ � Owner's Name:
A. P. Number. 7 Z
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r) (g -r; J-117 Address:
O T1� �V
f< 7
Legal Description:
City, ST, Zip:
Contractor:
V �L Telephone: gC),
Address: jq 3
97 3 Project Description: %ivt--• n
City, ST, Zip:
c.rcLt�,(�
S be,2 �.
Telephone: 4f
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Tcriuc.#:
State Lie. # : (�
Arch., Engr., Designer:
c % u,
Address:
�D y /� (o 4 -'es.
cc^ e> r o 7-199
City, ST, Zip:
So - 6 6S' -
Telephone:
ot "ti
State Lic. #:
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Project type (circle one): ew Add'n Alter Repair Demo
Name of ContactPerson•
re S Sq. Ft.: # Stories:
# Units:
Telephone # of Contact Person: 760-2'7 -,g 7 Estimated Value of Project: 3
APPUCANT: DO NOT WRITE BELOW THIS UNE 24COS
# Submittal
Req'd Reed TRAC[QNG
Plan Sets
PERNM FEES
Plan Check submitted Item Amount
Stractaral Cale.
Reviewed, ready for corrections Plan Check Deposit
Truss Cale.
Called Contact Person
Energy Cale.
Plan Check Balance
Pians Picked up
Flood plain plan
Coastrrctiod
Plans resubmitted
Grading, plan2
Mechanical
4 Review, ready for correctiouslissue
SubconTactor List
Electrical
Called Contact Person
Grant Deed
Plumbing
Plans picked up
H.O.A. Approval
S.M.I.
Plans resubmitted
IN HOUSE:-
Grading
'a Review, ready for. correctioustissae Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
AXP.P.
Date of permit issue
School Fees
Total PermitFees