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08-1613 (ELEC)Ste. .....m. • i�� P.O. BOX 1504 4 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT _Application Number: 08-00001613 1 Owner: Property Address: 80841 VISTA LAZO WORDEN RESIDENCE APN: 762-250-013- - - 80-841 VISTA LAZO Application description: ELECTRICAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1000 Applicant: Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION - I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division.3 of the Business and Professionals Code, and my License is in full force and effect. License Class: Cr5b3 License No.: 878400 Dater -ok 3-7. Contractor: �r - /_�•.p ,� 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 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 applicantfor apermit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_ ) 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 _ 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.). 1 1 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 permit is issued (Sec. 3097, Civ. C.). - Lender's Name: Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 9/23/08 Contractor: SKEEN POOL/SPA WATERFEATURE, PO BOX 11349 PALM DESERT, CA 92255 (760)766-5554 /\ Lic. No. 878400 V f ----------------------------------------------- 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 become subject to the workers' compensation laws of California; " and agree that, if I shout become subject to the workers' compensation provisions of Section 3700 of the Labor Cod (shall hw'th comply with those provisions. Date.9—a3' Applicant:. WARNING: FAILURE TO SECURE W ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL 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 tieing 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 buildin const tion, and hereby authorize representatives of this county to enter upon the above-mentioned property f insp ion rposes. Date: Signature (Applicant or Agent Application Number . . 08-00001613 -, Permit ELEC-MISCELLANEOUS " Additional desc . Permit Fee 16.50 Plan Check Fee 4.13 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/22/09 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 7500 PER ELEC DEVICE/FIXTURE 1ST 20 ---------------------------------------------------------------------------- 1.50 ` Permit . . . PLUMBING Additional desc ...- Permit Fee 21.00 Plan Check Fee _ 5.25 Issue Date . . . . Valuation .". . . 0 Expiration Date 3/22/09. Qty Unit Charge Per "Extension ` BASE FEE 1.5.00 • �° 1:00 6.'0000 EA PLB FIXTURE 6..00 , Special Notes and Comments BBQ, GAS/ELECTRICAL CONDUIT, WATER SUPPLY -DRAIN FOR FUTURE BBQ. COURTESY BLOCK WALL (ORCO) 18" X 20' L.•F. Fee summary Charged Paid Credited -- - Due. ' -- - - - - - - - - - - - - - --- _-- - - - ------ - - -------- - - - - - Permit Fee Total 37.50 .00. .00 ----------, 37.50 Plan Check Total 9.38 .00 .00. 9.38 , Grand Total 46.88 .00 . 00 46.88 - • a LQPERMIT - r. lit l fPi ; i u _< \J . . . . . . . . . .... , x I -W S l fPi \J . . . . . . . . . .... , x -W S �T 1 t ' ' 0 E_ to 6 g Li \ T !�K: is I� 1 .Z 45 g 1 j \r-4' Ajr ow .12 -.. -�,. .. � ... .: - ""mom �. F _ F�--� t`= �.. .,•� .<.., 4� ::�',�' � .cam s --.! �- 2`�.��4, __..�,.,�'A Bin # City of La Quinta Building u Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Perini Project Address:' _ _ ®(� t Owner's Name: A. P. Number: Address: Legal Description:-- City, ST, Zip: Contractor: — S k-ec," � �51-)A Telephone: Project Description: _ Address: 4 113 5 J I):!-- City, ST, Zip: . QJIW-O C.4 + Telephone:' %- ' J--L:PPLV State Lie. # Lion City Lic. �1 6 Arch., Eng., Designer: Address: ry City, ST, Zip:0110 Telephone:Construction State Lic. #: AM, Name of Contact Person: AMES S ��,�� Type: --' Occupancy: Project We (circle one): New Add'n Alta Repair Demo Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: — 7 -SSS Estimated -Value of Project �� APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd -: Rec'd TRACEINIG _ PERbIrr FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Persons Plan Greek Balance Energy Calcs. Plans picked up' Conshnetion Flood plain plan Plans resubmitted Mechanical Gradingplan' 2q° Review, ready forcorrections/issne Electrical . subcontactor.List Called Contact Person Plumbing . Grant Deed Plans picked up S.1►LL H.O.A. Approval: Plans resubmitted Grading IN HOUSE:- ''' Review, ready for correetionshssue Developer Impart Fee Planning Approval Called Contact Person A,I_P.P. Pub. Wks. Appr -Date of permit issue School Fees Total Permit Fees