12-0171 (ELEC)P.O. BOX 1504 �^� VOICE 760 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253•. BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 2/27/12
Application Number: 1512-0 0 00 0171`,, Owner:
Property Address: 78555 VILLETA DR MICHELLE WININGER-
APN: 604-144-013-228 -23269 - 78555 VILLETA DR.
Application descri tion: ELECTRICAL _. LA92253,- - - -- - • _
_ pP P � _ � � QUINTA, CA
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 2500
Contractor:
Applicant: Architect or Engineer: JP ELECTRICAL POWER & CONTROLS
4634 VIA LA QUINTA2.1
q
YORBA LINDA, CA 92886 icy®,C if
(714)695-9119 Or.
,r) Lic. Noo..:: 6 633319 � QF'A
LICENSED CONTRACTOR'S DECLARATION . r WORKER'S COMPENSATION DECLARATION
-'1 hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with. I hereby affirm under penalty of perjury one of the following declarations:
Sectio 000) 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
Lic se Class: C10 License No.: 633319 for by Section 3700 of .the Labor Code, for the performance of the work for* which this permit is
issued.
Date:, I�ctor. - - _X, I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for whichthispermit 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 MARKEL INS Policy Number MWC00311801
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, I 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 a subject to 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 Co , I shall r ' hcomply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by i'� -
r .any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: e/ 2 � pplicant:
(_) 1, 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 ISec. 7044, Business and Professions Code: The WARNING: FAIL RE TO SE E 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' -
(_ I 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 onthis application.
r 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. , B.&P.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 the 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. - - -
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of th''d 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 con and h by authorize representatives
Of t is unty to enter upo the above-mentioned property fo pection ses.
Lender's Name:
- r ate: nature (Applicant or Agent):
. Lender's Address: - -
. LQPERMIT -: ..
Application Number- 12-00000171,
Permit ... . . . . ELEC-SERVICE
CHANGE
Additional desc
Permit Fee 33.50
Plan Check
Fee
00
Issue Date . . . .
Valuation'*'.
0
Expiration Date 8/25/12
Qty Unit ,Charge Per
Extension
BASE
FEE -- --- -
15.00
1:00 18.5000 EA ELEC
SVC <=600V/<=200A
18.'50
-----------------------------------------------------
Special Notes and Comments
UPGRADE SERVICE TO 200 AMPS. 2010.CODES.
Other Fees . . . BLDG STDS,ADMIN'(SB1473)
1.00
Fee summary Charged
Paid. Credited
Due
Permit .Fee Total 33.50
.00
00
33.50
Plan Check Total .00
.00
.00
.00
Other Fee Total 1.00
.00
.00.
1.00
Grand Total 34.50-
.00
.00
34.50`
LQPERMIT
Bin #
o
. Bulldliag a Safety.Dlvtslon,, +:
Box! 1504,:7&4.95 Calle. Tampico
4.Quinfa, CA 92253::(760).777-7012 z�
Building Permit Application and Tracking Sheet
Perinit #P.O.
1:'�-
Project Address:.
SS -S
i l
'
Owner's Name:..Rr•
A P. Number
Address: 95
Legal Description:
Contractor. J
{�
19 lr
City, ST,Zip.I
61-<& 7
Telephone:
Address: (�
i C,
Project Description:
City, ST, Zip: U.
Telephone:
State Lie. # :
:
City Lic. #,
Arch, Engr., Designer:
..
Address:
City, ST, zip: .
Telephone:
State Lic. #:
Construction Type: _ Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
ll
Sq, Ft.:
# Stories:
# unit;:'
Telephone # of Contact Person:
Estimated value of Project:
APPLICANT: DO NOT WRITE BELOW THIS. UNE
#
Submittal
Req'd
Reed
TRACICYIQG PERMIT FEES
Pian Sets
Pian Cheek submitted Item Amount
Strgctuial Calm
Reviewed, ready for corrections Plan Check Deposit. .
Truss Cal cs•
Called Contact Person Plan Check Balance
Title 2d Calcs.
Plans picked up Construction
Flood plain plan
Pians resubmltted.. Mecharilcal
Grading plan
2id Review, ready for corrections/issue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up t SALL
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
1i° Review; ready for correctlons/issue Developer Impact Fee
Planning Approval.
Called Contact Person AXP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees