06-2283 (ELEC)4 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
w Date: 6/06/06
Application Number: 06-00002283 Owner:
Property Address: t 46858 LA QUINTA CENTER DR WASHINGTON 111 LTD
APN: 643-020-999-1 -30903 - C/O JACK TARR
Application description: ELECTRICAL
Application valuation: 1500
Contractor: f r
Applicant: Architect or Engineer: BRAY CORP, SR DBA POWER P '�
1005 N. EDWARD CT)�
ANAHEIM, CA 92806
(714) 764-0020 IDI7yp
Lic. No.: 523596 FINANCE EU Tq
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I an, 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: C61 C10 D3 License No.: 523596
Date: 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 (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 applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
1 _ 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.).
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 contractorls) licensed
pursuant to the Contractors' State License Law.).
(_ 1 1 am exempt under Sec. , B.&P.C. for this reason
Date:'LI d Owner: bfliC�_�ca��-
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
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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 AMER HOME Policy Number WC717-16-34 (CA)
I c=at, 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 should become subject to the workers' compensation provisions of Section
3700 of the La or Codes, I Spall forthw' comply with those provisions.
irate: �"V plicant:
WARNING: FAILURE TO SECURE WORKERS' 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 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 construction, and hereby authorize representatives
of this c unty to enter upon t> above-mentioned property for inspection purposes.
atO e: 641gg gnature (Applicant or Agent):
Application Number .
. . . . 06-00002283
Permit . .
ELEC-TEMPORARY POWER
Additional desc .
Permit Fee . . . .
37.50
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
12/03/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 15.0000
EA ELEC
TEMPORARY POWER POLE
15.00
1.00. 7.5000
EA ELEC
TEMP SUB POLE
7.50
---------7----------------------7-------------------------------------------
Special Notes and Comments
1 TEMP'POWER POLE & 1
SUB POLE TO
PROVIDE POWER FOR LA
QUINTA CENTER
DRIVE
Fee summary Charged
---------------------------
----------
Paid Credited
--------------------
Due
Permit Fee Total
37.50
.00 .00
37.50
Plan Check Total
.00
.00 .00
.00
Grand Total
37.50
.00 .00
37.50
LQPERMIT
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Site Plan -Revised -
Rola misjl DaNote. A D&eloprttatt By.
am o2ioeioe TKID inlormolan It conceptual in nature and is
mt evbjec t to odfvetmente pending further Washin ton 111 Ltd.vanftcatlon and Client. Tenont and 6overnmentol KKE Architects, Inc.MTO
Agency approvole. No Ia Pllod I t Arantac, JACK Washington Park KK
o! dny kind are given or Impllad bj the Architect. 90827 ew bbeh street, O 201
Na Date Rev6ltn Dewbtlan B4Q/ �amnA as Y2BE0
30240 Rancho Viejo Road, Suite B La Quinta, CA 94en80.39ti ra
loo' ol so' loo' 200. San Juan Capistrano, CA 92675 �
(949) 443.1234 architects
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-HEAVY AG PAVING
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-GONGRETE
-SPECIFIC PLAN
BOUNDARY
VISIONAIRE AMERICAN
AME -2 T5 -250-D.?
BACK -TO BACK-VLF6
MOUNTING FIEI6HT 20'
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VISIONAIRE AMERICAN
AME -2 1B-250-51
SINGLE -VLF& MOUNTING
HEIGHT 20'
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VISIONAIRE AMERICAN
AME -2 TB -250-51
51N&LE-VLF6'MOUNTING
HEIGHT 25'
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VISIONAIRE AMERICAN
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AME -2 T5-250-02
BACK -TO BACK -VLF&
MOUNTING HEIGHT 25'
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STOP SIGN I
' t PARKING LOT STOP 916N
Site Plan -Revised -
Rola misjl DaNote. A D&eloprttatt By.
am o2ioeioe TKID inlormolan It conceptual in nature and is
mt evbjec t to odfvetmente pending further Washin ton 111 Ltd.vanftcatlon and Client. Tenont and 6overnmentol KKE Architects, Inc.MTO
Agency approvole. No Ia Pllod I t Arantac, JACK Washington Park KK
o! dny kind are given or Impllad bj the Architect. 90827 ew bbeh street, O 201
Na Date Rev6ltn Dewbtlan B4Q/ �amnA as Y2BE0
30240 Rancho Viejo Road, Suite B La Quinta, CA 94en80.39ti ra
loo' ol so' loo' 200. San Juan Capistrano, CA 92675 �
(949) 443.1234 architects
�.
Ke Plan
Lr eC" kola
Y minneepolle newporl beach paee0ene
Bin #
City of La Quinta
Building 81 Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #3
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Project Address:' 7 _
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Owner's Name: �/ 4 TV
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:
Telephone:
Address:
Project Description:
City, ST, Zip:
Q .7
Telephone:
_
State Lic. # :
Arch., Engr., Designer:
City Lic. #:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
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Construction Type: Occupancy:
j type one): Pro a New Add'n Alter Repair Demo
Sq. Ft.: A/14
# Stories: y/
# Units: y
Telephone # of Contact Person: 3 2 -2,67 Y
Estimated Value of Project: /Sdv
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
/
( LO
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading,plan*
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
7n° Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees