13-1127 (ELEC)78010 Main St
13-1127
0402-328
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
ceity , 44 "
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
13-00001127
Property Address:
78010 MAIN ST
APN:
- - - -
Application description:
ELECTRICAL
Property Zoning:
COMMUNITY COMMERCIAL
Application valuation:
260
Applicant: Architect or Engineer:
n , . - A) 110
------------------
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 CI s: C10 License No.: 786678
Date: Contractor:
G
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, 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.).
I—) 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
Owner:
OLD TOWN LLC
78010 MAIN ST. STE 108
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/09/13
Contractor: D
WEST BOUND ELEC CONTR & SVCS 1
74170 HIGHWAY 111 STE 3
PALM DESERT, CA 92260 OZ ® 9 zo
(760)776-8314
Lic. No.: 786678 CITYOF I
FINAfV ' QUINTA.
CF WEPT
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I ave 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 HARTFORD UNDER Policy Number 57WECES1661
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 should becomesubject to the morkers' compensation provisions of Section
3700 off the Labor Code, I shall fort ith comply with those provisions.
bate PPllcant:
WARNING: FAILURE TO SECURE WORKERS' COMPE N 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. 1 agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this cou t enter u n the above-mentioned property for inspecti rposes.
/te: gnature (Applicant or Agent l:
Application Number 13-00001127
Permit . . . ELECTRICAL 2013
Additional desc . .
Permit Fee . . . . 23.83
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 3/08/14
Qty Unit Charge Per
Extension
1.00 23.8300 LS ELEC DEVICES,
FIRST 20
23.83
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Special Notes and Comments
---------------------------------
ELECTRICAL - CONVERT (1)* 220V CIRCUIT
INTO (2) 120V CIRCUITS FOR KITCHEN
EQUIPMENT. 2010 CALIFORNIA BUILDING
CODES.
----------------------------------------------------------------------------
Other Fees . ... . . . . . . BLDG STDS ADMIN- (SB1473)
1.00
PERMIT
ISSUANCE M/P/E
90.57
Fee summary Charged Paid
Credited
Due
----------------- ----
Permit Fee Total 23.83
.00 .00
23.83
Plan Check Total .00
.00 .00
.00
Other Fee Total 91.57
.00. .00
91.57
Grand Total 115.40
.00 .00
115.40
LQPERMIT
Bin #
City Of ,a Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012 `
Building PP Permit Application and Tracking Sheet
Permit #
` I v
Project Address: O\
Owner's Name: 5 r i
A. P. Number: 1 D
Address: -71- Dl a M -Ay\
Legal Description:
City, ST, Zip: L,,o OVs,-
Contractor: Wes&Telephone:
'7I00- (pk(, I 15'(Q
Address: 1q- k-70 (l 3
Project Description:
City, ST, Zip:
Telephone: % •
State Lic. # :
City Lie. #.:
Qbkk^ «
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
P
tructi n T e: O ccu ane
Cons o YP T. P Y
Lie. #:
...
Add'n Alter Repair DemoState
Project tYPa circle one): Newi
Name of Contact Person:. SAC -c- &W V-v%0lM
Sq. Ft.:
# Stories: i
# Units:
Telephone # of Contact Person: --%(o0 '30 g' 141 7,3
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2' Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
'"' 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
W Wv
'. , )&I\ F4 ap Weto 0 10 0
OfFi c,- C
TY OF LA QUINlTA
/BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DAT BY
- c" / co.
Indicates location of new
footing and 1 hour rated wall
------- ------ ---------I
I I
Run studs to dbl top plate at f
I
15/8" Type 'X' gyp. bd.
on 2x6 studs @ 24" O.C. under side of stair shtg. I
fI
I 2x6 wolm. sill w/ shot pins
f Gravel — at 32" o.c.10
I
- I
o I
z a FConc. ftg. w/ #4 bar cont. f
f I
I
I 90% compacted sub grade I
f
I
jNote: Entire stair shall be separated from equipment room by
I a 1 hour separation.
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