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07-0529 (ELEC) ot 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 Date: 2/20/07 Application Number: 07-00000529 Owner: Property Address: 51905 AVENIDA BERMUDAS RUIZ REFUGIO URENA ' APN: 773-184-019-7 -000000- 51905 AVENIDA BERMUDAS Application description: ELECTRICAL LA QUINTA, CA 92253 Property Zoning: COVE RESIDENTIAL • Application valuation: 100 Contractor: Applicant: Architect or Engineer: Owner • • LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000)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 License Class: License No.: for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Date: Contractor: 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 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 Policy Number 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 beco .•act to the workers'campensa- provislons of Section License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or 3700 of the Labor Code,I I forth th corn 1th those I s. 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).: Date: Applicant: (s) 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 WARNING: FAILURE TO SECURE RKERS'C PENSATION COVERAGE UNLAW-. • IL Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CR1 INAL PEN IES AND CIVIL FINES UP Tr ONE -• '- ---- • and who does the work himself or herself through his or her own employees,provided that the DOLLARS($100,000). IN ADDITION TO THE COST OF COMPENSATION, I AMA'.S AS PROVIl ED F•- IN improvements are not intended or offered for sale, If,however,the building or improvement is sold within SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES C) one year of completion,the owner-builder will have the burden of proving that he or she did not build or ••f 'T'I improve for the purpose of sale.). APPLICANT ACKNOWLEDGEM :T1 ( 1 I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. IMPORTANT Application is hereby made to the Director of Building and Saf: • Co pert' T sbbje•l �5- 7044,Business and Professions Code: The Contractors'State License Law does not apply to an owner of conditions and restrictions set forth on this application. r property who builds or improves thereon,and who contracts for the projects with a contractor(s)licensed 1. Each person upon whose behalf this application is made,each p: * ;t wh$liiikequ• and f.r pursuant to the Contractors'State License Law.). whose benefit work is performed under or pursuant to any per - -d as Iasult o this a.plication, ( 1 I am exempt under Sec. ,B.&P.C.for this reason the owner,and the applicant,each agrees to,and shall defend, . "-ify arkkiald ha i•ss he City •• of La Quinta,its officers,agents and employees for any act or. reia o the' "N eing performed under or following issuance of this permit. • ..,I C Date: Owner: 2. Any permit issued as a result of this application becomes null a •vow wor"R'!i not•• me cod within 180 days from date of issuance of such permit,or teas. fon of work for 180•ays ill subject CONSTRU N LEND! AGENCY • permit to cancellation. • I hereby affirm under penalty of perjury I t there is a truction lending agency for the performance of the I certify that I have read this application and state that the above informatic. is correct. I c==in with all • work for which this permit is issued(Sec.3097,Civ.C.). city and county ordinances and state laws relating to building constru -•- •- • • .....••. • tatives of this county to enter upon the above-mentioned property forion pure•- • • Lender's Name: y Date: Signature(Applicant or Agent): - Lender's Address: LQPERMIT Application Number 07-00000529 Permit ELEC-MISCELLANEOUS Additional desc . Permit Fee . . . 17.25 Plan Check Fee . . 4.31 Issue Date . . . Valuation . . 0 Expiration Date . 8/19/07 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 2.25 Special Notes and Comments ADD ONE SWITCH & TWO FIXTURES TO PREVIOUSLY PERMITTED WALL Fee summary Charged Paid Credited Due Permit Fee Total 17.25 . 00 .00 17.25 Plan Check Total 4.31 . 00 .00 4.31 Grand Total 21.56 . 00 . 00 21.56 LQPERMIT Bin# City of La Quinta Building 81 Safety Division Permit# P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: , Owner's Name: i J�, A.P.Number: Address: S ) 0 n f. V Legal Description: City,ST,Zip: (....A4 & 01 ATC4. • Contractor. Telephone: -2C1.-7 ip Address: Project Description: City,ST,Zip: N Telephone: 6 /165 l J n,- LC /iL l rl�J%�Q-A State Lic.#: ����� City Lic.#: Arch.,Engr.,Designer: Address: nI w A• City,ST,Zip: L/ 145 p �� /.a 07fV.tiJ Telephone: -_•• - _ •j _'-' - Construction Type: Occupancy: State Lic.#: `f'=' Project type(circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq.Ft.: 1 #Stories: 1 #Units: Telephone#of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calls. - Reviewed,ready for corrections Plan Check Deposit Truss Caics. Called Contact Person Plan Check Balance Energy Cala. Plans kicked 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.L H.O.A.Approval Plans resubmitted Grading IN HOUSE:- 3.1 Review,ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub.Wks.Appr T _Date of permit issue School Fees Total Permit Fees pa- Chi cetu Ajizat aCrs, alba 5g -- ,1.-, -1- j..,!i_ (........ -1110F,r0,U 78-495 CALLE TAMPICO— LA QUINTA, CALIFORNIA, 92253 TELEPHONE (760) 777-7012 FAX (760) 777-7011 OWNER/BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "Owner/Builder"you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license . from the City or County. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection. If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer,you must register with the State and Federal Government as an employer and you are subject to several obligations include State and Federal income tax withholding, federal social security taxes, worke' s compensation insurance, disability insurance costs and unemployment compensation contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. • Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N. Street, Sacramento, California 95814. Please complete and return the enclosed owner-builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La Quinta, CA 92253 C6 ) 777-7012 F : (760) 777-7011 G TE PROPERTY ADDRESS PERMIT NUMBER(S)