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07-0749 (ELEC) athal 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: 3/15/07 Application Number: 07-00000749 Owner: Property Address: 81807 CAMINO SAN JUAN LA QUINTA 57 ESTATES INC APN: 764-010-008-77 -31910 - 78401 HWY 111 STE G Application description: ELECTRICAL LA QUINTA, CA 9225 1 k \1 Property Zoning: LOW DENSITY RESIDENTIAL D Application valuation: 500 Contractor: MAR 15 20017 , Applicant: Architect or Engineer: HERINGTON DEVELOP C, JAMES 0 40960 CALIFORNIA OAIC'D DF LPI Ciffid" OOUINTA • MURRIETA, CA 92562 FINANCE DEPT. 1 //L/ (951)677-8415 N (/'� Lic. No. : 753190 • 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 C a: $ License No.: 753190 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is , issued. gC 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 STATE FUND Policy Number 1542746-2006 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 become subject to the 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 Code,I shall forthwith comply with those provisions, 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).: sate: pllcarn: (_I 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: FAIL.RE TO SECURE 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,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 on this application. 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 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 Quints,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. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the 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 construction,and hereby authorize representatives t of th' fourrty to enter upon the above-mentioned property for inspection purposes. Lender's Name: ■ Date: Sign a(Applicant or Agent): Lender's Address: LQPERMIT • Application Number 07-00000749 Permit ELEC-TEMPORARY POWER Additional desc Permit Fee . . . . 30.00 Plan Check Fee . . .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/09/07 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 15.0000 EA ELEC TEMPORARY POWER POLE 15.00 Special Notes and Comments TEMP POWER POLE FOR NEW CONSTRUCTION Fee summary Charged Paid Credited Due Permit Fee Total 30.00 . 00 .00 30.00 Plan Check Total .00 . 00 . 00 .00 Grand Total 30.00 .00 .00 30.00 LQPERMIT MAR-13-2007 TUE 10; 11 AM �� P, 0. 1 Bin# _ 14 -- City of La Quinta ' ` . -' Bilking at Safety Division Permit I!: n 1 j .O. fox [50¢, fig_495�!!e Tampico ii 14—1 Quinn, CA 92253-(760)-M-7012 " _ Building Permit Application and Tracking Sheet Project Address:* 8/ drip ,T . ., ■ _-- fad , _„v.* E tz s___ A. Number: • Address: Legal i]es ptiort; City,ST,Zip: K _ Contractor. x _IN lit%PF'' i r 'Er, i,Ai Telephone;p A 4. 110 }�d~ — � Address:. '-� ' 4 �*�' .. r+.,L, 1�r*ct Description: Af fa�■ +A 1 AiCity.ST,Zip:( /fl izg ;E. 4 �4 Telephone: K5 �7 y - State Lic.# K 1 j i►O City I.ic.#: '1 J<�0 ";:: ,r.�arrrr i LC Arch..Engr.,Designer: Address, — — City,ST,Zip: Telephone: r.' :i �: , ; . Construction Type: Occupancy: 5ta t •'!:, r ,r: ' : t Lic.#: ...,?;:_:: Project e(circle type( 1rGIC one): New Add'n Alter Repair Demo Name of Contact Person:K Sq,Ft.:X, #Stories; #Units: ` Telepphone#of Contact Person: ' Estimated Value afProject:K 0 r - APPLICAN1: DO NOT WRITE BELOW THIS LINE n 1 Submittal Retedl Ret d TRACKING PERMIT FEES • Pion Sets Plan Check submitted J Item Amount Structral Cin. Y Reviewed.ready for corrections Plan Check Deposit ��~ Truss Cases. Called Contact Person Plan Check Balance --* 1 — Plans picked up t Consruction _L Flood plain planPlans resubmitted Mechanical Grading plan IL .�� ^�. �•�Review.ready fnforcorreetionaliasue Electrical y Suhcontacror List �� Called Contact Person Plumbing M Grant Deed Plans picked up S.M.J. �� H.O.A.Approval — Plans resubmitted Grading ' IN HOUSE: w 3"Review,ready for corrections/issna Developer Impact Fee PlanningApproval `~ .� ApP — Called Contact Person A.r.P.p. Puh.Wks.Appr Date of permit issue School Fees r �, MA �,. Total Permit Fees MAR-13-2007 TUE 10: 11 AM FAX NO. P. 03 11B.26'2007 19:08iin) you 909674i5,23 righ:�ra #32141 P,O0E/002 --- ‘.......<6, 02 1 222. �Op &$ to ' I\ r[ L � 6 4*4P1(110 ;/.. f%1 p. 114460 r .4„,04 . ,,4041) L.IN Los LoF"V 110."em 731..* TO TO* .. *41110\ e & 444) r.-'.. III • L:L1i' ' Y ‘?/,‘ Nip i•I- . , ex/ I lr4,40, LOT'0444. 0 12 ! IC. 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