07-0798 (ELEC) ceitit. 4 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: 3/19/07
Application Number: 07-00000798 Owner:
Property Address: 80705 LA DOCENA TR _ DR BERNIE GELLAR
APN: 777-040-005- ~�� —t 80705 LA DOCENA TR
Application description: ELECTRICAL D } LA QUINTA, CA 92253
Property Zoning: VERY LOW DENSITY RES '-"��
• Application valuation: 5000 I 2007 I
.I. 1 MAR- li
I Contractor:
Applicant: Architect or Engineer: s CI YOFLAQu TA I REESKE, MIKE
Ff �`<"o J 80199 BARCELONA AVENUE
INDIO, CA 92201
(760)466-7529
Lic. No. : 610056
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 tI Business and ofesswnais•We,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: B , r Licdfse No.:Ai0056 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is
�p issued.
▪ Date: 5 ` / 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-BUILD DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I ern exempt from the Contractor's State License Law for the Carrier EXEMPT Policy Number EXEMPT
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_eµble a the workers'compensation laws of California,
permit to file a signed statement the�jthe or she is licensed pursuant to the provisions of the Contractor's State and agree the if I shout. me subject to the raters'corn alien provisions of Section
License Law(Chapter S{comma rpirfg with Section 7000}of Division 3 of the Business and Professions Code}or 37 of the L r Crate,I U forthwit co y with thos ovisions.
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).: Da
( 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 WARNING: FAILURE TO SECU 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 C IMINAL 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 IS 100.000), IN ADD• ON 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 ODE,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 ereby 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 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•wer180 days will subject
CONSTRUCTION LENDING AGENCY I 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£hat the above information is correct. I ree to comply all
work for which this permit is issued(Sec.3097,Civ.C.). city and county ordin noes and state laws relating o building constnyCtlpn,and ereby thorlxe reps Wives
of this count o e r upon the above-mentioned roperty for Inspictlon pus
Lender's Name: r
Date: ignature(Applicant or Agen
Lender's Address:
-
LQPERMIT -f
Application Number 07-00000798
Permit ELEC-TEMPORARY POWER
Additional desc
Permit Fee . . 30.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date 9/15/07
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 TO GATE. WHEN BARN STRUCTURE
IS FINALED, TEMP POWER TO BE REMOVED
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
Bin# City of La Quinn
Building 8,1 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: tj -- 70 s l Q Do Cei4 4.. /< Owner's Name: �5 awl i r ( ,.. /I-Jc
A.P.Number: / Address:
Legal Descrippn: City,ST,Zip: j �J� ft l:c {C
Contractor:4 ��4 vQ / , /�u; J� Telephone:
1441111111110'1 _,
Address:: - /-"f� S�a_(c e/�y�e� Project Description:
•
m�4�2cz2y Ci C� J c
City, Ti',Zip: _f'7i, /7
ififiiiime- .
Telephone: /I()G/ — 7/ 7V
Statf Lic.#: City Lic.#:
Arch.,Engr.,Designer:
Address:
City,ST,Zip:
Telephone: Construction Type: Occupancy:
State Lic.#: Project type(circle one): New Add'n Alter Repair Demo
Name of Contact Person: i .A, L R.-eS Sq.Ft.: #Stories: #Units:
Telephone#of Contac rson: .9ii — 7/ 7/ Estimated Value of Project: ,S
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Rec'd TRACKING PERMIT FEES
Plan Sets Plan Check submitted 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 12nd Review,ready for corrections/issue Electrical
Subcontactor List Called Contact Person I Plumbing
Grant Deed Plans picked up S.M.I.
H.O.A.Approval Plans resubmitted Grading
IN HOUSE:- m Review,ready for corrections/issue Developer Impact Fee
Planning Approval Called Contact Person A.1,P.P.
Pub.Wks.Appr Date of permit issue
School Fees
l
Total Permit Fees
. CITY OF LA QUINTA SUB-CONTRACTOR LIST,/ o - -' - 07
JOB ADDRESS o7°' { 4 7 0 � TX' PERMIT NUMBER O7- 7'8 OWNER _DR- £'e .e/!h/- BUILDER _t1e7
. This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance
of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
Trade / Classification Contractor State:.Contractor's License Workers Corn p ensatioii Insurance ^ .
Company Name Classification License Number Exp. Date Carrier Name Policy Number Exp. Date License Number Exp. Date
(e.g.A, B, C-8) (xxxxxx) (xx/xx/xx) (e.g.State Fund, CalComp) (Format Varies) . (xxlxxlxx) (xxxx) (xx/xxlxx)
EARTHWORK (C-12)
CONCRETE IC-8) f
FRAMING (C-5)
STRUCT.STEEL(C-51)
-
MASONRY (C-29)
PLUMBING (C-36)
LATH, PLASTER (C-35)
DRYWALL (C-9) • _
HVAC 1C-20) _
ELECTRICAL(C-10) c C lett!er* C- /O 2sZ O 0 o 2F ,Oti% D 'ems pS i GGSo9o( iA Q D 9S-5 2-27o5-
ROOFING (C-391
SHEET METAL(C-43) - -
FLOORING IC-15) -
GLAZING (Cu )- 7
INSULATION (C-2)
SEWAGE DISP (C-42)
PAINTING (C-33)
CERAMIC TILE(C-54)
CABINETS (C-6) •
FENCING (C-131 ,
LANDSCAPING (C-27) _ .
POOL (C-53)