07-1225 (ELEC) ,e„:„y i e, 4 4 at I,i a.ih.
...
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
II .1 ► PERMIT
Application Number: 07-00001225 Own Date: 4/23/07
Owner:
Property Address: 79036 MISSION DR W T.D. DESERT DEVELOPMEMT
APN: 649-460-003- - O
Application description: ELECTRICAL 4 2 a. P.O. BOX 1716
Property Zoning: LOW DENSITY RESIDENTIAL Crb LA QUINTA, CA 92253
Application valuation,. 500 cv .5t
OQ
Q4 a? Contractor:
1 Applicant: Architect or Engineer: ij TD DESERT DEVELOPMENT LP
11
P 0 BOX 1716
1 LA QUINTA, CA 92247
t SI 1 (760)771-1941
ill / j' Lic. No. : 762987
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 essio ats Cod y License is in full force and effect. I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided
Licen CIa■�: B Li e No.: 62987 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is
/9 issued.
Date9V'Z a Detractor: _ 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 Lic nse Law for the Carrier COMPWEST . Policy Number CA0 0 5 0 014 82 002
following reason(Sec.7031.5,Business and Professions Code: Any city or county that quires 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 ff and agree that,if I should becom-:subject to the workers'compensation provisions of Section
License Law(Chapter 9(commencing with Suellen 7000)of Division 3 of the Business and Professions Code)or f 37 of the or Code ' ith corn. •. •those provisions.
that ha.or,she is exempt therefrom and the basis For tIrealleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not mare than five hundred dollars IS 500.: .: . T a pplicant:
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: FAILURE TO SECURE WOR' F1S'COMPENSATION.COVERAGE IS U LAWFUL,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 TOO 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,DA AGES 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 err 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 jset. 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 en owner of conditions and restrictions set forth on this application.
property who builds or improves thereon,and who contracts for the projects with a ccntractor)s1 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,
(_1 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 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•• • - • 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 huildin- .nstructlon, rid here .+ .'e representatives
pl
of this cou t nter upon the above-mentioned prope -for inspection p roeLender's Name: pie
•.of nature(Applicant or Agent):
Lender's Address:
LQPERMIT
.
` Application Number 07-00001225
Permit ELEC-TEMPORARY POWER
Additional desc .
Permit Fee . . . 30.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 10/20/07
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 15.0000 EA ELEC TEMPORARY POWER POLE 15.00
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 Quints
/ Building 81 Safety Division
Permit# ti
r 43 P.O. Box 1504, 78-495 Calle Tampico
��/ La Quinta, CA 92253 - (760) 777-7012
0 Building Permit Application and Tracking Sheet
Project Address: /f'f/SS/.0 Ar I"(r'C1t LJ S7 Owner's Name: ( 9 9f 54 7 0 E-CJ (J
A.P.Number: Address: ,D 3 ?/1-7
`Legal Description: /?71 0 4 ecJ/-'U 74 City,ST,Zip: (_. of- 22 r 7
Contractor: 7x u c A-'5 Dc_s-0 �P.— TelephoneT7 '7 7—,' 5 Z
Address: Project Description:
City,ST,Zip: 02�5S b 2 <E/q D tO 14rcA-
Telephone: Q 7�i F/0 - c '3 O cw-ccc ---7C o l'O
State Lic.# : City Lic.#: 44/SS(o a/ 0/i( U F- t ' S
Arch.,Engr.,Designer: C /1.r a(C c.}/•al 7%1
Address: I '� 1 'fig l
T`
City,ST,Zip:
0 r rt.- �v. r-7 •
Telephone: Otk.
Construction Type: Occupancy:
State Lic.#: Project type(circle one): New Add'n Alter Repair Demo
Name of Contact Person: 4/0(�.sr�' $/*4 LDS Sq.Ft.: #Stories: #Units:
_ r
Telephone#of Contact Person: 777�° 5 2- Estimated Value of Project:
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 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:- ''d 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
o.