09-0335 (ELEC) .....
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P.O. BOX 1504 a 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: 4/15/09
Application Number: 09-00000335 Owner:
Property Address: 81742 BROWN DEER PARK SWC NORMAN 39
APN: 767-540-019-C -000000- C/O DAVID PEERY
Application description: ELECTRICAL 7161 INDIANA AVE
Property Zoning: LOW DENSITY RESIDENTIAL RIVERSIDE, CA 92504 ~~
Application valuation: 1600 --�
Contractor: / A
Applicant: Architect or Engineer: BRADLEY ELECTRIC INC. ;;-y y .7..
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1 42335 WASHINGTON ST, STE Fit �° 1009 I
' PALM DESERT, CA 92211 Cl7yr�F,,,
�`// ^/x (760)360-0944 fil;.�;,y & Q(�1�3q
A.
Lic. No. : 275466p
I
,`• -� --LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of hapter 9(commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000)of Division 3 of the Busin of s C e,and m In full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided
License Class: CI_0 Li n 7•46 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is
issued.
te: actor: X I have and will maintain workers'compensation insurance,as required by Section 3700 of the Labor
Code,for the performance of the work for whi mit is issued. My workers'compensation
OWNER-BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury t t I am exempt from the Contr to License Law for the Carrier ENDURANCE WC Policy Num. r KENO 03574 2
following reason(Sec.7031.5,Business Professions CO • rty or county that requires a permit to _ I certify that,in the performance of the work to which This permit Is issue ,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 tibia .workers''com:u•.-, s 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 s Ed•e ome subje. •kers'.corn.-i-.•ferr pr. llip Section
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or 3700 of the Labor C e, ^; ❑ 1,�--hose p 'ony
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).: gate: IS A scant: 4it, _ f
( ) I,as owner of the property,or my employees with wages as their sole compensation,will do the work,and w! ��*'•.
the structure is not intended or offered for sale(Sec.7044,Business and Professions Code: The WARNING: FAJLU E TO SECURE WORKERS'COMPENSATION COVERAGE .WFUL,AND ALL
Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL P•• •LTIES AND CIVI •-TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees,provided that the DOLLARS 0100,000). IN ADDITION TO THE • • •MPENSATION,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 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 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 6missi =ed 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 cold if work i5 not commenced
within 180 days from date of issuance of such permit,or cessation of work for 18o 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 .mply wi-
work for which this permit is issued(Sec.3097,Civ.C.). city and county ordinances and state laws relating to b Idi a struction, . herd) authorlx: -
of this • ntyr enter upon the above-mentioned pro pert. ��
Lender's Name: �]
\1?‹ 7.-te. Y ure(Applicant or Agent): „ol. 4110.1.11111,
-yiiiliK1/4- t,
Lender's Address:
111 Ti
LQPERMIT
Application Number 09-00000335
Permit ELEC-MISCELLANEOUS
Additional desc . .
Permit Fee . . . 33.50 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 10/12/09
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 18.5000 EA ELEC SVC <=600V/<=200A 18.50
Special Notes and Comments
INSTALL 1 ADDITIONAL 100 AMP HOUSE METER
ON PERIMETER WALL FOR LANDSCAPE LIGHTING
Other Fees BLDG STDS ADMIN (SB1473) 1.00
Fee summary Charged Paid Credited Due
Permit Fee Total 33 .50 . 00 .00 33.50
Plan Check Total .00 . 00 .00 .00
Other Fee Total 1.00 . 00 .00 1.00
Grand Total 34.50 . 00 .00 34.50
LQPERMIT
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Q IS MAY SSUMED FOR NOTCOMPLY WITHE ALOCALCY LOT-SPLIT OR BUI THE DATA ILDING SITESORDINAANCES. CITY OF LA QUINTA 767-33
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ASSESSOR'S MAP BK767 PG.54 MB 285/60-64 TRACT NAP NO. 29347 Si-Tr 07?Doc
Riverside County, Calif. SLY Aug 2000
Bin#
11.33 Ti93 V City of La Quinta
L a-6 c Building 8r Safety Division
Permit# P.O. Box 1504, 78-495 Calle Tampico
I _ La Quinta, CA 92253- (760) 777-7012
- 7.5t/c7 /q Building Permit Application and Tracking Sheet
Project Address: g5 i 7L i Owner's Name: I�� z/ 6/,
,,,rsr
A.P.Number: i +^ rQek Address: -. `'�r iirA.
Legal Description: 7 ■
City,ST,Zip: f �` I
Contractor: �] �` • .,„ :;`:y
L� �.� elephone: ,:; •• .:
Address: •10 / `. 7� Project Description: G G��
City,ST,Zip: w i. 1 -Zi. Dr d J, 41044...."" im.A.1 e giii 1 0 c-,
Telepho • : Y:%
7• 6 ,.r OPdr, : :-:x '<<''= it m i 11 mile,
State Lic.#: ]�" ar 11 City Lic.#; "IPP/74 Cn Pti ZiAtiZZ J
Arch.,Engr.,Designer:
Address:
City,ST,Zip:
Telephone: SP >! :` `>%',' '=<> !':! Construction Type: Occupancy:
>�:�, �`;F.,:;�. � ;:�� .,;;,;,�,, _ YP . O cup y:
State Lic.#: —
4,:WM: WASZ
;:;;.;;. .._,,,,,--% ;:::_;,,,• _> Project type(circle one): New Add'n Alter Repair Demo
Name of Contact Person: Sq.Ft.: I #Stories: #Units:
....)
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Telephone#of Contact Person: , Estimated Value of Projp �
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Rec'd TRACKING J 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
Title 24 Calcs. Plans picked up Construction
Flood plain plan Plans resubmitted Mechanical
Grading plan 2nd Review,ready for corrections/issue Electrical
Subcontactor List - Called Contact Person t Plumbing
Grant Deed Plans picked up S.M.I.
H.O.A.Approval Plans resubmitted Grading
IN HOUSE:- ''J 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
1 Total Permit Fees