07-2683 (BLCK)11111111IIIIIIIIIIIII 18
IE
PI BOX 1504
w�49J CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 07-00002683
Property Address: 81647 ANDALUSIA
APN: 764-200-999-57 -316813
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 4075
Applicant:
Tiht 4 4 Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Prof ionals Code, and my License is in full force and effect.
License Cla- : ^ry Licens 62987
atel 0 / ontractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. A6y 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).:
(_) 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 ISec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
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.).
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
( 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: A -
Contractor: Address: 7
LQPERMIT
Owner:
CORAL OPTION I
79295 RANCHO LA QUINTA DR
LA QUINTA, CA 92253
Contractor:
TD DESERT DEVELOPM
P O BOX 1716 D
LA QUINTA, CA 9224
(760)771-1941
Lic. No.: 762987
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/03/07
OCT 10 2007 L
LA QUINTA
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
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
insurance carrier and policy number are:
Carrier COMPWEST Policy Number CA005001482003
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
a d agree that, if Ishould bj bject to the workers' compensation provisions of Section
700 of the Labor Cod shall fortwith comply with those provisions.
Dat,/0. Applicant:
WARNING: FAILURE TO SECURE W ERS' COMPENSATION COVER E IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
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.
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
permit to cancellation.
I certify that I have read this application and state that the7inspe
mation is correct. I agree to comply with all
city and co ty dinances and state laws relating to ingtion, and hereby authorize representatives
of this my enter upon the above -mention roperty foon purposes.
Q nature (Applica or Agentl: _
Application Number . . . . . 07-00002683
Permit . . . WALL/FENCE
PERMIT
Additional desc .
Permit Fee . . . . 72.00
Plan Check
Fee
00
Issue Date . . . .
Valuation
. . .
. 4075
Expiration Date 3/31/08
Qty , Unit Charge Per
Extension
BASE
FEE
45.00
3.00 9.0000 THOU BLDG
2,001-25,000
27.00
----------------------------------------------------------------------------
Special Notes and Comments
163 L.F. 6' GARDEN WALL, PROTO SYSTEM
Fee summary Charged
-------------------------------------
Paid
Credited
--------------------
Due
Permit Fee Total 72.00
.00_
.00
72.00
Plan Check Total .00
.00
.00
.00
Grand Total 72.00
.00
.00
72.00
LQPERMIT