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04-7513 (BLCK)P.O. Box 1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT VIII VIII III VIII IIII 52 IE --- - - - - -- - - BUILDING & SAFETY DEPARTMENT (760) .777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Application Number . . . . . 04-00007513 Date 12/01/04 Property Address . . . . . . 81769 AVENUE 5.2 APN: 767-200-999-A -312021- Application description . . . WALL/FENCE Property Zoning. . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 193750 Owner Contractor ------------------------ DESERT CHEYENNE, INC. ------------------------ HERINGTON DEVELOPMENT, JAMES O 78401 HIGHWAY.111, SUITE G 40960 CALIFORNIA OAKS RD, #283 LA QUINTA CA 92253 MURRIETA CA 92562 (760) 777-9920 (951) 677-8415 WCC: STATE FUND WC: 1542746 11/01/05 CSLB: 753190 04/30/06 CCC: B ------------=-------------7------------------------------------------------- Permit WALL/FENCE PERMIT Additional desc Permit Fee . . . . 968.50 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 193750 Qty Unit Charge Per Extension BASE FEE 639.50 94.00 3.5000 THOU BLDG 100,001-500,000 329.00 ---------------------------------------------------------------------------- Special Notes and Comments 7750 LF 6' SLUMPSTONE PERIMETER WALL -A SMALL PORTION OF THIS PERIMETER WALL IS COMBINATION UP TO 24" RETAINING WITH 6' GARDEN WALL. PER APPROVED ORCO STRUCTURAL CALCS & WALL PLAN APPROVED BY BRIAN CHING(PUBLIC WORKS) & OSCAR ORC I ( CDD) . Fee summary ----------------- Permit Fee Total Plan Check Total Grand Total Charged. Paid 968.50 .00 .00 .00 968.50 _y_kk0 IJ G L, Credited Due, .00 968.50 .00 :00 .00 968.50 P.O. sox 1504• �� VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 a LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 2N-7, / 3 Applicant: / Applicant's Mailing Address: Date: Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS 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 Professionals Code, and my License is in II force and effect. - i C License class / C License No. �� r Date/u//0 '5e contractor ���/��G/�4N />� 141— l 0/l/I/a T /nom OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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. 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).): U 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 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 or 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 sate.). (, 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.). U I am exempt under Sec. , B'.& P.C. for this reason Date Owner WORKERS' 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 sssyed. y workers' compensation insurance carrier and lic number re: Carrier J 7 /�% /�d��/J rPolic Number / `/y1 7 S' 6 — _ I certify that, in the performance of the 'c for wttich 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, and a e th��jl if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date WARNING: FAILURE TO SECURE WORKERS' COtVPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO 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. 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.). Lenders Name Lender's Address 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 Ouinta, 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 nd 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 cancelk ti I certify that I have read this application and state that the above informati i rect. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter u t e above-mentioned property for inspection purposes. Date/1. ///d %' Signature (Applicant or Agent): C 1-11 ow 2003 IN THE CITY OF L-A OUINTA 'A V COUNTY OF RIVERSIDE. 13TATE OF CALIFORNIA TENTATIVE TRACT MAP NO. 31202 AND PRELIMINARY GRADING PLAN SECTION A -A SECTION 8- 52ND AVENUE AbVONROE STREET PRIVATE STREETS 'A' THRU 'L VIGHTY MAP M.I.6. A8BE8BORB PARCEL Nl1MBERB. TIST-200-0OWNER 04 707-200-008 . ..... .. ..... .. . ..... 7� POW.- P-01SOWI- �wriLm -- ---------- — ------- --------- -------- �.QT- W � FqWm - : T 'A. 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