08-0034 (BLCK)c
P.O. BOX 1504
-' 78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
08-00000034 '
Property Address:
46965 HIGHLAND PALMS DR
APN:
643-191-002-2 -2117 -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
224
Applicant:
T-iht 4 4 Q"
Architect or Engineer:
aim
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLA TION
I hereby affirm under penalty of perjury that I i ed under provision Chapter 9 (commencing with
Section 7000) of Division 3 of the Business d Profes 'onals Code, a my License is in full force and effect.
License lass: A -C -C8 Licens o.: 840210
ate: li tractor:
LDER DECLARATION
I hereby affirm under penalty of perjury m e t from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and P ions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he o e is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 70001 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).:
(_ 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
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.).
( I 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:
Lender's Address:
LQPERMIT
Owner:
HILL STEPHEN ERIC
46965 HIGHLAND PALMS DRIVE
LA QUINTA, CA 92253
Contract)
CROCOD
53080
LA QUI
(760) 5
Lic. N
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/04/08
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.
K I have and will maintain workers' compensation insurance, required by Section 3700 of the Labor
7� Code, for the performance of the work for which thi ermit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 1828832
1 certify that, in the performance of the work f which this permit is issued, I shall not employ any
person in any manner so as to become su ect to workers' compensation laws of California,
nd agree that, if I should bec t t rkers' compensation provisions of Section
700 of the Labor Code all fort com with those provisions.
V
WARNING: FAILURE TOSECU E C PENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TOC (NAL E>AtTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION T E 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 ac r omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application beco s null and void if work is not commenced
within 180 days from date of issuanc it, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and to that th bove i formation is correct. 1 agree to comply with all
city and unty ordinances and state law r at
to b ding construction, and hereby authorize representatives
of this cy�irity tp enter upon the above- tioned pr erty for inspection purposes.
/1ASigna a IApplica I +/ -
LQPERMIT
Application Number . . . . . 08-00000034
Permit . . . WALL/FENCE
PERMIT
1
Additional desc . .
Permit Fee . . . . 15.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 224
Expiration Date 7/02/08
1
Qty Unit Charge Per
Extension
BASE
FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
14 L.F. 4' EQUIPMENT WALL, CITY
STANDARD
Fee.summary Charged
-----------------
Paid Credited
Due
--------------------
Permit Fee Total 15.00
----------
.00
----------
.00
15.00
Plan Check Total .00
.00
.00
.00
Grand Total 15.00
.00
.00
15.00
c _
1
Bin #
City of La Quinta
Building U Safety Division
Permit #
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit plication and Tracking Sheet ,
Ap
Project Address:
Owner's Name: rl 4"
A. P. Number:
Address:. (4-96% F G/4'
Legal Description:
City, ST, Zip: L �" 9
ZZS
Contractor:. C'
rot D ` Jn/5 .
Telephone:
Address:2 --
Project Description:
City, ST, Zip: (, `` �2
Telephone: _ _ 4 y
.P
�
State Lic. # : 9 o
City Lic: #:
Arch.,Designer:
Address:
City, ST, Zip:
Telephone:
Constnrotion Type: Occupancy:
P cY:
State Lic. #:
Ac
Project -type (circle one): New.. Add'n Alter Repair Demo
Name of Contact Person:
-d �,,�y' /�
S FG:O 9 #Stories: Units.
Telephone # of Contact Pe ;.
Estimated Value of Project:
APPLICANT: DO NOT WRITE
BELOW THIS LINE
#
Submittal
Req'd I
Rcc'd
TRACIQNG
PERMIT FEES
Plan Sets
Plan Check submitted .
Z 2(t •
Item Amount
Structural Cities.
Reviewed, ready for corrections• .
Plan Check Deposit
Truss Calcs.
Called Contact Person '
Plan Check Balance
Energy Cale&
Plans picked up
J.
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:- Review, ready for corrections/issue Developer Impact Fee
' Planning Approval Called Contact Person A.LP.P.
Pub. Wks. Appr Date of permit issue
School Fees
Total Permit Fees 't
'r