10-0983 (BLCK)P.O. BOX 1504 ^�
78-495 CALL -E TAMPICO -- -- - - - -- -- -
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: `10-00000983
Property Address:
-46422 BRADSHAW TR
APN:
643-170-999-52 -31348 -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
758
Owner:
GLOBAL INVESTMENTS
3470 WILSHIRE BLVD. #1020
LA QUINTA, CA 92253-9001
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/23/10
Contractor:
Applicant: Architect or Engineer: FD CONSTRUCTION
73081 FRED WARING DRIVE 10
PALM DESERT, CA 92260 11
(760) 776-8300 � 4.4 Lic. No.: 814468�i?1 t�
1 1'�
COYImo"
P'i�b:tt9tf:1� 14fy1�. i
;--------- - - - - - -
UC SED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjufy that am licensed and p visions of Chapter 9 (commencing with
Section 7000) of Division 3 of the B sines an fessionals C nd my License is in full force and effect.
lic�ens Class: Lice Li
Date: 6 tractor:
.. OWNER-BUILDERN
I hereby affirm under penalty of perjury that I am exempt from thStat License Law for the
following reason (Sec. 7031.5, Business and Professions Code: nty at requires a permit to
construct, alter, improve, demolish, or repair any structure, prior 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. 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).:
(_ 1 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, 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 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: I VX
LQPERMIT
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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.
NL I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performanc of the work for which this permit is issued. My workers' compensation
insurance carrier policy n mber are:
Carrier GRANITE STAT
"be'ec
Policy Number WC003957781
I certify that, i he perork for which this permit is issued, I shall not employ any
person in a y mannes je to the workers' compensation laws of California,
and agree t t, if I sec tot workers' compensation provisions of Section
3�/7q�J0 of the or Cith c with those provisions.
at, `� plicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATI N COVERA E IS UNLAWF ND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND Cl IL FINES UP ONE HUNDRED THOUSAND
DOLLARS ($100,000)• IN ADDITION TO THE COST OF CO PENSATION, MAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATT NEY'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 h6ld 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 applic ecomes.null and void if work is not commenced
within 180 days from date of issuan Isuc permit, or cessation of work for 180 days will subject
permit to cancellation.
1 certify that I have read this application anCatethat above informati'correct. I agree to comply with all
city and county ordinances and state lawsding constructio an here thorize representatives
of`this county nit upon the above-meyforinspe o pDate: , Sig ture (Applicant
1
LQPERMIT
Application Number 10-00000983
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . 21.00 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 758
Expiration Date 3/22/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
3.00 2.0000 HND BLDG 501-2,000
6.00
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Special Notes and Comments
TOTAL OF 35 L.F. 5' GARDEN WALL TO
CREATE FRONT COURTYARD, CITY STANDARD.
2007 CODES.
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Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
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Due
Permit-Fee Total 21.00 .00 .00
21.00
Plan Check Total .00 .00 .00
00
Other Fee Total 1.00 .00 .00
1.00
Grand Total ' 22.00 .00 .00
22.00
1
LQPERMIT
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