07-1266 (BLCK)v w.
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: \
07-00001266 �
Property Address:
46638 BRADSHAW TR
APN:
643-170-999-61 -31348 -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
3475
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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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 full force and effect.
License Class: C27,C8,C29 LicenseNo.: 849837
Date: Contractor:
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. 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 buildin ,or improvement is sold within
one year of completion, the owner -builder wil have the burden of provin hat he or she did not build or
improve for the purpose of sale.).
( 4) I, as owner of the property, am exclusively ontracting ith licensed co ractors to construct the project (Sec.
7044, Business and Professions Code: The Contracto ' State Lic nse Law does not apply to an owner of
property who builds or improves ther on, and who cont cts for a projects with a contractor(s) licensed
pursuant to the Contractors' tate Li ense Law.).
I—) I am exempt under Sec. C. for this reason
F CONSTRUCTION LENDI G AGE"Y
I hereby affirm under penalty of perjury that there is a construction lend gagcy for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: r�
Lender's Address:
LQPERMIT
Owner:
PH RANCH LLC
78370 HIGHWAY 111 STE 200
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
DESERT CONCEPTS LANDSCPE/MAINT
41800 WASHINGTON ST, B-105
BERMUDA DUNES, CA 92201--0
(760)200-900.7
Lic. No.: 849837
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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.
_ 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 polic tuber are:
Carrier REDWOOD FIRE & icy Number W67342-134
I certify that, in the pert rmance of the ork for hich thi permit is issued, I shall not employ any
person in any mann so as to become ubje t the orkers' compensation laws of California,
and agree that, if I , hould become subjec o he o cers' compensation provisions of Section
3700,,W a Labor Code, I shall forthwith c ply ith those provisions.
WARNING: FAILURE TO SECUPI WORKERS' COMPENSATIOWCOVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO MINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 0100,000). IN AD ION 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 suc erm ,, ces a n o work for 180 days will subject
permit to cancellation.
I certify that I have read this application and sta that the bove informati�ajreby
rrect. I agree to comply with all
city and county ordinances and state laws rel ing t buil ng construction, authorize representatives
of this county to enter upon the above -mens ned pro rt for inspection p
(Applicant o( Agent):
Application Number
07-00001266
Permit . .
. WALL/FENCE PERMIT
Additional desc .
.
Permit Fee .
. 63.00
Plan Check
Fee
.00
Issue Date . . .
.
Valuation
. . .
. 3475
Expiration Date
10/21/07
Qty. Unit Charge
Per
Extension
BASE FEE
45.00
2.00 9.0000
THOU BLDG 2,001-25,000
18.00
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Special Notes and
--------------------------------
Comments
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139 L.F. 6' GARDEN
WALL, CITY STANDARD
Fee summary
-----------------
Charged Paid
----------
Credited
- ----
----------
Due
Permit Fee Total
----------
63.00
-----
.00
.00
63.00
Plan Check Total
.00
.00
.00
.00
Grand Total
63.00
.00
.00
63.00
LQPERMIT