07-1260 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Nurtiber:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
j07-00001260 1
.46662 BRADSHAW TR
643-170-999-62 -31348
WALL/FENCE
LOW'DENSITY RESIDENTIAL
3325
T-iht 4 4a 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 Professionals Code, and my License is in full force and effect.
License Class: C27, C8, C29 License No.: 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 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.).
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 d 's not apply to an owner of
property _who builds or improv hereon, an contracts for th p ect with a contractor(s) licensed
pursuant to the Contractors' tate er a w.l.
(_ 1 I am exempt under Sec. , B.&P. . f r this reason
CONSTRUCTION LENDING AGgNCY,�
I hereby affirm under penalty of perjury that there is a construction lending age r the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
PH RANCH LLC
78370 HIGHWAY 111 STE 200
LA QUINTA, CA 92253
11 UIP'
Contractor:
DESERT CONCEPTS LAND
41800 WASHINGTON ST,
BERMUDA DUNES, CA 92
(760)200-9007
Lic. No.: 849837
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/24/07
/MAAPJ? 3 0 2007
1 --
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 whictthiermit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier REDWOOD FIRE & )icyNumber4284I certify that, in the performan of he ork forwer ' s issued, I shall not employ any
person in any mannerso to become bject trs' compensation laws of California,
and agree that, if I shout become subject ths compensation provisions of Section
3700 of the Lq )aLCod I shall forthwith co ph se provisions.
WARNING: FAILURE TO SECURE W R ERS' COMPENSATION CEg[IERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMI AL ENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITIOVYO 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/aa a result f this application,
the owner, and the applicant, each agrees to, and shall defend, innd hol harmless the City
of La Quinta, its officers, agents andemployees for any act or omted o the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null andis not commenced
within 180 days from date of issuance of such permit, or cessatk for 180 days will subject
permit to cancellation.
1 certify that I have read this application an tate t the ove infor 'on iI agree to comply with all
city and county ordinances and state laws elating to ild' gconstruction, uthorize representatives
of this county to enter upon the above -me boned prope for inspection purp
(Applicant (k Agent):
Application Number . . . . . 07-00001260
Permit . . . WALL/FENCE
PERMIT
Additional desc . .
Permit Fee . . . . 63.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 3325
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
----------------------------------------------------------------------------
Special.Notes and Comments
133 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