07-1268 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: C07-00001268
Property Address: 46710 BRADSHAW TR
APN: 643-170-999-64 -31348 -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 2700
T44t 4 - XP Q"
Applicant: Architect or Engineer:
64�� . P JA-
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 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 k4i,I, as owner of the property, am exclusively contracting with licensed contractors to co uct the project (Sec.
7044, Business and Professions Code: T tractors' State Licen Law d not apply to an owner of
property who builds or improves thereon and wh ontracts for th p je with a contractor(s) licensed
pursuant to the Contractors' S e Licen a Law.).
(_ 1 I am exempt under Sec. P. . for this reaso
I hereby affirm under penalty of perjury that there is a construction len ng a cy for the performance of the
work for'which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/24/07
Owner:
PH RANCH LLC
78370 HIGHWAY 111 S
LA QUINTA, CA 92253 d
Contractor: �i
DESERT CONCEPTS LAN
41800 WASHINGTON ST, B -
BERMUDA DUNES, CA 92201--0 A.Q
(760)200-9007
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 S (tion 3700 of the Labor
Code, for the performance of the, work for which this permit is issued My workers' compensation
insurance carrier and policy number are:
Carrier REDWOOD FIRE & P tuber W67 284
I certify that, in the performance the work which thi p mi s issued, I shall not employ any
person in any manner so as to ecome subject t he w rk r compensation laws of California,
and agree that, if I be ome subject to the w e mpensation provisions of Section
/r 337000 of the Labor ode, all forthwith comply with a provisions.
/flaiw��-; o.vY � lirant� .
WARNING: FAILURE TO SECURE`WORK S' COMPENSATION COVERAN IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL RENALTIES AND CIVIL FINES UP TIRQNE 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. _
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 is application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold ha less the City
of La Quinta, its officers, agents and employees for any act or omission related to th 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 of commenced
within 180 days from date of issuance of such(pe essation of wor f 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the anformation correct. a ree to comply with all
city and county ordinances and state laws relati o ildinstruction, and reby th rize representatives
of this county to enter upon the above-mentio d proper fpection purposes.
(Applicant or
Application Number . . . . . 07-00001268
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee 54.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
2700
Expiration Date 10/21/07
Qty Unit Charge Per
Extension
BASE FEE
45.00
1.00 9.0000 THOU 'BLDG 2,001-25,000
9.00
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Special Notes and Comments
108 L.F..6' GARDEN WALL, .CITY STANDARD
Fee summary Charged .Paid Credited
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Due
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Permit Fee Total 54.00 .00
----------
.00
54.00
Plan Check Total .00 .00
.00
.00
Grand Total 54.00 .00
.00
54.00
LQPERMIT