05-3657 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
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Application Number:
05-00003657
Property Address:
81660 CHARISMATIC WY
APN:
767-200-999-36 -312021-
Application description:
WALL/FENCE
PropertyZoning:
LOW DENSITY RESIDENTIAL
Application valuation:
6550
Applicant: . at"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VJ
AUG 19 2005
OF LA
LICENSED CONTRACTOR'S DECLARATION
I hereby of iirm,under penalty of perjury that Iorn licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3, of the Business' and Professionals G ,.and my License is in full force:and.effect.
Lice Class: S Li : 75 190
Date: t X tractor: •
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that! em 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 Sacuon 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.Professionss Code: The
Contractors' State License.Law does not apply town owner of property who builds or improves thereon,
and who doesrthe 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 saleJ.
(_ 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 dries not apply to an ownerof
property who builds or improves thereon, and who contracts for the projects:wkh a contractor(s) licensed
pursuant to the:Contractors' State License Law:l,
_ 1 I -am exempt under Sec. , 8:&P:C. forthis 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: WN
LQPERAUT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/18/05
Owner:
DESERT ELITE, INC:.
18401 HIGHWAY 111., SUITE G
LA QUINTA, CA 92253
(760)777-9920
Contractor:
HERINGTON DEVELOPMENT, JAMES O
40960 CALIFORNIA OAKS RD, #283
MURRTETA, CA 92562
(951)677-8415
Lic. No..: 753190
'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.setPinsure for workers' compensation, as provided
for by SectioW3700.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 forwhich permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 1542746
I certify that, in the performance of ;the work for which this permit is issued, I shall not employ any
person in any manner so as.to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to th_ e_ orkers' compensation provisions of Section
3700 oofp'the LeborCode, 1 a II forMwith Com with ose pr ons.
WARNING: FAILURE TO SECURE WO KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (9100,000). IN ADDITION TO THE,COST OF COMPENSATION, DAMAGES AS PROVIDED. FORdN
SECTION 3706 OF THE LABOR CODEi 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 Quints; its officers; agents and,employees for any act'oromission 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 such permit, or cessation of work for 180 days will subject
permit to cancellation:
I certify that 1 have read this application: and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction ,.and.hereb tho' a representatives
of/thio ca ty o enter upon the above-mentioned property f inspection purposes
D _ Signature (Applicant or Agent).
1
Application Number . . . . . 05-0.0003657
Permit . . WALL/FENCE PERMIT
Additional. desc . .
Permit Fee 90.00 Plan Check Fee .00
Issue Date . . Valuation . . . . 6550
Expiration Date . . 2/14./06
Qty Unit Charge Per Extension
- BASE FEE 45.00
5.00 9.0000 THOU BLDG 2,00`1-25,000 45.00
--------------------------------------------------- I ---------- ---------------
Special
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Special Notes and Comments
262 L.F. 6- GARDEN WALLS, ORCO SYSTEM
Fee summary Charged Paid: 'Credited Due
----------------- - ----- --
Permit Fee Total 90.00 .00 .0-0 90.00
Plan Check Total . .0.0 .00 .00 .00
Grand Total 90.00 .00 .'00 9.0.00