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10-0121 (BLCK)Iii P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000121 Property Address: 81667 CHARISMATIC WY APN: 767-640-041- - Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 2900 Applicant:. Architect or Engineer: C�� BUILDING & SAFETY DEPARTMENT BUILDING PERMIT ------------------ ----------------------- I -------- ENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury th am licensed under provisions of Chapter 9 (commencing with Section 7000) of, Division 3 of the Busines nd Professionals Code, and my License is in full force and effect. License CI B License No:: 753190 Dat % Contractor. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I 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'toits issuance, also requires the applicant for the permit to file a signed statement that hear sheds 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 thwalleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of notmore;than five hundred dollars (8500):: 1 _ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the; work,, the structure is not intended oroffered forsale (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 herown,employess; provided that the improvements are not intended or offered forsale. If, however, the building orimprovement is sold within one year of completion, the owner -builder will have the burden ofproving that he or she did not build or improve for the purpose of sale.). (_ 1 I; as owner of the property, am exclusively contracting with lioensed.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 coniractor(s) licensed pursuant to the Contractors' State License Law.). (_ 1 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: - LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/18/10 Owner: DESERT CHEYENNE, INC. 78401 HIGHWAY 111, A ti AWA LA QUINTA, CA 9225IDL (760)777-9920Lr�J u Contractor. F E 8 i 2um HERINGTON DEVELOP NC, 40960 CALIFORNIA O RD, MURRIETA, 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 matritairi 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 Cole, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy -number are: Carrier STATE FUND Policy Number I certify that, in the perfor nce of the work for which this permit.is issued, I shall not employ any persortany manner so become subject to the workers' compensation laws of California, and agreethat, if I should ma subject to the workers' compensation provisions of Section 3700 of:the Labor Code, I jail forthwith comply with those provisions. Dat . / �i Applicant: - WARNING: FAILURE TO SECURE WORKE S' COMPENSATIONCOVERAGE IS UNLAWFUL, AND SHALL SUBJECT AWEMPLOY.ER TO CRIMINAL P ALTIES AND CIVIL FINES UP TO ONE 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 applicatiom,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 forany'.act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued wa.resutt of this applic 'on bicomes null and void if work is not commenced within 180 days from date of issuance AsNh itirmit, or r cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and statethat t a ,information is correct. Iagree,to comply. with all city and county ordinances and `state -laws relating to bui_ in onstruction, and hereby authorize representatives of this cou t enter upon the above-mentioned propert f inspection purposes. Date �0 Signature (Applicant or Agent): _ d v Application Number . . . . . 10-00000121 Permit . . WALL/FENCE PERMIT Additional desc . . Permit Fee 54.00 Plan Check Fee .00 Issue Date Valuation . . . . 2900 Expiration Date 8/17/10 Qty Unit Charge Pet Extension BASE FEE 45.00 1.00 9.0000 THOU BLDG 2,001-25,000 9.00 -------- - Special Notes and ----- - Comments 116 LN FT X 6 FT HT ORCO STANDARD_ BLOCK WALL PER APPROVED PLANS. --------------------------------- Other Fees . - ---- - . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due ----------------- Permit Fee Total ---------- ----------- --------- ----------- 54.00 .00 .00 -- --Permit 54.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.0.0 Grand Total 55.00 .00 .00 .55.00 LQPExMrr �. rola rA M 1N .araa..AO '411 Ls. 'd . 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Zip: (,% 4,4 � CLQ 972 5 3 Contraetor,.x .J � Q �7E�,✓ v Telephone: ` � l Address;)C PrcjectDescription: X City..ST.Zip:-<- /%�GCiZt�.� 14 C1q' pZ5 G. /oaf sale// [ il�fic/ GJ..411 Telephone: x aZ 94C77;/ fC!ty State Lic. tl : K 7S Q Lic. #: Arch_. Engr.. Designer G+ J�•a% / l a�- .�e?C�.,�w,,�;s., T�� r,� AddM39: Ciry. ST. Zip: Cel hone ;- «;:' �!y„"' „ Construction Tvpe: p «ale Gam! cp H.�4'..�� g::>r >.'r :... lj' Occupanc}': State Lic. #: s: ' `' . `•" -, Project we leirck oncl; Nen' Add`n. Alter Repair Demo Name of Contact,Petson: Sq" Ft.: i.'Z 7 It Stories: a Units:. Telephone # of Contact Person: Estimated Valde ofPcoject: X Jr' 71 1 APPLICANT: DO NOT WRITE. BELOW THIS LINE M - Submittal Rcq'd Reed TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Revic-ed.,ready for correetlons Plan Check Deposit Truss Cales Called Contact Person Plan Check Balance Tide 24 Calcs. Plans picked up Construction Flood plain plan Plana resubmitted Mech9nical Grading plan 2" Review;.ready for eorreetidnsAssoc Electrical SubcontaetorList Called Contact Person Plumbing , Grant Deed Plana picked up 5.i►1.1. 1LOA. Appravgl Plans resubmitted Grading IN HOUSE.- Review. ready for correctionslissue Developer Impact F'cc Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permiClssue E School few Total Permit Fees - 10/10 'd 'ON VE Wb 65 11 AHI 0103-81-M