08-1694 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO.
LA QUINTA, CALIFORNIA 92253
Application Number:
08-0`0001694
Property Address:
81699 CHARISMATIC WY
APN:
767-200-999-54 -312021.-
Applicati6n description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
4750
Applicant: Architect or Engineer:
VI "
I hereby affirm under penalty of pe
Saction,7000) of Division 3 of the
rector:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-70.12.
FAX (760) 777-70.1.1
INSPECTIONS (760) 777-7153
Owner:
DESERT. ELITE, INC.
78401 HIGHWAY 111; .SUITE'G
LA QUINTA, CA 92253
(760)777-9920
Contractor:"
HERINGTON DEVELOP INC, JAMES Oi~
40960 CALIFORNIA OAKS RD, #.283 D
MURRIETA, C.A 925,62
(:951)677-8415
Lie. No.: 753190
Date: 10/10/08
w u
e.CT 13 2008
SED CONTRACTOR'S.DECLARATION WORKER'S COMPENSATION DECLARATION
IhD ns d.under provisions of Chapter 9 (commencing.with I hereby affirm under penalty of perjury one of the following declarations:
professionals Code, -and my License is in full force and effect. _ I have:and will maintain a certificate of consent.to self4nsure for workers' compensation, as provided
License No.: 753190 for by Section 3700 of the Labor Code, for the, performance of the work for which this permit is
Issued.
/t I have .and will maintain workers' compensation insurance, as required by Section 3700 of the.. Labor
T Code, for the performance of the work, for which this: permit, is issued. My workers' compensation
ER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that Ia emptfrom the Contractor's State License Law for the
insurance carrier and poi'r number are:
Carrier STATE FUND -Policy Number- 1542746-2007
following reason (Sec. 7031.5, Business and Pr fe ions Code: Any city or county, that requires a permit to
_ 1 certify that, in the 'perfor
of1he work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, orrepair any structure, prior to its issuance,.also requires�the applicant.for the
person in any manner so
be -dome subject to the workers' compensation laws of California,
permit to file a. signed statement that. he or she is licensed pursuant to the.provisions of the Contractor's State
and_agree that,.if I shoul
me subject to the.workers' compensation provisions of Section
License Law (Chapter'9 (commencing. with Section 7000) of Division 3 of the, Business and Professions Code) or
3760 of the Labor Code,
all forthwith comply with those provisions.
that he orshe 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 (8500).:
(_) 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 roan 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 'w_ ill 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 does not apply to an owner of
property who builds or improves thereon; and who: contracts for the projectswitha contractor(s) licensed -
.pursuant to the Contractors' State License Law.):
1 _ 1 I amaxempt under Sec. , B.&P.C. for this reason
bate:
Owner:
CONSTRUCTION LENDING, AGENCY
1"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: Ci).
.Lender's.Name:
Lender's Address: k
LQPERMIT
WARNING: FAI RE TO:SECURE'1NORK S' COMPENSATION COVERAGE IS UNLAWFUL, ANO SHALL
SUBJECT AN EINPLOYER TO CRIMINA NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS'18100,000). IN ADDITION TO HE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3708 OF THE LABOR CODE, INTERESTi AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Buifdingsand Safety for. 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 Le Quinta, its officers, agents.and employees for any act.or'omission related to the: work being
performed under or following issuance oPthis•permit.
2. Any permit issued as a result of-this,appli ti i becomes null and void'if work is not commenced
within 180 days from date of issuance o u i permit, or cessation of workdor 180 days will subject
permit to. cancellation,
I certify that I have read this application and state�that ibove information is correct: 1 agree to comply with all
cityand county ordinances and state laws:relating to 11 i ig construction, and hereby authorize representatives
Of this county to enter upon the above-mentioned pr -' or inspection purposes.
Det.,aZ a Si ure (Applicant or Agent):
Application Number . . . . . 08-0.0001694
Permit . . . WALL/FENCE.PERMIT
Additional desc . .
Permit Fee . . 72.00
Plan Check Fee
00
Issue Date . . . .
Valuation
4750
Expiration Date . . 4/08/09
Qty Unit Charge Per
Extension
BASE
FEE
45.00
3.00 9.0000 THOU BLDG
2,001-25,0.00
27.00
------------------------- -
Special Notes and Comments
-
190 L.F. 6 ' GARDEN WALL.,
Oe—C-0. Y-, k
Fee summary Charged
Paid Credited
Due
Permit Fee Total 72.00
00 .00
72.00
Plan Check Total .00
,:00 :00
.00
Grand Total 72.00
.00 .00
72.00
LQPERMff
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