06-4185 (BLCK)P.O. BOX 1504
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
06-00004185
Property Address:
81867 RANCHO SANTANA DR
APN:
767-200•-999-24 -312023.-
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
4375
c&ht 4 4 Q" _-
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
ICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury t t I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busine and Professionals Code, and my License is in full force and effect.
License Clas B License No.: 753190
ate C Contractor:
t1
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury t at 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 _ 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 does not apply to an owner of
property who builds or improves thereon, and who contracts for -the projects with a contractor(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.1.
Lender's Name:
Lender's Address:
I.QPERA1IT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/04/06
Owner:
DESERT ELITE INC.
78401 HIGHWAY 111, SUITE G
LA QUINTA, CA 92253
(760)777-9920
Contractor:
HERINGTON DEVELOPMENT, JAMES O
40960 CALIFORNIA OAKS RD, #283
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 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.
�L�I have and will maintain workers' compensation insurance, as required by Section 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 STATE FUND Policy Number 1542746-2006
I certify that, in the perfor ance of the work for which this permit is issued, I shall not employ any
person in any manner s s to become subject to the workers' compensation laws of California,
Znd agree that, if I sho become subject to the workers' compensation provisions of Section
0 of the Labor Cod shall forthwith comply with those provisions.
te� �� pplicant:
WARNING: FAILURE TO SECURE WO ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 15100,0001. 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 this application, -
- the owner, and theapplicant, each agrees to; and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission 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 )buildi
rmit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that 1 have read this application and state tha information is correct. I agree to comply with all
city and county ordinances and state laws relating toonstruction,,and hereby authorize representatives
of this c un to ter upon he above-mentioned prnspection purposes.
D e� G (� � nature (Applicant or Agent):
Application Number . . . . . 0-6-00004185
Permit WALL/FENCE PERMIT
Additional desc
Permit Fee . . . . 72.00.
Plan Check
Fee
..00
Issue Date . . . .
Valuation
. . .
. 4375
Expiration Date .6/02/07
Qty Unit Charge Per
Extension
BASE
FEE
45.00
3.00 9.0000 THOU BLDG
2,001-25,000
27.00
----------------------------------------------------------
Special Notes and Comments
7 ----
7 -------------
175 L.F. 61 GARDEN WALL AT SIDE AND
REAR PL, ORCO SYSTEM
Fee summary Charged
-----------------
Paid
Credited
Due
---------- ----------
Permit Fee Total 7.2.00
----------
.00
-
.00
--------
72.00
Plan Check Total .00
..00
.00
.00
Grand.Total 72.00
.00
.00
72.00
LQPERAI[T
.03.,4375
.Sladden Engine'erihg .....................
679Sa'nton Ave.,- Suite A 39-725 Garan&Ln., Suite G 114 S. California Ave. 15438 Cholane Road
Buena Park, CA 90621 Palm Desert, CA 92211 Beaumont,,.CA 92223 Victorville, CA 92392
(714) 523-0952 - .(760),,772-3893. - (951) 845-7743 760-962-1868
Fax (714) 523-1369 Fax (760) 772-3895 Fax (951) 845-8863 Fax 760-962-1878
Date
FIELD MEMO Job, No. -Z 306
,.Project Name Client:
Site Address 7 ---e Vk &,-)-I
Job Phone
Work Done
0 b-
5-e v L..---�-
.Test Summary Footings Inspected
Comments
24 hour notice requested to schedulefield Technician., Thank.you for the opportunity to -be of service.
ER1 Mki Na
MWAW.�
EM INS Mw- mm�
Comments
24 hour notice requested to schedulefield Technician., Thank.you for the opportunity to -be of service.