07-2007 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
07-00002007 •y
57599 SALIDA.DEL SOL
762-240-014-51 -34243
WALL/FENCE
RL AG/EQ OVERLAY
1691 .. I.
Architect or Engineer:
. . :ib I_A_
PC
.4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MADISON 58TH LA QUINTA,
1282 PACIFIC OAKS PLACE
ESCONDIDO, CA 92029
Contractor: ' ,
INNOVATIVE COMMUNITES,
200 E. WASHINGTON AVE,
ESCONDIDO, CA 92025
(760)839-8238
Lit. No.: 763187
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/10/07
LLC
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: 11
LQPERMIT
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 of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I 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 hereby authorize representatives
offtthjs�aunty to enter upon the above-mentioned property for inspection purposes.
atD e: Z�g�re (Applicant or Agent): ,
LICENSED CONTRACTOR'S,DECLARATION'
- - WORKER'SCOMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of thefollowing declarations:
Section 7000) of Division 3 of the Business and Professionals Code,'and my License is in full force and :effect.
e
_ I have and will maintain a certificate of consent'to self -insure for workers -compensation, as provided
License Class:' B r. License' o.:' 763187 _
sfor by Section 3700 of the Labor Code, for the performance of the.work for which this permit iso' -
ate: M7L. i C ractor. - - -•
issued.^
1 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
' OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perj ,11-t I am exempt from the Contractor's State License Law for the
Carrier STATE FUND Policy Number 756000304
following reason (Seca 7031.5, Business and Professions Code: Any city or county that requires a permit to -
_ I certify that; in the performance of the work for which this permit is'issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become 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 1 should become 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
3700 of the Labor Code, I.shah forthwith comply with those. provisions.
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 nat.more than five hundred dollars ($500).:
(_ 1 1, as'owner of the property, or my employees with wages as their 'sale compensation, will do the work, and
the.structure is not intended or offered for sale (Sec. 7044, Business and Professions. Code: TheWARNING:
FAILURE TO'SE E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
"Contractors' State License Law does not'apply to an owner of property.who'builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL' PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
, .and who does the work himself or -herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however,:the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST,.AND ATTORNEY'S FEES. '
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.). -
APPLICANT ACKNOWLEDGEMENT
(_ 1 1, as owner of the property, am exclusively contracting withlicensed contractors to construct the project (Sec.
_
IMPORTANT Application is hereby made to the Director of. Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors: State License.Law does not apply to an owner of
conditions and restrictions set forth on this application. '
. property.who-builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person at whose request and,for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application, ,
(_ I I am exempt under Sec. , B.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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: 11
LQPERMIT
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 of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I 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 hereby authorize representatives
offtthjs�aunty to enter upon the above-mentioned property for inspection purposes.
atD e: Z�g�re (Applicant or Agent): ,
J
Application Number . . . . . 07-00002007
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 39.00
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 1691
Expiration -Date.. 1/06/08
Qty Unit Charge Per
Extension
BASE
FEE
15.00
•. 12.00 2.0.000 HND BLDG
501-2,0.00
24.00
--------------
SpeCial Notes and Comments
----
- 69 LE:'311&1 .RETAINING WALL .& 69 LF
6'
HIGH WROUGHT°IRON FENCE.
Fee summary Charged •
'Paid
Credited
Due
$----------------------- 777-. -------
----- - - - - ---
---- - - - - --
Permit 'Fee .Total' 39.00
.00 .00
z Plan Check Total 0,0
00- .:00
00
Grand Total - 39.0'0
.•00 00
39.'00
LQPERMIT