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07-2004 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 0_7700'0"0'20'0.4�-7--3. Property Address: 57671 SALIDA DEL SOL APN: 762-240-014-48 -34243 - Application description: WALL/FENCE Property Zoning: RL-AG/EQ OVERLAY Application valuation: 1691 "`&t!t 4 4 Q" Applicant: Architect or Engineer BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION .1 hi reby affirm under penalty ofperjury that I am licensed under provisions of Chapter 9 (commencing with . Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class:- I3` '• License No.: 763187 wate. tractor: .. Oz OWNER-BUILDER DECLARATION I hereby,affirm under penalty of perjury that I am exempt frd"m-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 anyatructure,.prior to'itsissuance; also requires the applicant.for the permitao,file a signed statement that he or she is'licensed pursuant to the provisions of the Contractor's State _License Law IChapter,9 (commencing with Section.7000) of Division3 of the Business and Professions,Code) or o6t he or she is exempt therefrom and the basis for the alleged' axemption. Any violation of Section' 7031.5 by ' any applicant for a permit subjects the applicant to a•civil penalty of notmore than five hundred dollars ($500).: (_ I I, as owner of the,property, or, my employees witfi wages as their sole compensation, will do the work, and the structure is hot intended or offered for sale (Sec. 7044, Business and Professions Coder 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, asowner 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 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 Owner: MADISON 58TH LA QUINTA, LLC 1282 PACIFIC OAKS PLACE ESCONDIDO, CA 92029 Contractor: INNOVATIVE COMMUNITES; INC.' 200 E. WASHINGTON'AVE, ST_E_#1 ESCONDIDO, CA 92025 (760)839-8238 Lic. No.: 763187 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 sio Date: 7/10/07 IJUL 17 2007 L FEM CE DEPT WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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 /1 .issued.' I have and will maintain'workers' compensation insurance,.as required by Section 3700 of the Labor. 7- Code, for -the performance of the work for whichthis-permit is issued. My workers' "compensation insurance carrier and policy number are: ' Carrier STATE. FUND', . 'Policy;Number ' 756000304 I certifythat,' 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 the workers' compensation provisions of Section 3700 of theLabor Code, I shall forthwith.comply with those provisions. ate: _ Plicant: WARNING: FAILURE TO SEC, 'WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES:UP TO ONE HUNDRED THOUSAND DOLLARS 15100,000). INADDITION 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 the applicant, 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 funder 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 ' of this y to enter upon the above-mentioned property for inspection purposes. at r/ C ,gnature (Applicant or Agen[��� e-]�� _ Application Number 07-00002004 Permit . . . WALL/FENCE PERMIT . Additional desc . . Permit.Fee -39.00 Plan Check Fee .00• Issue Date . . . . Valuation 1691 Expiration Date 1/06/0.8 Qty 'Unit Charge Per Extension BASE FEE 15.00 12.00 2.0000 HND BLDG 501=2,000 24.00 -------------------- 7t --------------------- Notes• and --Comments = Not-es . ------------------------------- ---------------------------------- 69 : LF 3:4� RETAINING 'WALL & 69 LF 6' HIGH WROUGHT IRON FENCE. �- ' Fee ,.summary ' Charged'_ Paid ". Credited . _ .. Due., ------------------- _ _ 'Permit Fee Total. 39.00 .0-0-, '.00 39..00 - Plan Check Total:. 00 00 :00 00 Grand'. Total 3'9.00 .00 .00 39.00 LQPERMIT '