07-2002 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number.-�07-00002002
Property Address:
551-k9—SAI;IDA DEL SOL
APN:
762-240-014-46 -34243
Application description:.
WALL/FENCE
Property Zoning:
RL AG/EQ OVERLAY
Application valuation:
1691
Tit!t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
I
_.-------------------------------------- - - - - -- -- - - -
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty,of: perjury that) am licensed under provisions of Chapter 9.(commencing with
Section470001.of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
Licen's-e' Class: B License Nol63187
i .
.. ate. %/ / % 6 1� ntractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 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 asigned statement that she or she is licensed pursuant to the provisions of the.Contractor's State
License Law -(Chapter 9 (ciimmencing`with Section 70001 of Divisio
d n 3 of the Business and Professions Code) or
that he or she is exempt therefrom. and -the-basis for the allegeexemption. •Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five.huhdred dollars ($500).:
(_ 1 1, 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 whodoes,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 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 aconstruction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.I.
Lender's Name:
Lender's Address: r]
LQPERMIT
Owner:
MADISON 58TH LA QUINTA,
1282 PACIFIC OAKS PLACE
ESCONDIDO, CA 92029
LLC
Contractor:
INNOVATIVE COMMUNITES, INC.
200 E. WASHINGTON AVE,, STE#
ESCONDIDO, CA 92025
(76.0)839-8238
Lic. No.: 763187
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/10/07
M
WORKER'S COMPENSATION DECLARATION ..
I hereby affirm under: penalty of: perjury one of the following declarations: r
I have and will maintain a certificate of consent to self -insure for workers%compensation, as provided
for by Section3700 of the.Labor Code, for theperformance of,the work for which this permit is
` Tissued.
I have and will maintain workers'compensation -insurance,. as requved'by Section,3700 of thii Labor
Code,. for theperformanceof the work for which this permit is issued.' My workers', compensation
insurance carrier and policy number are: -
Carrier STATE FUND . Policy Number 756000304
I certify that, 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 the Labor Code, shall forthwith comply with ose provisions.
ate>" o picant \
WARNING: FAILURE TO+SECU .WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE.HUNDRED THOUSAND
DOLLARS ($100,000). • IN ADDITIONTO 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 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
/of/thus c7ounI to/ePter upon the above-mentioned property for inspection purposes.
Date: / % % / 0 �' nature (Applicant or Agent):
Application Number . . . . . 07-00002002
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 2.0000 HND BLDG
501-2,000
24.00
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Special Notes and Comments
69 LF 3=4' RETAINING WALL & 69 LF"6'
HIGH WROUGHT IRON FENCE.
Fee summary Charged
Paid
Credited
Due
----------------- ---------- ----------
Permit Fee Total 39.00
----------
.00
-7
.00
--------
39.00
Plan Check Total .00
.00
.00
.00
Grand Total 39.00
.00
.00
39.00
LQPERMIT