07-1251 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: L 07-000012511
Property Address: 78320 CLARKE CT
APN: 643-170-999-24 -31348 -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 2950
T`ht 4 4 Q"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury 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: C27, C8, C29 License No.: 849837
Date: Contractor:
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 ISec. 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 1$500).:
1 _ 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 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.).
(. I, as owner of the property, am exclusively contract? 9,cffl lis sed contractors to construct the project (Sec.
7044, Business and Professions Code: The C tractors' Stat ?cense law does of apply to an owner of
property who builds or improves thereon, an who contracts for proje w' a
contractor(s) licensed
pursuant to the Contractor to ?cense w.l.
1 _ 1 I am exempt under Sec. B. C. f r this reason
Date: wrier:
C I
TRUCTION LENDING AGENY
I hereby affirm under penalty of perjury that there is a construction lending agent fo)th>�erformance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
IIQ-
LQPERMIT
Owner:
PH RANCH LLC
78370 HIGHWAY 111 STE
LA QUINTA, CA 92253
Contractor:
DESERT CONCEPTS LANDS
41800 WASHINGTON ST!
BERMUDA DUNES, CA 9�"
(760)200-9007
Lic. No.: 849837
VOICE (760) 777-7012
FAX (760) 777-7011.
INSPECTIONS (760) 777-7153
Date: 4/24/07
Fu q
APR 3 0 26p
C MAINT '
B - l Ot51*a. _ .
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.
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 R5PWOOD FIRE & Policy Number W6734284
certify that, in the performance of the rk for �he,Tsp'
' sued, I shall not employ any
person in any manners to beco a subject tompensation laws of California,
and agree that, if I s uld be or bject to the nsation provisions of Section
3700 of the Labor ode, I sha fo with complyisions.
WARNING: FAILURE TO SECU E WORKERS' CCftAPENSATION COVER"A E IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CFkMINAL PENALTS AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE C9PT OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTERES7 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 applbed void if work i not tom enced
within 180 days from date ofissuance , or cessat of work r 180 d s will subject
permit to cancellation.I certify that I have read thisapplication a d state thformation is corr t. a re o complywith all
city and county ordinances and state la relating toruction, and hereby t ze representatives
of th?s county to ent r upon the above- entioned prection purposes.
te: • 1% ature (Applicant or Agent):
Application Number . . . . . 07-00001251
Permit . . . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 54.00
Plan Check
Fee
.00 .
Issue Date . . . .
Valuation
2950
Expiration Date 10./21/07
Qty Unit Charge Per
Extension
BASE FEE
45.00
1.00 9.0000 THOU BLDG 2,001-25,000
9.00
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Special Notes and Comments
118 L.F. 6' GARDEN WALL, CITY STANDARD
Fee summary Charged Paid
-------------------------------------
Credited
--------------------
Due
Permit Fee Total 54.00
.00
.00
54.00
Plan Check Total .00
.00
.00
.00
Grand Total 54.00
.00
.00
54.00
LQPERMIT