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09-1137 (BLCK)P.O. BOX 1504_ 78-495 CALLE TAMPICO LA QUINTA„CALIFORNIA 92253. Application Number:�z09- o00-113,7JJ Property Address: 52285 SILVER STAR TR APN: 767-630-015- - Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 2050 Applicant: 25.1k- 1 - I hereby affirm under penalty of perjury thA Section 7000) of Division 3 of the Busines License Cla§s: JB Contractor: Architect or Engineer: 44 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - SED CONTRACTOR'S DECLARATION i licensed under provisions of Chapter 9 (commencing with Professionals Code, and my License is in full force and effect. License No.: 753190 WNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I a xempt 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 _ 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 anowner 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: LQPERAIIT Owner: DESERT CHEYENNE, INC. 78401 HIGHWAY 111, SUITE G LA QUINTA, CA 92253 (760)777-9920 Contractor: HERINGTON DEVELOP INC, J 40960 CALIFORNIA OAKS RD MURRIETA, CA 92562 (951)677-8415 Lic. No.: 753190 VOICE (760) 777-7012 FAX (760) 777-7011. INSPECTIONS (760) 777-7153 Date: 10/28/09 o QCT- 2 9 209 3cITy0F LA QI.IIr11TA Flip"�^F .apt �'. ----------------------------------------------— 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 performanc of the work for which this permit is issued. My workers' compensation insurance carrier and poli ber are: Carrier STATE .FUND Policy Number 1542746-2009 certify that, in the performan f the work for which this permit is issued, I shall not employ any person in any manner so as ecome subject to the workers' compensation laws of California, and agree that, if I should be a subject to the workers' compensation provisions of Section 3700 of the Labor Code, I sh forthwith comply with those provisions. WARNING: FAILURE TO SECURE WORKERS' �MPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENPI TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 0100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. P 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 th permit. 2. Any permit issued as a result of this applicat becomes null and void if work is not commenced within 180 days from date of issuance Ignstruction, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state thrmation is correct. I agree to comply with all city and county ordinances and state laws relating to and hereby authorize representatives of this coun y to ter upon the above-mentioned prtion purposes. �.Date"N 1 i ] 1 Signatu a (Applicant or Agent): Application Number . - . . . 09'00001137 -Permit - - . - WALL/FENCE PERMIT Additional desc . Permit Fee 54.00 Plan Check Fee .00 Issue Date Valuation 2050 _ Expiration Date 4/26/10 Qty Unit Charge Per Extension BASE FEE 45.00 1'.00 :' 9.0000 THOU BLDG..2,001-25,000 9.00 l-------------------------------------------=--------=----------------------- Special Notes and Comments 82 LN FT X 6 FT HT ORCO STANDARD BLOCK _....._..__..._-- ... _... WALLS PER APPROVED PLAN. Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473) --------------- 1.00 Fee summary ChargedPaid Credited Due Permit Fee Total 54.00 .00 .00 54.00 Plan Check Total .00 .00 .00 .00 Other Fee. Total -1.06 .00 00 1.00 " Grand Total 55.00 .00 .00 55.00 . LQPERAIIT x Bin.. CEt�r of La Quina '�" Buitding 8L �afeE ©ivlstoa Perm9�Ce dam84` plco , La Qul ap CA 42253 s ��60� 777-70t,2 Buiidinu g;Permit Yom's, rF Ppitort and TFacCang Sheet aF3; r Project.dlddness: Owner''s.Name: y A. P_Number: 7% 7— .:2666 LeWDescription 1 SE �t city,.Tr, LU ^� M Contractor:; .. 14 vH s D //�� Telephone '] Address `�v P%jectiscription+ +w City; ST,Zip: ' 9,2 dre%/ly J Telephone:9s� - I C5 state Lic. #: % 5 1 9 d Ci 7o78p1, ty Lic. Arch., Engr., Designer. Address: City, ST, Zip: Telephone: " Construction Type: Occu an State Lic. #: p cY• Project type (circle one): New , Add'n Alter Repair Deme Name of Contact Person: Sq. FL: j 1' #Stories: # Units: Telephone # of+Contact Person: Estimated Value ofProj APPLICANT: DO NOT WRITE BELOW THIS UNE. # Submittal Req'd Recd TRACKING' m4r FEES Plan Sets s Plait Check submitted. . =' Item Amount _ Structural Calcs. Reviewed, ready for corrections .Plan Check Deposit . Truss Calcs. ; Called Contact -person 'Plan, Check Balance s {. a Energy Calcs. Plum pickedup y Construction: Ffood plain. plan Flans resubmitted - Mechanicar Grading plan Z'•Revier► ready for corrections/fssue EledrfcaE SubeontaetorList Calledr.CoatactPersoa x PT ib<Fz, { GrantD'eed' Elanss "cfcedtup4 S:11LL 1O1A1 Approoat- P11111s•resubmittetf ?� Grading' IK HOIISE:— Review, ready for correctionstissue • Developer Impact Fee ` Plsumf4gApprova[ CalledContactPerson� A.LP.F Pn6_Wks.Appr Date of permit issue Schoof Fees 4. 71 R ! L •' t , � �- '7•: �otaYYe[nrlt:llelS -.r .,,�- r �'�) -«r'£ }� yam,+ F t^ "`•eY�,}f Sri.; 1 iN'�".f t art' � St � ` — �dt'ln+.uF . 'uhf j • Z - f "Y` r - '_ •l'b� i ar' y.. m � ?�rc �'!as-�� '.uxK.