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07-0077 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 07-000.00077 Owner: Property Address: 81815 THOROUGHBRED TR. DESERT ELITE, INC. APN: .767-200-999-21 -3120247 78401 HIGHWAY 111, SUITE G Application description: WALL/FENCE. LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL (760) 777-9920 Application valuation: 3375 Applicant: Architect or Engineer: -------------------------------- CENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjuryt I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busin and Professionals Code; and my License is in full force and effect. License CI s: License No.: 753190 Date l tS / 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 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).: (_) 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.). (_) 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.). ' 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 Contractor: HERINGTON DEVELOPM 40960 CALIFORNIA O MURRIETA, CA 92562 (951)677-8415 Lic. No.: 753190 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760).777-7153 Date: 1/09/07 AMES r� - #283 JAN 17 2007 CITY OF IA ----------------------------------------------- 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 anj policy number are: Carrier STATE FUND Policy Number 1542746-2006 1 certify that, in the pert ma a of the work for which this permit is issued, I shall not employ any person in any manner o become subject to the workers' compensation laws of California, and agree that, if I sho come subject to the workers' compensation provisions of Section X700 of the Labor Co all forthwith comply with those provisions. WARNING: FAILURE TO SECURE WORK. RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION 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 under or following issuance of this permit. 2. Any permit issued as a result of this applif ution becomes null and void if work is not commenced within 180 days from date of issuance och permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state thJ*construction, nformation is correct. I agree to comply with all city and county ordinances and state laws relating to and hereby authorize representatives of th*outy to teZature above-mentioned prpection purposes. ate• Applicant or Agent): Application Number . . . . 07-00000077. Permit . . . WALL/FENCE PERMIT Additional desc -. Permit Fee . . 63.00 Plan Check Fee .00 Issue Date. Valuation 3375. Expiration Date 7/08/07 Qty Unit Charge Per Extension BASE FEE 45..00 2.00 9.0000 THOU BLDG 2,001-25,000 18.00 ---------------------------------------- - - - - ----------------------------•---------------------------- Special Notes and Comments Spe - - - - --- - - - - - - - - - - - - - - - - - 7.7 - - - - - 7-- 135 L.F. 6' GARDEN WALL AT SIDEYARD, ORCO 'SYSTEM Fee summary Charged Paid Credited Due . Permit Fee Total 63.00 .00 .00 63.00 Plan Check Total .00 .00 .00 .00 Grand Total 63.00 :00 .00 63.00 i LQPERMIT