05-3921 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05-00003921
Property Address: 52281 WHIRLAWAY TR
APN:' 767-20.0-999-44 -312021-
Application description: WALL/FENCE
Property Zoning: LOW. DENSITY RESIDENTIAL.
Application valuation: 4500
• u�l'�tiGv
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
DESERT ELITE, INC.
78401HIGHWAY 111, -SUITE -G,
LA.QUINTA, CA 92253
(760)777-9920
Contractor:
Applicant: Architect or Enginee ' ��' V� HERINGTON DEVELOPMENT, JAMES O
40960CALIFORNIA OAKS RD, #283
MURRIETA, CA 92562
(951) 677-8415
Aj q Lic. No.: 753190
LICE SED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury th I licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: .
Section 7000) of Division 3 of the Busines a Professionals Code, and my License is in full force and effect._ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Cla License No.: 753190 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. '
ate: A ontractor. 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State license Law for the Carrier STATE FUND Policy Number 1542746
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the perform nc of the work for which this permit is issued, I shall not employ any '
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so s become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State - anl agree'that, if I should b ome subject to the workers' compensation provisions of Section
-
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 00 of the abor Code, all forthwith comply with those provisions. -
_ 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).: ate: Applicant: -
(_ 11, as owner of the property, or my employees with wages as their sole compensation, will do the work, and oo
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WOR RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law�does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL ENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the - DOLLARS (5100,000): IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
..improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
one year of completion, the owner -builder will have the burden of proving that he or she did not build or r
improve for the purpose of sale.). APPLICANT ACKNOWLEDGEMENT ,
(_ ). 1, as owner of the property, am exclusively contracting with licensed- contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the -
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
- property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person'at whose request.and for
pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuantto any permit issued as a result of this application, -
(_) I am exempt under Sec. ,'B.&P.C. for this reason 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 foranyact or omission related to the work being
performed under or following issuance of this permit.
Date: - Owner: 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 lbuildic
or cessation of work for 180 days will subject
• CONSTRUCTION LENDING AGENCY. permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency<forthe performance of the I certify.that I have read this application and state thrmation is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ: C:). city and county o finances and state laws relating touction, and hereby authorize representatives
ofthi cou t enter upon above-mentioned prtion purposes.
Lender's Name: '
- Date: / g ignature (Applicant or Agent):
Lender's -Address:
VOICE (760) 777-7012
FAX (760) 777-.7011
INSPECTIONS (760) 777-7153
Date: 9/08/05
LQPERM.IT
J
Application Number 05-00003921
Permit . ... WALL/FENCE'PERMIT
"
Additional desc .
Permit Fee . . . `72.00 Plan Check
Fee
.00
Issue Date, Valuation
.
. 4500
Expiration'Date 3/07/06
Qty Unit' Charge Per
Extension
BASE 'FEE
45.00
3.00 9..0000 THOU BLDG 2,001-25,000
27.00
Special Notes and Comments
1801L.F. 6' GARDEN WALL, CITY STANDARD
Fee summary.. Charged Paid Credited
Due
Permit Fee Total 72.00 .00
.00
72..00
Plan Check.Total .00 .00
.00
.00
Grand Total 72.00 .00.
.00
72.00
. LQPERMIT -
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