05-3917 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
�05-00003917
Property Address:
52-290--WHIRLAWAY TR
APN:
767 -200=999 -41 -312021 -
Application description: WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:.
4500
Applicant:
JO
Architect or Engineer:
r
PIA
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
`6
U D CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that icensed under provisions of Chapter 9 (commencing with .
Section 7000) of Division 3 of tlie Business rofessionals Code, and my License is in full force and effect.
License CI License No.: '753190
to P' Y J — ntractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury tha m 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 1$500).:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and 10
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 _ I 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.). _ - ' I—) 1 am exempt under Sec. B.&P.C. for this reason
Date: Owner:
t
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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/08/05
Owner:
DESERT ELITE, INC.
78401 HIGHWAY 111, SUITE G
LA QUINTA, CA 92253
(760)-777-9920.
HERINGTON DEVELOPMENT, JAMES O
40960 CALIFORNIA OAKS RD, #283
MURRIETA, CA -92562
(951)677=8415
LiC. No. 753190
------------------
WORKER'S COMPENSATION DECLARATION
1 -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 STATE FUND- PolicyNumber , 1542746
certify that, in the performanc4 o the work for which this permit is issued, I shall not employ any - -
person in any manner so as 4 Vecome subject to the workers' compensation laws of California,
and agree that, if I should b e subject to the workers' compensation provisions of Section
/ 700 of the Labor Code, I s forthwith comply with those provisions.
9 //>pplfcant:
WARNING: FAILURE TO SECURE -WORKS ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL P ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000)` IN ADDITION TO HE 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 on this application.
Each person upon whose. behalf this applicationis made,each person at whose request and for - ---
whose benefit work is performed under or pursuant to any permit issued as a result of thisapplication,
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 actor 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 suc permit, or, cessation'of work for 180 days will subject
permit to cancellation.
I certify that 1 have read this application and state that the o information is correct. I agree to comply with all
city and county ordinances an tate laws relating to buildi struction, and hereby authorize representatives
u y
of this cot enter upo eabove-mentioned property spection purposes.
ate: r/ L -✓ ignature (Applicant or Agent)'
Application Number -05-000.03917
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 21"001-25,000
27.00
-- - - - - - - - - - - - -
Special Notes and Comments
180 L.F. 6' GARDEN.WALL, CI"TY 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 .. ..
-