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05-3926 (BLCK)P.O. BOX 1504 . 78-495 CALLE TAMPICO . , LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: 05=00003926 523'5TWH3RLAWAY TR 767-200-999-46 7312021- WALL/FENCE LOW DENSITY RESIDENTIAL 7875. Architect or Eng BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LIC SED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury tfiat m licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busin ss d Professionals Code, and my License is in full force and effect. License Clask BV License No.: 153190 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury hat I am exempt from the Contractor's State License Law for the following reason (Sec. 703 1.5, Busines 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, 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 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.). 1 1 I am exempt under Sec. , BAP.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: I� �I�► LQPERMIT :VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/08/0'5 Owner: DESERT ELITEINC. 78401 HIGHWAY 111, SUITE G LA QUINTA, ,CA 92253 (760)777-9920 Contractor: HERINGTON DEVELOPMENT, JAMES 4 40960 CALIFORNIA OAKS RD, #283 MURRIETA, CA 92562 (951)677-8415 Lic. No.: 753190 ------------------------------------ - ------- ------- WORKER'S COMPENSATION DECLARATION 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 3700ofthe 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 P icy Number 1542746 I certify that, in the performan of a work for which this permit is issued, I shall not employ any person in any manner so a o ome subject to the workers' compensation laws of California, and agree that, if I should o subject to the workers' compensation provisions of Section ��0 of the Labor Code, s a forthwith comply with those provisions. a6te: f �� icant WARNING: FAILURE TO SECURE WORKELT'ES COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION T 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 application becomes null and void if work is not commenced - within 180 days from date of issuance of s ch permit,or cessation of work for .180 days will subject- " permit to cancellation. _ r I certify that I have read this application and state that e a ve information is correct. I agree to comply with all City and county ordinances and s to laws relating to b di construction, and hereby authorize representatives of this coupfy tp enter upon above-mentioned pro y or inspection purposes. Application Number. . . . 05-00003926 Permit . . WALL/FENCE PERMIT Additional desc . Permit Fee99.00 Plan Check Fee .00 Issue Date Valuation 7875 Expiration Date-. 3/07/06 Qty Unit Charge Per Extension BASE FEE 45.00 6.00 9..0000 THOU BLDG 2;001-25,000 54.00, Special Notes and Comments 315 L.F. 6- GARDEN WALL, CITY STANDARD Fee summary Charged Paid Credited Due Permit Fee Total 99.00 .00 .00 99.00 Plan Check Total .00 .00 .00 .00 Grand Total 99.00 .00 .00 99.00 LQPERMIT ..