06-3023 (TT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application . Number: 06-00003623
Property Address: 78365 HERITAGE WY
APN: 643-170-999-1 -31348 -
Application description: TEMPORARY TRAILER
Property Zoning: LOW DENSITY RESIDENT -IAL
Application valuation:, 550
Applicant: Architect or Engineer:
CENSED CONTRACTOR'S DE1aa TION
WNJf/, _ N
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
1 hereby affirm under penalty of,pe ry't I em l
icensed'yl" ns of Chapter9 (r ommencjng;wlth
Section 7000)'of 4ivision 3' oft Businas and m_ y License to in full,foroe and; effect.
License.Class: B, No.: 588920
Date . If3 W . Contra or:
OECLARATION
I hataf►y,affirm under penaltyof perjury that Contractor's State License taw for the
following reason.(Sec. 7031.5, Business,and onsCe: Any city or county that'requireseipermttto
construct, alter, improve, demolish, or repair a 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'sState
License LaW4Chapter 9 (commencing with Section 7000) of: Division 3 o the Business and Professions Code) or
that.he or she is exempt 'theretrom and the bans for the alleged exam [on. Any violation of Section 7031.5 by
any epplicem for a permit:subjectsthe appl"icam to a cW penatty of not more than ftve.hundred dollars (s500)c:
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 ownerof property who builds -or Improves thereon,
and who:does the work himself or herself through his or her own.employees,,provided thot the
improvements -are not intended oroffered for sale. If, however, the building or improvemenVis sold within
one year _of completion, the owner -builder will have the burden of proving that he or;she,djd'notbuild or
improve for the purpose;of'sals.►:
(_ 1 I, as'owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
70", Business.arid'Professions Code: The Contractors''State License.Law doss.not apply--.to-an owner of
property who builds or improves thereon, and':whocontracts for the projects with is contractor(s) licensed
pursuant to the Contractors' State Ucense; Law.).
(_ 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 permitis. issued (Sec. 3097, Civ. C:1.
Lender's Name: .
Lender's Address:
LQPERMIT
Owner:
PH RANCH LLC
78370 HIGHWAY 111 STE 200
LA QUINTA CA 92253
Contractor:
ASARO BUILDERS,. INC.
42220 GREEN WAY,H
PALM DESERT, CA 92211
(760) 776:=0043
Lie.. No,.: 588920
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/18/06
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,parmit 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 perrnitis issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATS FUND Policy Number2900 420506'
I certify that, in the performance:of the work for whi this, rmit is issued, I shalrnot employ any
person in anv manner so-as'to beceme.subject to w erre"compensarion laws of California.
and agree
3700 oft
Date: I O� App
SUBJECT AN EMPLOYER_T1kCRIMINAL P ALTIES
DOLLARS ($100,000). IN ADDrrION TO E COST
SECTION 3705 OF THE LABOR CODE, INrEREST, AI
to the: ' compensation provisions of Section
%Wly ' those provisions.
i IS, UNLAWFUL, .AND SHALL
0 ONE HUNDRED THOUSAND
DAMAGES AS PROVIDED FOR, IN
APeUCANTACKNOWLEDGEMENT
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 behalfthis application is made, eachperson 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 Quints, its officers,.egerrts.end employees for any act:oromission related t the work being
performed under orfollowing issuance of this permit.
2. Any'permit'Issued asa result of this application mes null and void, if ww_ s not commenced
within 180 days from date of issuance of per or cess of wo for 180 days:will subject
permit to cancellation.
1 certify that, have reed this application and to t he above imor "o is cc a I agree to comply with all
city and county ordinances and state laws r a'to ilding construction, rid y authorize representatives
of this c rpK to emeruponthe above me pro rty for inspection, seDate: (J _ Signature (Applicant
!.oL
Agentl:
Application Number . . . . . 06-00003023
Permit . .
. TEMP .TRAILER
/ MOBILE HOME
Additional desc .
Permit Fee . . .
. 200.00
P1an.Check.Fee
.00
Issue Date . .
.
Valuation
. . .
. 550
Expiration Date
2/14/07
Qty Unit Charge
Per
Extension
BASE
FEE
200.00
Fee summary
Charged
Paid Credited
Due.
Permit Fee Total
200.00
.00
::00
200_.00
Plan Check Total
.00
.00
.00
.00.
Grand Total
2'00.00
.00
.00
200.00
I
LQ
Bin #
17
City of La Quinta
Building a Safety. Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (.760) 777-70'12 `
Building Permit Application and Tracking Sheet
Permit 9
7 i 1
-
Project Address: Owner's Name: Ta U -C
A. P. Number: Address: 4(ozol,�1n I-,qQ ��T
�1'kU
Legal Description: _ City, ST, Zip; LA CA-
Contractolr: 5 Telephone7i�- 77 - ���
Address:Pjjr��oject Description:
City, ST, Zip: W ►r."�l l r7� f7Jk1 IZ:L>>
Telephone:.
State Lic. # :
City Lic. #: i /17
Arch., Engr., Designer 6-
Address:
City, ST, Zip:
Telephone: Construction Type: Occupancy:
State1ic. #: Project type (circle one): New Ad'd'n - Alter Repair Demo
Name of Contact Person: 'Sq. Ft.: # Stories: # Units:
Teiephone #' of Contact Person: Estimated Value -of Project:
APPLICANT: DO NOT WMTE. BELOW THIS LINE
it J
Submittal
Req'd
Recd
TRACIMG
PERMIT FEES
Plan Sets
Plan Checksubmitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposlt
ISvss Calcs.
Called Contact Person
Plan Check Balance
Energy Galts.
,Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for eorrectiousftsue.
Electrical
Subcontactor ListCalled
Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
'Plana resubmitted
Grading
IN ROUSE:-
'"' Review, ready for correcdons/issue
Developer Impact Fee
Planning Approval
Called,Contact Person
A.I.P.P.
Pub. Wks:Appr
Date of permit issue
School.Fees
Total Permit Fees