07-1270 (BLCK)P.O. BOX: 1504
78-495 CALLE. TAMPICO
LA QUINT'A, CALIFORNIA 92253
Application Number. 07-00.00.1270 ,
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Property Address: 783.65 HERITAGE WY
APN: 643-170-999-1 --31348 -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application Valuation: 2750
Tiloyl 4 4 Q”
Applicant: Architect or Engineer:
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LICENSED "CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am.licensed under provisic f'Chapter9 (commencing with
Section 7000) of Division'3 of the Businesfessionals Cade, Wd my License is, in, fullforce and effect.
License lass: C27,C8,C2 Lice ns o:: '849837
ate: Q - C • ctor•
O ILD
CLARA71ON
1 hereby affirm undeepenalty of perjury'that,l am, mprfroontractor's State LicenseLaw for the
following reason (Sec. 7031.5, Business;and Professi s Cocity or -county that requires a permit to
construct, alter, improve, demolish; or repair any-structu s issuance, also requires the, applicant for the
permit to file a signed statement thathe or,she is licensed pursuant to the provisions of the Contractor's*State
License Law (Chapter 9 (commencing withSection 7000),of'Division,3 of the Business:and Professions Code) or
that he or is exempt therefrom and the,basis for the alleged,exemption. Any violation of Section 7031.6; by
any applicant for permit subjects the applicant to a: civil penalty of _not more -then five hundred.dollars:(8500)'.:.
1 _ 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 Cade: The
Contractors' State License Law does not; apply to an ownerof'propertyWho builds or improves
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. It however, the building or improvement is sold within
orwyear-of completion, the owner -builder will have the burden of proving that he orshe did notbuild or
improve for the. purpose of sale.).
(_) I, as owner of the property, am exclusively contracting:with;lie used contractors to construct:the project (Sec.
7044, Business and Professions Coder 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.).
l _7 I am exempt under Sec. 8.&P.C. fort is.reason
Date: Owner:, -_
CONSTRUCTION.LENDING AGENCY
I hereby affirm under penalty of,perjury that thereis-a construction lending agency for the performance ofahe
work for which this permit is issued. (Sec. 3097, Civ. C.).
Lender's Name:.
Lender's Address:
LMRMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS, (760) 777-7153
Date: 4/-25/07
Owner:
PH RANCH LLC
78370 HIGHWAY 111 STE 20.0
LA QUINTA, CA 92253
D •
Contractor:
DESERT CONCEPTS LAND P/MAAFR 30 2007
4-1800 WASHINGTON ST, 05 ^
BERMUDA DUNES, CA 92 01_-
(760):200-9007 CITY OF LA QUINT/
Lic. No.: 849837 FINANCE°DEPT.
WORKER'S COMPENSATION DECLARATION
"I -.hereby affirm, under penalty of perjury one of the.following declarations:,
I have and will maintain a cartificate,of consentto.self4risure.for workers' compensation, as provided
for by Secdom3700' of, the Labor Code, for the,performance.of' the work for which.this,permit is
AIissued.
have and will maintain workers' compensation: insurance, as required by Section.3700 of the Labor
Cade, for the'performanee,of the work for which this permit is issued. Myworkers',compensation
insurance carrier and policy number are:'
Carrier REDWOOD FIRE &. Policy Number W6734284
_- I certify that, in;the performance,of.the work for which°this permit is,issued, I shall not employ any
person in any manner so'as to become_ subject.to the workers"compensation laws of California,
and agree that, if 1 should 4*15-omalftkel to the'vy8\kers' compensation provisions of Section
WARNING: FAILURE TO1ECURE WORS' COMPENSATKjIyArOVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMIN PENALTIES:AND CIV([ S UP TO ONEHUNDRED THOUSAND
DOLLARS (0 100,000). IN ADDITION WO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3708 OF THE -LABOR CODE, INTEREST, AND ATTORNEY'S FEES.-
APPLICANT
EES:
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Directorof Building and Safety for a permit ,subject, o the
conditions and restrictions setforth on this application.
1. Each person upon whose,behalf this application is made, each person at whose requestand for.
whose,benefit work is,performed under or pursuant4o any,permitiissued'as a result of this application,
the owner, rand -the applicant, each agrees id.,and'shall defend,;indemnify�and hold; harmless the City
of Le Quints, its officers;:agent s and employees for any act or omission related to the work being
performed under or following issuance of. this permit.
2. Any permifissued as -a result ofthis application becomes null and void if work is notcommenced
within 180 days from date,of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation_
I certifythatI have read this application and state that ,the 'above Information is correct.. I agree to comply with all
city and county ordinances and state laws relating. ui 'ng f1$trr . ,and hereby_ authorize representatives
of this county to enterupon:the above mentjo_ roperty o inspection:p - ses.
Dag a
(Applicant or A nt):
4e _�1
Application Number . . . . 07-000.01270
Permit . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 54.00 Plan Check Fee .00
Issue Date . . Valuation 2750
Expiration Date . . 10/22/07
Qty Unit Charge Per Extension
BASE FEE 45.00
1.00 9:000.0 THOU BLDG 2,001-25,000 9.00
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Special.Notes and Comments
110 L.F': 6' GARDEN WALL-, CITY STANDARD
Fee summary Charged Paid Credited Due
Permit Fee Total 54.00 .00 .00 54.00
Plan Check Total •.00 .00 .00 .00
Grand .Total 54.00 .00 .00 54.00
LQPERMCr