05-4419 (TT)P.O.. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
05-00004419
48925 EISENHOWER DR
658-130-013- -
TEMPORARY TRAILER
LOW DENSITY RESIDENTIAI
2000
Architect or
ro,,55 We! � S L MAJ 7,1!WW
M=
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
�)Ir-v
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I here.by'affirm under penalty of`perjury that I am licensed under provisions of Chapter'9 (commencing with
Section 7666) of Division 3 of the Business and Professionals Code, and my License is lwfull force and effect.
License Class: A -B / Li o : 825943
0ete: � O �f+hactor: � .� '
OWNERBIII
DER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's StateLicense Law for the
following reason (See. 7031.5, Business'and Professions Code: Any city or county that requires a permit to
construct, after, 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.Contrecior's State
License Law (Chapter g (commencing with Section 7000) of Division 3 of the Business and Professions.Code) or
that he or sheds exempt rtherefrom 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 I, as owner of the property, or my employees with wages," their. sole.compensation, will do.the work, and
the structure is not intended or offered for sale Mac. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds.orimproves thereon,
and who does the work himself or herself through his ocher own employees, provided that,the
improvements are not intended or offered focsale. 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 purpose of sale.).
(_ ► 1, 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; end who contracts for the projectswith s contractor(s) licensed
pursuant to.the Contractors' State License Law.).
(_) 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 permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
t:QF RMT
VOICE (760) 777-7012
FAX (766) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/30/05
Owner:
CENTEX DESTINATION PROPERTIES
41865 BOARDWALK, STE. 101
PALM DESERT, CA 92211
Contractor:
CENTEX HOMES
1123 AURARIA PARKWAY, STE 400
DENVER, CO 80204
(720)279-6600
LiC. No.: 825943
-------------------
WORKER'S COMPENSATION DECLARATION
I Hereby affirm underpenalty of perjury one of the following declarations:
_ 1 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:
LL I haye.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 cariier.and policy number are:
Carrier ZURICH AMER INS Policy Number _WC832209708
I certify that, in the performance ofithe work for which this permit is issued; I shall not employ any
person in any manner so as to becomwsubject'to the workers' compensation laws of California,
and agree that, ifTshould become subject to the:workers' compensation provisions of Section
700'of the r' Codj,ysMel fort 'tit co
' w h so provisions.
ate: ffiDOS
pplicant:
'G
WARNING: FAILURE TO SECUREwORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN.ADDIT.ION TO THE 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 fora 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 requesbend'for
whose benefit work is'performed under or pursuant to any permk iesued as a result of this application,
the owner, and the appl"roant, each agrees to, and shall defend, indemnity and hold harmless the. City
of La Ouinta, 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 18o days from date of issuance of such permit„or cessation of workfor 180 days will subject
permit to cancellation..
I certify that I have read this application and state that the above Information incorrect. I agree to comply with all
city and county ordinances and state laws relating to building construction,' and hereby authorize representatives
/-'his cou to nter upon the above-mentioned property�prwre actio urpo
e: "nature (Applicant or'Agant): `
r
LQPPMT
Application Number
Permit. . . .
Additional desc .
Permit Fee . . . .
Issue Date
Expiration Date .
05-0000441-9
TEMP TRAILER / MOBILE HOME
200.00 Plan Check Fee . .
Valuation . . . .
3/2.9/06
.00-
2000
Qty Unit Charge Per
Extension
BASE
FEE
200.00
----------- ----.
Special Notes and Comments
---------
TEMPORARY CONSTRUCTION TRAILER;
PER MUP
# 2005-670
Fee summary Charged
Paid
Credited
Due
Permit Fee Total 200.00
.00
.00
2.00.00
Plan Check Total .00
.00
.00
.00
Grand.Total 200.00
.00
.00
200.00
Bin #
City of La Quinta
Building at Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253' - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
LX
Project. Address: ner'sNam e: CEw It)C uC`s�'INa►TIowJ f SLOP
A. P. Number: Address: ' �(� AS0A-"/n/M.I . SulTt 10 /
Legal Description: City, ST, Zip: PkLm bt�T C 14 IT 2 21 /
,Contractor: 0_� tx -�, QHS Telephone: 1�p0
=Address: ft7-rL vq_L 5 )D) Project Description:
City, ST, Zip: �tl� ins'$ Z Z_g 1
Telephone:
State Lie. # : City Lie.-#: �� t +�
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: Construction Type: Occupancy:
State Lie. #: Project type (circle one): New Add'n Alter Repair Demo
—7 Name of Contact Person: bmzAru,t W G� 1' Sq. Ft.: # Stori : #Units:
Telephone# of Contact Person: - stimated Value of.Project: �, z>=16
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
'truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calm
Plans,bicked up
Construction
Flood plain plan
Plansresubmitted
Mechanical
Grading plan
2"d'Review, ready for correctionsfissue
Electrical
5ubcoutactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''",Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total:Permit Fees