07-2427 (TT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 07-00002427
Property Address: 80750 AVENUE 58
APN: 762-240-014-A -34243
Application description: TEMPORARY TRAILER
Property Zoning: RL AG/EQ OVERLAY
Application valuation: 0
Ta!t °f 4Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer: /
731L. Sc4A t7"
-----------------------
LICENSED CO
I hereby affirm under penalty of perjury that I am ens
Section 7000) of Division 3 of the Business and o
License Class: B
Date: /�i " Lr 0� ✓Contractor. ,
I'S DECLARATION
visions of Chapter 9 (commencing with
, and my License is in full force and effect.
No.: 763187
OWNr-BUILDER DECLARATION
I hereby affirm under penalty of perjury th am exe t from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Busines and Professio s 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 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 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.).
(_) 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 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:
LQPERIMIT
Owner:
MADISON 58TH
1282 PACIFIC
ESCONDIDO, CA
LA QUINTA,
OAKS PLACE
92029
Contractor:
INNOVATIVE COMMUNITIE;
200 E. WASHINGTON AVE
ESCONDIDO, CA 92025
(760).839-8238
Lic. No.: 763187
owe
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/26/07
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 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 whictlws permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Num r 56-0000304-07
_ I certify that, in the performance of the wo f r whic this permit is issued, I shall not employ any
person in any manner so as tolbecoe u ct to t e workers' compensation laws of California,
and agree tha Id becobj ct o the orkers' compensation provisions of Section
3700 of the r Code, 1 s aw h omp with those provisions.
Date: Ia•3t-67 Applicant:
WARNING: FAILURE TO SECURE WOR ER MPEN TION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL AL IES AN CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO HE COST OF OMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, EREST, 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 Quints, 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 ak'ws not commenced
within 180 days from date of issuance of such permit, or cesr 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above infor dgree to comply with all
city and county ordinances and state laws relating to buildin construc n,orize representatives
9f this county to enter upon the above -mentioned pro yfor ' pecti p
Date: /O••Zi��gnature (Applicant or Agent):
Application Number . . . . 07-00002427
Permit . . . . . .
TEMP TRAILER / MOBILE HOME
Additional desc . .
PASA TIEMPO SALES TRAILER
Permit Fee . . . .
200.00 Plan Check
Fee
.00
Issue Date . . . .
Valuation
0
Expiration Date . .
4/23/08
Qty Unit Charge
Per
Extension
----------------------------------------------------------------------------
BASE FEE
200.00
Permit . .
PATIO COVER PERMIT
Additional desc . .
TRELLIS @ SALES TRAILER
Permit Fee . . . .
54.00 Plan Check
Fee
35.10
Issue Date . . . .
Valuation
2873
Expiration Date . .
4/23/08
Qty Unit Charge
Per
Extension
BASE FEE
45.00
1.00 9.0000
THOU BLDG 2,001-25,000
9.00
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Special Notes and Comments
24x60ft TEMPORARY SALES
TRAILER W/
6X36FT TRELLIS."PASA
TIEMPO" SALES
OFFICE.2001 CBC [MUP
#2007-9551
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . ACCESSIBILITY PLAN REVIEW
2.80
HOURLY PLAN CHECK
455.00
STRONG MOTION (SMI)
- COM
.60
Fee summary Charged Paid Credited
-----------------
Due
----------
Permit Fee Total
--------------------
254.00 .00
----------
.00
254.00
Plan Check Total
35.10 .00
.00
35.10
Other Fee Total
458.40 .00
.00
458.40
Grand Total
747.50 .00
.00
747.50
LQPERMIT