10-0993 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 10-00000993
Property Address: 46686 BRADSHAW TR
APN: 643-170-999-63 -31348 -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 779
to - M, Pit - W11 q r,
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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UCmDivisionusiness
ON CTOR'S DECLARATION
I hereby affirm under penalty of perjury that I un r provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business asi nals ode, and my License is in full force and effect.
Licen ss: B is se No.: 814468
� Y
ate: � Contr or.
R-BUILDER DE RATION
I hereby affirm under penalty of perjury that I pt from the ntractor's State icense Law for the
following reason (Sec. 7031.5, Business and ns Code: A y city or county th t requires a permit to
construct, alter, improve, demolish, or repair ture, prior t its issuance, also quires the applicant for the
permit to file a signed statement that he or shsed pursuan o the provisi of the Contractor's State
License Law (Chapter 9 (commencing with S00) of Division usiness 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 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 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, and who contracts for the projects with a contractor(s) licensed '..
pursuant to the Contractors' State License 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 permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address: /001
Owner:
GLOBAL INVESTMENTS
3470 WILSHIRE BLVD. #1020
LOS ANGELES, CA 90010
Contractor:
FD CONSTRUCTION
73081 FRED WARING DRIVE
PALM DESERT, CA 92260
(760)776-8300
Lic. No.: 814468
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/23/10
l � r
-
•—— ———————————— ————— ——— —— — — —— ---C—, rc.;r'rw�P—�...
WORKER'S COMPENSATION D LARATIO `� .
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 which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier GRANITE STATE Policy Number WC003957781
_ I certify that, in the performance of the work for which ermit is issued, I shall not employ any
person in any manner so to ecome subject to e w kers' compensation laws of California,
and agree that, if I shout b ome subj to t wor rs' compensation provisions of Section
_3700ofthe Labor C hall fo hw ply w' those provisions.
/Date .. �TO.EaCURE
nt:
WARNING: FAIL WORKERS' COMPENS TION COV �I FUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND L FINES UP ONE HUND THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMP , 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 such perm' cessatio ork for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that th ov nformation is rrect. I agree to comply with all
city and county ordinances and state laws relating to b 'ding nstructio nd he by uth resentativas
of his coun o er n the above -mentioned pro arty for'nspecti S.
D€eb�, nature (Applicant or Agent):
LQPERMIT
Application Number . . . . . 10-00000993
Permit . .
. WALL/FENCE PERMIT
Additional desc .
.
Permit Fee . . .
. 21.00
Plan Check
Fee
.00
Issue Date . . .
.
Valuation
. . .
. 779
Expiration Date .
. 3/22/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
3.00 2.0000 HND BLDG 501-2,000
6.00
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Special Notes and
Comments
TOTAL OF 36 L.F. 5' GARDEN WALL TO
CREATE COURTYARD,
CITY STANDARD. 2007
CODES.
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Other Fees . . .
. . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary
-----------------
Charged Paid
Credited
Due
Permit Fee Total
--------------------
21.00
----------
.00
----------
.00
21.00
Plan Check Total
.00
.00
.00
.00
Other Fee Total
1.00
.00
.00
1.00
Grand Total
22.00
.00
.00
22.00
LQPERMIT