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06-3213 (BLCK) 1111111 VIII III VIII IIII 45 P.O. BOX 1504 ��� � IE VOICE(760) 777-7012 4 4Q 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING&SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/01/06 Application Number: 06-00003213 Owner: Property Address: 81245 ANDALUSIA CORAL OPTION I APN: 764-200-999-66 -316812- 79295 RANCHO LA QUINTA DR Application description: WALL/FENCE LA QUINTA, CA 92253 Q Property Zoning: LOW DENSITY RESIDENTIAL D Application valuation: 3150 Contractor: SEP 2 rJ 2006 Applicant: Architect or Engineer: TD DESERT DEVELOPMENT L. P P O sox 1716 CITY OF LA QUINTA LA QUTNTTA, CA 92247 FINANCE DEPT. I ^ (760)771-1941 �Jl Lic. No. : 762987 ---- - - ------ --- ----- ---- ------- --- ----------- ----- -- -------------------------- ----- -- - ---- ------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000)of Division 3 of the Busin and Professionals Code,and my License is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided License lass: icen No.: 87 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. at . . om,actor' 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 OWNER-BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier COMPWEST Policy Number CA005001482002 following reason(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to _ 1 certify that,in the performance of the work for which this permit is issued,I shall not employ any construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for the person in any manner so as to become subject to the workers'compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State anSI agree that,if I should becom ubject to the workers'compensation provisions of Section - License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or00 of the Labor Code,I forth ith comply those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by ,116 11 any appticant'for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).: ate plicant: (_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 WARNING: FAIL RE TO SECURE WORKERS'COMPENSATION COVERAGE I UNLAWFUL,AND SHALL Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP T ONE ONE, THOUSAND and who does the work himself or herself through his or her own employees,provided that the DOLLARS($100,000). IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If,however,the building or improvement is sold within SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. 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.). APPLICANT ACKNOWLEDGEMENT 1_1 I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044,Business and Professions Code: The Contractors'State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon,and who contracts for the projects with a contractor(s)licensed 1. Each person upon whose behalf this application is made,each person at whose request and for pursuant to the Contractors'State License Law.), whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_1 I am exempt under Sec. ,B.&P.C.for this reason 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. Date: Owner:' 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 permit,or cessation of work for 180 days will subject CONSTRUCTION LENDING AGENCY permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all work for which this permit is issued(Sec.3097,Civ.C.). city an ounty o finances and state laws relatin w ding nstruction, a1Me eby authorize representatives of ' cc ty t enter up the above-menti d property for i pecY urposes. Lender's Name: ate' ignature(Apptica or A r Lender's Address: LQPERMIT Application Number . . . 06'-00003213 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 63.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 3150 Expiration Date 2/28/07 Qty Unit Charge Per Extension BASE FEE 45.00 2.00 9.0000 THOU BLDG 2,001-25, 000 18.00 ---------------------------------------------------------------------------- Special Notes and Comments 126 L.F. 6' GARDEN WALL, PROTO SYSTEM Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 63.00 .00 .00 63 .00 Plan Check Total .00 .00 .00 .00 Grand Total 63.00 .00 .00 63 .00 LQPERMIT