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07-2680 (BLCK) IIIIIIIIVIIIIIIILIIIIII 72 P.O. BOX 1504 IE �^I. VOICE(760) 777-7012 4 78-4t)5 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING &SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 10/03/07 Application Number: 07-00002680 Owner: Property Address: 81623 ANDALUSIA CORAL .OPTION I APN: 764-200-999-54 -316813- 79295 RANCHO LA QUINTA DR Application description: WALL/FENCE LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 3975 Contractor: D Applicant: Architect or Engineer: TD DESERT DEVELOPMENT L P 0 BOX 1716 LA QUINTA, CA 92247 OCT 10 2007 (760)771-1941 Lic. No. : 762987 CITY OF LA QUINTA FINANCE DEPT. 07P ----------------- ------- -- ---- - --- - -- ----------- -- - -- -- - ----- -- -- - - - -- -- -- - -- - ----- --- - - -- ----- -- 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 Business 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 Cla B License No.: 2987 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ate: ntractor: �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 Licens Law for the Carrier COMPWEST Policy Number CA005001482003 following reason(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to _ I 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 a1_�/'agree that,if I should became subject to the workers'compensation provisions of Section License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or 3700 of the Labor Code, a I forth ' t comply with those provisions. 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).: Date © Ap ' nt: (_) 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 WARNING: FAILURE TO SECURE ERS'COMPENSATION COVERAGE IS U LAWFUL,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 TO ONE HU 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 P VIDED 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, (_) 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 commPnred 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 and co my finances and state taws relating to but' � <tion,and hereby authorize representatives of s co t, enter upon th above-mentione pr6 erty for inspectia purposes. Lender's Name: Da nature(Applicant o Agent): Lender's Address: II LQPERMIT Application Number 07-00002680 Permit WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 63 .00 Plan Check Fee .00 Issue Date . . . . Valuation . . . 3975 Expiration Date 3/31%08 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 159 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