BLCK (07-2013)Y
P.O. BOX 1504
78-495 CALLE TAMPICO '
LA QUINTA, CALIFORNIA, 92253
Application Number: �07aR000020 3
Property Address: .61736 MESA CT
APN: 764-280-999-66 -300237-
Application description: WALL/FENCE
Property Zoning: MEDIUM rHIGH DENSITY RES
Application valuation: I . 2375 '
14
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/10/07
r r Owner: D
$HEA LA QUINTA a
C/O JEFF MCQUEEN
P. 8800-N GAINEY CENTER 35 JULy'
SCOTTSDALE, AZ 85258 U 1 6 2007
ciry OF LA QuiNr
Contractor: FINANC A
SHED, HOMES, INC. E 0EPr
LQPERMIT
60800 TRILOGY PARKWAY
LA QUINTA, CA 92253 i
(760)777-6005
Lic. No.: 672285
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:
..ition 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
s Cla s: El LicenseNo.: 672285
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
t ontracto . V V -
issued.
I have and will maintain workers' compensation insurance, as required bySection3700 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 AMERICAN HOME Policy Number '1247619
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, atter, 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 _
and agree that, if I s ould 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
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
)01
3700 of the Labo de, all foi
comp with those provisions.
,
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: -
te.
- plicant: `
(._ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, ande
_ the structure is not intended or offered for sale (Sec. 7044, Business and Professions Coder The
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS 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 TO ONE HUNDRED THOUSAND
- and who does the work himself or herself through his or her own employees, provided that the
DOLLARS 1$100,0001. 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, 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 _ 1 I am exempt under Sec. BAP.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.
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 county
co nt
ordinances and state laws relating o uildin construct' n, and hereby authorize representatives
to enter upon the above-mentione prp perty ut5pe i ur oses.
�
Lender's Name:
t
� nature (Applicant or Agent)'
' Lender's Address: r J
LQPERMIT
Application Number . . . . . 07-00002013
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee . . 54.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 2375
Expiration Date 1/06/08
Qty Unit Charge Per
Extension
BASE FEE
45.00
1.00 9.0000 THOU BLDG 2,001-25,000
9.00
--------.-------------------------
Special Notes and Comments
--
------------
95 L.F 61 -GARDEN WALL, ORCO SYSTEM
Fee summary Charged Paid
Credited
Due
Permit Fee Total 54.00
.00
.00
54.00
Plan Check. Total .00
.00
.00
00
Grand Total 54.00
.00
.00..
54.00
LQPERMIT