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BLCK (06-3762)A4L P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: �_ 06-00003762 Property Address: 81103 MONARCHOS CIR APN: 767-320-999-266 -32879 - Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 5975 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: MCCOMIC GRIFFIN LLC 7979 IVANHOE AVE #550 LA JOLLA, CA 92037 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/23/06 Contractor: D Zx " Applicant: Architect or Engineer: TRANS WEST HOUSIN - NC. 9968 HIBERT STREE , TE U#,rV 2 2 5 2UU6 SAN DIEGO, CA 9211 (858)653-3003 CITY OF LA QUINTA Lic. No.: 701039 FINANCE DEPT. ------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION 1 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 Busine s and Professionals 96de, 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 .Cl s: B Li ense No.: 701039 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is / `' issued. ractor: y �' 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 OWI' R -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of peri t t I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1648813-2006 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 and agree that, if I should become subject a workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 00 of the Labor Co I shall forthwi s ply 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).: at2: is pplicant: (_ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and 00, the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECUREVO KERS' 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 CRI AL 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 ($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.). (_ 1 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.). 1 _ 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: I,QPERAIIT 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 ahy 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 permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that t above informatioKisrrect. I agree to comply with all f an county ordinances and state laws relating[o buil ing construction, eby authorize representatives ft county tonterupon t above-mentioned propert or inspection. nature (Applicant or Agent): Application Number . . . . . 06-00003762 Permit . . . . . WALL/FENCE PERMIT Additional desc . . Permit Fee . . . . 81.00 Plan Check Fee 00 Issue Date Valuation . . . . 5975 Expiration Date 4/21/07 Qty Unit Charge Per Extension BASE FEE 45.00 4.00 9.0000 THOU BLDG 2,001-25,000 36.00 -----------------------------7-----------------------------7---------------- Special Notes and Comments 239 L.F. 6' GARDEN WALL AT REAR & SIDE YARDS, ORCO SYSTEM Fee summary Charged Paid Credited Due Permit Fee Total 81.00 .00 .00 81.00 Plan Check Total .00 .00 .00 .00 Grand Total 81.00 .00 .00 81.00 LQPERn7IT