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DEMO (06-1261)s P.O. BOX 1504 4 • �� 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: (060_0_00.1.2-6.1 Owner: Property Address: 51397 AVENIDA NAVARRO PRICE PAUL APN: 773-103-009-3 -000000- 343 STONEHAM RD Application description: DEMO - COMML/OTHER LA QUINTA, CA 92253 Property Zoning: COVE RESIDENTIAL Application valuation: 0 Contractor: J D Applicant: Architect or Engineer: PEERLESS GOLF, INC P.O. BOX 611 LA QUINTA, CA 92253 (760) 564-3455 �•! (n Lic. No.: 775904 LICENSED C S DECLARATION I hereby affirm under penalty of perjury t a lic sed under provi s of Chaptei e icommencing with Section 7000) ofpivision 3 of the.Bu ' essian P fessionaLS Code m License is irlfull force and effect. — OWNER -BUILDER DECLARATION 1 I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State 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 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 1 _ 1 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 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.). (_) 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 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: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: MAR 2 91006 CITY OF LA QUINTA 3/28/06 WORKER'S COMPENSATION DECLARATION 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 E} EMPT _ Policy Number EXEMPT T I certify that, in the performanc f the work for which this ermit is issued, I shall not employ any person in any manners s to come sub' a workers pensatio ws of California, and p9ree that, if I sh Id'beco esu ' to wor s' compe ation provi ons of Section /.i�i9�fit$e Labor C de, hal ith�om v h thasrl' oroai loris.. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS U FUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HU RED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGESJS 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 permit, or cessation of work for 180 days will subject permit to cancellation. certify that I have read this application an a that he abov rm�correcree to Fomply with all city and unty dina ces and sta law relati to b in onst ctirize repre ntatives of tly�c � upon bove- entione yho pr ilopec�i Application.Number . . 06-00001261 Permit . . . DEMO PERMIT Additional desc . Permit Fee . . . 45.00 Plan Check Fee 00 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/24/06 Qty Unit Charge Per Extension BASE FEE 45.00 ------------------ Special Notes and Comments -- - - DEMOLITION OF SHADE'STRUCTURE(BUILT WITHOUT PERMIT) Q SIDE P/L. Fee summary Charged Paid --------------------------- Credited Due ---------- Permit Fee Total 45.00 ---------- .00 ---------- .00 45.00 Plan Check Total .00 .00 .00 .00 Grand Total 45.00 .00 .00 45.00 Mar 28 06 02:51 p Irene Davis i (760) 564-3475 p.1 P.O. Box 611 La Quinta, CA 92247 Golf,! TEL:760.554.3455 • FAX:760.564.3475 f .Califomia Cowabon E-MAIL: pprce@peerlessgolfinc.com RK Date: 3I29V63 From F r;1,! Price t ' To: Ed Randall Company: City of La Quinta Fax: 777-7112 Phone: 7 -7-7012 Re: One-time only permit authorization 1 pages total including cover sheet This note is to authorize Irene Davis to sign one time only for a permit related to demolition at my La Quinta house. Sincerely, CPU1 ��