07-2145 (BLCK)P.O. BOX 1504.
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
0.7_-000021_45 -.
Property Address:
5595 -ROSEWOOD CT
APN:
762-240-01174 -32279 -
Application description:
WALL/FENCE -
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
2550
Applicant: Architect or Engineer:
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT,
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date
Owner:
'STANDARD PACIFIC COACHELLA VLY
15326 ALTON PKWY
IRVINE CA 92618
(949)789-1600
On : = J�q1,
3
Contractor: S
STANDARD PACIFI , RP A�' �+ 1, U
2007
7/23/07
act omission
1717 E VISTA CHINO
A7 PM �#303-
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PALM.. CA
Y
9 11"),; LA iTA
(760)669-6200
F!P!/a;LCEr7Mw%
Pr
Lic. No.: 641666
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 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 Cl ss: B
License No.: 641665
`
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
gate: D ntractor:
"-
`, issued.
f� 1 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-BUILIUR 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 SEA BRIGHT INS Policy Number BB1070237
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 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 thatif I ould bec me 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 th abor :l ose 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 ($5001.: .
ate: Applicant: -
• 1 _ 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: AILURE TO SECURE RKERS' NSATION VERAGE 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$100,000). 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, 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 improver -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
f L O' ff' d I f related to the work bein
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: -
r
LQPEPAIIT
o a . uinta, its o ;cers, agents an emp ogees or any or ;ssio 9
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 the bove 'nf atiomirca t. I agree to comply with all
city and county ordinances and state laws relating to bur in n truc on, nd hereby thorize representatives
of this co ty t /enn�ter upon the above-mentioned pr rti es; w. ses. -
ate: re (Applicant or Agent):
r
Application Number. .. . . . 07-00002145
Permit WALL/FENCE PERMIT•
Additional desc
Permit Fee 54.00 Plan Check Fee .00
Issue Date Valuation, . . .2550
Expiration Date 1/19/08
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
102 L.F 6' GARDEN WALL, PROTO II SYSTEM