07-2146 (BLCK).P.O._-BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92.253
Application Number.
X07_00002146
Property Address:
57625—ROSEWOOD CT
APN:'
762-240-011-5 ' -32279"-
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
2550
Applicant: Architect or Engineer:
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
Contractor:
STANDARD PACIFIC CORP '
1717 E VISTA CHINO A7 PM 303
PALM SPRINGS, CA 92262
(760)669-6200 l7
L i C . No.: 6 416 6 5RYA( O�: LA QU,6;a
7/23/07..
' LICENSED CONTRACTOR'S DECLARATION
- WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Ihereby affirm under penalty -of perjury one of the following declarations: _
Section 7000) of Division 3 of the Business and Professionals Code, and my :ci
ense s in full force and effect. -
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
'. License Cla s: Licepse No.: 6 665
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
ate: C ractor: L
issued.
I have and will maintain workers'' compensation insurance, as required by Section 3700 of the Labor
kECLARATION
Code, for the performance of the work for which this permit is issued. My workers' compensation
- - OWNER -BUILDER
insurance carrier and policy number are: ..
-1 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 so a o 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 sho b esubjggct o the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
700 of the Labor C , s a h I ith those provisions.
- that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
p, _
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred' dollars ($500).::cant:
(_ 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
WARNIN F I RTo ECURE WORKERS' COMPENSATION C RAGE 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 ($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 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
7644, 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. , 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
Date:. Owner:
CONSTRUCTION LENDING AGENCY
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:��W
LQPERMIT
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 th is co r act. I agree to comply with all
city and county ordinances and state laws relating riding con ion, an uthorize representatives
of this cou yto e�{n/.i/�e�r upon'the above-mentioned pro a for inspe ion p S.
D ./V [r.� Sig ure (Applicant or Agent):
Application Number . . . 07-00002146•
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"
Fee summary '. Charged
Paid Credited
Due
Permit Fee Total 54.00
.00
.00
54.00
P1an.Check Total .00
.00
.00
.00
Grand'Total 54.00
.00
.00"
54."0.0
LQPERMIT
.