07-2148 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO"
LA QUINTA, CALIFORNIA 92253
Application. Number: 0 -7=00002148 -
Property
7=00002148`Property Address: 576 85` ROSEWOOD ' CT
APN: 762-240-011-7 -32279 -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 2550
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION '
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of .the Business and Professionals Code, and my License is in full force and effect.
License
�jCl sus}: B License No.: 641–�—
ate: D V ntracto,:
OWNER -BUILDER DECLARATION -
Thereby 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 - I
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 Contractors 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).:
( _,) 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.).
(_ 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 whobuilds or improves thereon, and who contracts for theprojectswith a contractor(s)-licensed - - -
pursuant to the Contractors' State License Law.). -
(_ I 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:
LQPERAt[T
Owner:
STANDARD PACIFIC
15326 ALTON PKWY
IRVINE, CA 92618
(949)789-1600
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (160) 777-7153
Date: 7/23/07
COACHELLA VLY
Contractor: Yk
-. �STANDARD PACIFIC CO//1717 E VISTA CHINO MB #303
PALM SPRINGS, CA 9 l R
(760)669-6200 N�� 1 (7Zo®�
Lic. No.: 641.665 CA�'
OF A n _
-
-------------------------- - - -- ——-- - - - -—
WORKER'S COMPENSATION DECLARATION
1 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
ssued.
' 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 SEA BRIGHT INS I Policy Number BB1070237
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner as become q bject to the workers' compensation laws of California,
nd agree that, if I s ould bec a su ct to the workers' compensation provisions of Section
Q1 �(1 700 of the Lab r ode, I s rt h those provisions.
ate:U CV Applicant:
WARNING: AILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS 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 behalfthis 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 actor 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.nulland 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%.the aboy�%+a�rmation is correct. I agree to comply with all
city and county, ordinances and state laws relating to build'r� rud ion, a hereby authorize representatives
of this ty So/e�](n1�t,er upon the above-mentioned: pr y far inspecti n p os
te:�J( 1/7 Si ature (Applicant or Agent):
Application Number 07-00002148
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
45.0.0
- 1.00 9..0000 THOU BLDG
2',.001-25,000
9.00
------------------------------ --------------------------------------------
Special Notes and. Comments
102,E F.61 GARDEN WALL,-PROTO"II
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.