07-2161 (BLCK)oww"'7-
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number. 07-00002161
Property Address: 57750 ROSEWOOD CT
APN: 762-240-011-22 -32279 -
Application description: WALL/FENCE
Property Zoninq: LOW DENSITY RESIDENTIAL
Application valuation: 4500
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
STANDARD PACIFIC COACHELLA VLY
15326 ALTON PKWY
IRVINE, CA 92618
(949)789-1600
Date: 7/24/07
Contractor: \ { I I
Applicant: Architect or Engineer: STANDARD PACIFIC CORP
1717 E VISTA CHINO A7 PM 03 J
PALM SPRINGS, CA 92262 r� �¢it± 0)2U�1 1
(760)669-6200 UU Ul7
Lic. No-- 6416651,A CIW i3F L61l�mI��
FIKIANCR 0 rPT
LICENSED CONTRACTOR'S. DECLARATION WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury that I am licensed.un r 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 Busines ession 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 Class: Lice se No.' 665 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
�J ssued.
ate: .I% tractor: IC 1 have and will maintain workers' compensation insurance, as required by Section'3700 of the Labor
i Code, for the performance of the work for which this permit is issued. My workers' compensation
OW R -BUILDER D insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am empt 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 tm
performance f 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 anner so as to be me 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 t he workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3 00 of the Lor C de, o wi hose provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by _1
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: e: V U/ pplicant:
(_ 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 WARNING: F (LURE TO SECURE WORKERS' COMPENSATION CO E NLAWFUL, 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.).
(_ 1 I, as owner of the property, am exclusively contractingwithlicensed 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 con[ractor(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.).
Lenders Name:
Lender's Address: -
LQPERMIT
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permitsubjectto 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.
I certify that I have read this application tate-tAa formation is correct. I agree to comply with all
city and county ordinances and state laws to bud g constr 'o nd ereby out representatives'
of this ccgun y to a ter'upon the above-mentioned pro y sp cIi ur
D�Ce: v atute (Applicant or Agent):
. Application Number. . . . . 07-00.002161
Permit ° . ... . . . WALL/FENCE PERMIT
"
Additional desc
Permit Fee 72.00
Plan Check
Fee.00
Issue Date-
Valuation
. .
4500
Expiration Date,1/20/08
Qty Unit Charge Per
Extension
BASE FEE
45.00 ,
3..00 9.000.0 THOU BLDG 2,0,01-25,00027,p0''
Special Notes .and Comments
180 L.F. 6' GARDEN.WALL, PROTO SYSTEM
Fee summary Charged Paid
Credited
Due
Permit Fee Total 72.00
.00
.00
72.00'
Plan Check Total .00
.00
.00
.00
Grand Total 72.00
.00
.00
72.00
LQPERMIT _ ..
...
..