06-2922 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: \06-0000292i
Property Address: 81757 CONTENTO
APN: 767-2007011-8 -318742-
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 4100
Ti,ht 4 4 a"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
TAYLOR WOODROW HOMES, INC
15 CUSHING
IRVINE, CA 92618
Contractor:
Applicant: Architect or Engineer: TAYLOR WOODROW HOMES INC
16745 W. BERNARDO DR, STE
SART. DIEGO, CA 92127
(949)341-1200
Lic. No.: 352047
1
LICENSED CONT. TO DE LARATION
I hereby affirm under p ally of perjury that I am licensed un er pr visi s of Ch er 9 (commencing with
Section 7000),6f Div' ion 3 of the Busines nd Profession s Co e, a y �Cse is in full force and effect.
V.
License Cla s B Lic s o.: 3 47
ate tractor
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 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 site. 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 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: 8/07/06
k D
AUG 3 0::006
CITY AF i A QUINTA
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 performanceof 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 LIBERTY MUTUAL Policy Number WA7 D283614056
I c rtify t t, in the performance of the work for which t s ermit is issued, I shall not employ any
�agree
in any manner so as to become subj to th rkers' compensation laws of California,
athat, if I should ome subjec o thew ers' tom ensati provisions of Section
�of the abor Co, shall forthwi comp) ith those ov' s.
ate: plicant:
WA NING - FAILU E TO SECURE WORKERS' COMPENSATION COVERE UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). 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 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 gcorct.
n t commenced
within 80 days from date of issuance of such permit, or cesr 80 days will subject
per ' to cancellation.
I certify tha ehfre read is application and state that the above informatiree to comply with all
city and udin ce and state laws relating to buildin struction,ori a repre atives
of th' n on tbeabove-mentioned prop or mspectip p/
(Applicant or Agent):
Application Number . . . . . 06-000.02922
Permit . .
. WALL/FENCE PERMIT
Additional desc .
Permit Fee . . .
. 72.00
Plan Check
Fee
00
Issue Date . . .
.
Valuation
. . .
. 4100
Expiration Date
2/03/07
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
3.00 9.0000
THOU BLDG
2,001-25,000
27.00
---------------------------------------------------------------------=------
Special Notes and
Comments
164 L.F. 61.GARDEN
WALL, PROTO II
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
N
LQPERMIT