06-2918 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
01
4 -le
Ve
06-00 002918 %
81808 CONTENTO
767-200-011-4 -318742-
WALL/FENCE
LOW DENSITY RESIDENTIAL
2775
LICENSED
I hereby affirm and r penalty of perjury that I am IiCE
Section W001 of ivision 3 of the Business�nd Prof
Contractor:
Tityl
�W
VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/07/06
Owner:
TAYLOR WOODROW HOMES, INC
15 CUSHING
IRVINE, CA 92618
Architect or Engineer:
0IA-
----------------------
DECLARATION
ons of hapter (commencing with
y icense i 9 s in full force and effect.
2047
OWNER-BUI LDER J�ECLARATION
I hereby affirm under penalty of perjury that I am exempt from the'Contractor's State License Law for the
following reason ISec. 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 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
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.).
(_ I 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
I 1 1 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.1.
Lender's Name:
Lender's Address:
LQPERMIT
Contractor:
TAYLOR WOODROW HOMINC e
16745 W'. BERNARDO
SAN DIEGO, CA 9')12
(949)341-1200 AUG �O'�oos
Lic. No.: 352047 U
CITY OF LA AUINTA
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 performance of the work for which this permit is
issued.
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 p rmit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier LIBERTY MUTUAL Policy Num r 7 5D283614056
I certify that, in the performance of the work f -hi th' permit is issued, I shall not employ any
pZ
in any manner so as to become sub ct to he orkers' compensation laws of California,
aree that, if I should me suh�ec o th w kers' comp anon provisions of Section
J-3 bf the Labor C I shall forth co with thos isions.
WA ING:[FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SU JECT 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 and void if w is not commenced
within 180 days from date of issuance of such permit, or cessation of w for 180 days will subject
permit to cancellation.
WIhave d his application and state that the above informationi torr t I agr e t o ply with all
es and state laws relating to building con truction, a d he aut riz sentatives
on the above-mentioned property nspectio p pos
ignature (Applicant or Agentl:
Application Number . . . . . 06-00002918
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 54.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 2775
Expiration Date 2/03/07
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
111 L.F. 6' 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