06-2916 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
06-00002916
Property Address:
81840 CONTENTO
APN:
767-200-011-2 -318742-
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
2525
Applicant:
moc
LICENSED
I hereby affir�j under,(�enalty of perjury that I am lice
Section 70001 of Di7flsion 3 of the Business and Prol
License la r
Date: ractor
Tit!t44Q"
Architect or Engineer:
PIA
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
TAYLOR WOODROW HOMES, INC
15 CUSHING
IRVINE, CA 92618
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 77.7-7153
Contractor:
TAYLOR WOODROW HOMES INC
16745 W. BERNARDOft
0
SAN DIEGO, CA 921(949)341-1200
Lic. No.: 352047A�� 3 p 2006
Date: 8/07/06
1_�Rlv Or
Cl ECLARATION I WORKER'S COM ENS CLARATION
is of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Vy 1GEense is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
2047 for by Section 3700 of the Labor Code for the performance of the work for which this permit is
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 703,1.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).:
1 _ 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 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 _ 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 contractors) licensed
pursuant to the Contractors' State License Law.).
I 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: l
Lender's Address: !�
LQPERMIT
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 A765D283614056
I certify that, in the performance of the wor for is this permit is issued, I shall not employ any
person 'n any manner so as to become bje to t e workers' compensation laws of California,
and a ee that, if I should me subj t t the or rs' mpensation provisions of Section
370 the Labor C all forth ith o vi 0 provisions.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIOVWVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLQYER 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 work is t ommenced
within 180 days from date of issuance of such permit, or cessation of work fo 18 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information is co ect. agr to cam with all
city and coun o nces and state laws relating to building construction, and reb au rize epr ntatives
of this c tr upon the above-mentioned property pection pu p es.
i
te: Si ure (Applicant or Agent):
Application Number . . . 06-00002916
Permit . .
. WALL/FENCE PERMIT
Additional desc .
Permit Fee . .
54.00
Plan Check
Fee
.00
Issue Date . . .
.
Valuation
. . .
. 2525
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
----------------------------------------------------------------------------
Spe.cial Notes and
Comments
101 L.F. 6' GARDEN
WALL, PROTO II
SYSTEM
Fee summary
-----------------
Charged
----------
Paid
Credited
Due
P�rmit Fee Total
----------
54.00
----------
.00 —.00
----------
54.00
Plan Check Total
.00
.00
.00
.00
Grand -Total
54.00
.00
.00
54.00
LQPERMIT