Loading...
05-0321 (BLCK). (f 1504 4LE TAMPICO CALIFORNIA 92253 BUILDING PERMIT XT'on Number y Address APN: - Application description . . . Property Zoning . . . . . . . Application valuation . . . . BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 05-00000321 Date 1/31/05 81802 COUPLES CT 764-060-047- - -. WALL/FENCE LOW DENSITY RESIDENTIAL 3 72 5 Owner Contractor BIRDIE HOMES 111, LLC FIRST PACIFICA DEV CORP 3.00 EAST STATE STREET STE 100 300 EAST STATE ST, SUITE #100 REDLANDS. CA. 92373 REDLANDS CA 92373 (90.9) 798-3688 WCC: STATE FUND WC_: 0008353-2005 01/01/.06 CSLB: 760044 03/31/05 CCC: B Permit . . . . WALL/FENCE PERMIT Additional desc Permit Fee . . . . 63.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . 3725 Qty ,Unit Charge Per Extension BASE FEE 45.00 2.00 9.0000 THOU BLDG 2,001-25,000 18.00. Special Notes and Comments 149 L.F. V BLOCK WALL, CITY STANDARD. Fee summary ---------------- Permit Fee Total Plan Check Total Grand Total Charged Paid Credited Due 63.•00 .00 .00 63.00 .00 .00 .00 .00 61.00 .00 .00 63.00. P.O. Box 1.504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Date: _ "d Applicant:. Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's dress: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under pe alty of perjury that I am licensed un provisions of Chapter 9 (comm Hang with Section 7000) of Division 3 of the Business and Professionals p6de, and my License i full force and effect. License Class -cense N ©o /-Da`te2� t Contra a OWNER43UILDER DECLARATION I hereby aifirn,under penalty of pedurythat I am exempt from the Contractors' 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 str 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 andthe basis for the alleged exemption. Any violation of Section 7031.5byanyapplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): U 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 or through his or her own employees, provided that the'tmprovements are not intended or offered for sale. If; however, the building or improvemenfle 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 cele.).. U 1, as owner of the property, am exclusively contracting with licensed contractors to,00nsbW the project (Sec. 7044, Business and. Professions Code: The Contractors' State License Law.does •not applyto 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 Liceinse'Law:,)., U I am exempt under Sec. , SA P.C. for this reason' Date WORKERS' 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. I ve and will maintai workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is 'ss ed. 1wvers pen 'on insurance carne� _ I cert. t, pe mance of a workior which this permit is Issued; I shall not employ any person In any manner so as to become subject to the workers' compensation laws of;California, and agree that. It l should become subject to the workers' compensation provisions of Sec ibn.3700 of the Labor Code, I shall forthwith comply with those provi ons. at Applica Ae - WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS 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. 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 Wissued (Sec. 3097, Civ. C.). Lender's Name Lenders Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permitsubject to the conditions and restrictions set forth onthis application. 1. Each person upon whose behalf this application is,made, each person at whose.requestand for whose benefit work Is pertormed;underorpursuant to any permit issued as a resultof this application, the owner, and the applicant, each agrees to, and shall, defend., indemnify and hold hsrmless'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 ISO days from date of issuance of such permit; or cessation of.work for 180 days will subject permit to.cancellation. t certify that I have read this application and state that the above i rmation is I agree t0 comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this coun e r upon a ned property for inspection purposes. �i `Hate Signature (Applicantor A