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06-1256 (BLCK)-P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 06-0.0001256 Property Address: 46177 ROADRUNNERJLN APN: 649-040-007-6 -31816 - Application description: WALL/FENCE Property Zoning: MEDIUM DENSITY RES Application valuation: 2500 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Applicant: Architect or Engineer: -------------------------------------------- LICENSED CONTRACTOR'S RATION I hereby affirm under penalty of perjury that I am licensed under pr ns of Chapter 9 (commencing with Section 7000) of Division 3 of the Busj ess ak Professionals fAife, and m License is in full force and effect. Liilcw Class: H 01Li6'4_e No.: 0821 tract. . 41 VWNER-BU,PDER DECLARATION I herebyaffirm under penalty of perjury that I am xem m hContractor'si n p y p l y e p o the State License se Law for the following reason -(Sec. 7031 .5, Business and Professi Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any str cture, 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 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.l. (_) 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: 3/28/06 WORKER'S COMPENSATION DECLARATION 1 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 permit is issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 174857005 I certify that, in the performance of the work for ich his ermit is issued, I shall not employ any person in any manner so as t become subjec to e w kers' compensation lawsof California, and agree that, if I sh Id be me subject to w ers' compensation provisions of Section 3700 of the Labor 2Y, I s II forthwith ith those provisions. WARNING: FAILURE TO SECURE WORK ERSAOMPE ATION COVERAGE IS UNLAWFUL, AND SHALL .� SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE§OKNO CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 0100,0001. 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 not commenced within 180 days from date of issuance of such permit, or cessation of r 180 days will subject permit to cancellation. 1 certify that I have read this application and state that th abov information is ect. I ree to comply with all city and county ordinances and state laws relating tp'b ' ing c4 struction, a _ ereby thorize representatives of thi ounty to eAt Pon the above-mentioned p�efor ection pu o Y//J nature (Applicant or Agen , Owner: LA QUINTA NORTH PARTNERS LP 2 CROOKED STICK DR NEWPORT BEACH, CA 92660 (949)533-9408 d ontractor: CONSTRUCTION ®�q® tr�prl 881 29 PALMS HIGHWAY 3 0 y�O 6 00 _RONGO VALLEY, CA 92256 ® 760)363-7740 C OFA ic. No.:. 820821 �eN�an►c,� �ur� l VWNER-BU,PDER DECLARATION I herebyaffirm under penalty of perjury that I am xem m hContractor'si n p y p l y e p o the State License se Law for the following reason -(Sec. 7031 .5, Business and Professi Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any str cture, 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 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.l. (_) 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: 3/28/06 WORKER'S COMPENSATION DECLARATION 1 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 permit is issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 174857005 I certify that, in the performance of the work for ich his ermit is issued, I shall not employ any person in any manner so as t become subjec to e w kers' compensation lawsof California, and agree that, if I sh Id be me subject to w ers' compensation provisions of Section 3700 of the Labor 2Y, I s II forthwith ith those provisions. WARNING: FAILURE TO SECURE WORK ERSAOMPE ATION COVERAGE IS UNLAWFUL, AND SHALL .� SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE§OKNO CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 0100,0001. 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 not commenced within 180 days from date of issuance of such permit, or cessation of r 180 days will subject permit to cancellation. 1 certify that I have read this application and state that th abov information is ect. I ree to comply with all city and county ordinances and state laws relating tp'b ' ing c4 struction, a _ ereby thorize representatives of thi ounty to eAt Pon the above-mentioned p�efor ection pu o Y//J nature (Applicant or Agen , 4 Application Number 06-00001256 Permit . . . WALL/FENCE'PERMIT Additional desc ,. Permit Fee . . . . 54.00 Plan Check Fee 00 Issue Date Valuation . . . . 2500 Expiration Date 9/24/06 Qty Unit Charge Per Extension BASE FEE 45.00. 1.00 9.0000 THOU BLDG 2,001-25,000 9.00 ------------------------------ - Spec Special Notes and Comments ------------------------------- ------- 100 L.F. 6' GARDEN WALL, ORCO SYSTEM Fee summary Charged. Paid Credited Due y Permit Fee Total 54.G0 .00 .00 54.00 Plan Check Total .00 .00 .00 .00 Grand Total 54.00 .00 .00 54.00