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07-0557 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 07-0000055-7 Property Address: 54940 SECRETARIAT DR APN: 767-320-999-248 -32879 Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 5500 Applicant: Architect or Engineer ----------------- LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING 'PERMIT Owner: MCCOMIC GRIFFIN LLC 7979 IVANHOE AVE #550 LA JOLLA, CA 92037 D � Contractor: FE8 1.0 2001 TRANS WEST HOUSING, INC. v 9968 HIBERT STREET, STE #102 ���T SAN DIEGO, CA 92131 OF LA QUEI (7.60)777-4307 Lic. No.: 701039 I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. Lice a ass: 13 icense No.: 701039 Date: a JG ntractor: , OWNER•B DER DECLARATION 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 dd the work, and -the structure is not intended or offered for sale ISec. 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 _ 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 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: 2/21/07 ----------------------------------------------- WORKER'S COMPENSATION DECLARATION 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. >! 1 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 1648813-2006 I certify that, in the performance of the work for 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, if I should become subject to the workers' compensation provisions of Section - 3700 of the Labor Cod , I shall forthwith comply with those provisions. ate: O pplicant: s� WARNING: FAILURE TO SECURE W KER COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND 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 work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and cou y ordinances and s e laws relating to building construction, and hereby authorize representatives of this My to enter upon above-mentioned propert for inspect2on p rposes. ate: Z1O ignature (Applicant or Agent): Application Number •. . . . . 07-00000557 Permit WALL/FENCE PERMIT Additional desc . Permit Fee 81.00 Plan Check Fee .00 Issue Date . . . . Valuation 5500 Expiration Date 8/20/07 Qty Unit Charge Per Extension BASE FEE 45.00 4.00 9.0000 THOU BLDG 2,001-25,000• 36.00 ----------------------------- Special Notes and Comments -------------------------------- 220 L.F. 6' INTERIOR PROPERTY WALLS, ORCO SYSTEM Fee summary Charged Paid Credited Due Permit.Fee Total 81.00 .00 .00 81.00 Plan Check Total .00 .00 .00 ..00 Grand Total 81.00 .00 .00 81.00 LQPERMIT - .