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06-1223 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA .92253 T4tyl 4 ul�tiGv BUILDING & SAFETY DEPARTMENT BUIFNG PERMIT 6/ Application Number: r 06-00001223 Property Address: 56198 PALMS DR APN: 764-020-020- Application description: WALL/FENCE ,! Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1525 � 6 Applicant: Architect or Engineer: 0 LICENSED CONTRACTOR'S DECLARATION 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. License Class: B LicenseNo.: 760044 Date: ontractor: OWNER -BUILDER 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'penaltyof not more than five hundred dollars ($500).: 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.ProfessionsCode: 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 1, as owner of the property, am exclusively contracting with licensed contractorsto 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 Owner: BIRDIE HOMES 300 E. STATE STREET, #100 ADLANDS, CA 92373 tractor: RST PACIFICA DEV CORP 300 EAST STATE ST, SUITE #100 REDLANDS, CA 92373 (909)798-3688 Lic. No.: 760044 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/24/06 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. 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 STATE FUND Policy Number W613-4291 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 Code, I shall forthwith comply with those provisions. 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. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety fora 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 county ordinances and state laws relating to building construction, and hereby authorize representatives of tt aunty to enter upon he above-mentioned property for inspection purpo e aU t nature (Applicant or Agentl' i Application Number . . . . . 06-00001223 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . 37.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 1525 Expiration Date 9/20/06 Qty Unit Charge Per Extension BASE FEE 15.00 11.00 2.0000 HND BLDG 501-2,000 22.00 ---------------------------------------------------------------------------- Special Notes and Comments LOT 20 - 61 L.F. 6' GARDEN WALL, CITY STANDARD Fee summary ------------------ Charged ---------- Paid Credited --------------------- Due Permit Fee Total ---------- 37.00 .00 .00 37.00 Plan Check Total .00 .00 .00 . .00 Grand Total 37.00 .00 .00 37.00 LQPERMIT P.O. Box 1504 78-495 CALLE TAMPI'CO LA QUINTA, CALIFORNIA, 92253 VOICE (760)777-7012 j FAX (760) 777-701 1 c ./ INSPECTIONS (760) 777-7153 BUILDING &`•SAF'ET.Y DEPARTMENT Application' Number: Applicant: Applicant's Mailing Address: "FICA G%/0 if Date: /.•�' OS Architect or Engineer: -Arc Engineer's -Address: 1..1ic. No.: BUILDING; PERMIT.DECLARATIONS :- LICENSED CONTRACTOR'S DECLARATION 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 Licer,}s2)is in full force and effect. ^� .Xicense*Class y� License No!/ ' / �e . T j i Contractor / ,C. T �RCritC - OWNER -BUILDER DECLARATION. I hereby affirm under penalty of perjury that 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 structure, pnorto its issuaince, also requires the applicant for the perrnit4o file a signed statement that he cr she is licensed pursuant to the:provisions of the Contractors' State LicenseLaw•(Chapter. 9 (commencing with.'Section 7000) of Division 3 of the Business and,Professions Code) or that he or she is exempt iherefrom'and the basis for the alleged exemption. Any diolatio-,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).):11 n 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 guilds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that the -improvements are not intended'or offered for,saje. If, however, the building or improvement is sold within one year of completion, the owner -builder will hale the burden of proving thatJheor she did•not build or improve for the purpose of sale.). U 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.). C_), I am exempt under Sec. , BA P.C. for this reason ` Date Owner 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 bySection 3700 of the Labor Code, for the performance of the work for which this permit.is issued.;. I have and will maintain workers' compensation insurance, as required bySection 3700 of the Labor Code, for the performance of the work for which this permit is Jss �vly y+erkers' ompensation insurance came,_and, I' --y nu e5 �Carner_ S(L tv� Policy Number✓ I certify that, in the performance of the•work for which this permit is issued 1 shall not employ any person in any manner as to become subject to the workers' compensation laws of California, and agree,that, if l should become subject to;the workers' compensation provi forthwith comply with those provisions. sions of Section 3700 of the Labor Code; I shall ✓Date WARNING: FAILURE TO SECURE WORKERS' CQMPENSATION.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 perfonnance.of the work.for which'this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to'the- Director dfBuilding and Safety for a permit subject to:the,conditions andrestnc6onssel:forth on this application. 1. Each person upon whose behalf this app6cafion,is made each person..at whose request andfor whose benefit work 'is`performed under or pursuant to any permit issued asoma result of this application; the'owner",I'and the applicant; each agrees to, ari6 shall, defend] indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or ,ornission related'to the work'being performed under or f ffiollowing issuance of.,this'perrmit. 2. Any permit issued as,a result of this.applicationbecomes null and void.if work isnot commenced within 180 days from date of issuance of such permit, or cessation of work for 166;days will;subject.permit to cancellation.. ation°and state_that the above information is correct. I agree to complynwith all city and•county ordinances and state laws relating to building I certify that I have read this applic construction, and hereby authorize representatives of this countyto enterupon the above-mentioned property for inspection;piirposes. Da t¢ ✓ •�l-%C�,J ✓ � e Signature (Applicant or Agent): �F �dZ�rw P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Application Number . . . . . 05-00000688 ` Date Property Address . . . . . . 56198 PALMS DR APN: 764-020-020- - - Application description ELECTRICAL Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 2000 2/28/05 Owner Contractor ------------------------ ------------------------ BIRDIE HOMES FIRST PACIFICA DEV CORP 300 E. STATE STREET 300 EAST STATE ST, SUITE #100 SUITE 100 REDLANDS CA 92373 REDLANDS CA 92373 (909) 798-3688 WCC: STATE FUND WC: 0008353-2005 01/01/06 CSLB: 760044 03/31/05 CCC: B ---------------------------------------------------------------------------- Permit . . . . . . ELEC-MISCELLANEOUS Additional desc . . Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 15.0000 EA` 'ELEC TEMPORARY POWER POLE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments TEMP POWER POLE Fee summary Charged Paid Credited Due ----------------- ---------- ------ - --- ---------- ---------- Permit Fee Total 30.00 .00 .00 30.00 Plan Check Total .00 .00 .00 .00 Grand Total 30.00 .00 .00 30.00 D ll MAR 14 2005 I CITY OF LA nc� A —