05-3592 (BLCK)4-
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT'
Date: 8/11/05
Application Number: 050'O'0:03:59'2' Owner:
Property Address: 57855 PASATIEMPO CT K. HOA
.VN_ NIAN FORECAST HOMES.
APN: 764-010-011-91 -300.92 - D 4240 S. JURUPA ST. STE. 402
-Application description: WALL/FENCE CHINO, CA 91710
Property'Zoning: LOW tDENSITY RESIDENTIAL ( q anC
Application.,valuation:. R '1625 SEP" 2 1005-
CITY OF LAQBINTA Contractor:
Applicant;, Architect "or Engineer:`. FINANCE DEPT. K. HOVNANIAN FORECAST HOMES
WCC:. ZURICH INS`
WC: WC343666302 •10/31/.05
^ CSLB: 700788 .;10/31/05
• �i
" - LICENSED CONTRACTOR'S,DECLARATION - - WORKER'S. COMPENSATION �DECLARATION
hereby affirm under penalty of perjury that.1 am licensed under'provisio-ris of Chapter 9".(commencing with I hereby affirm under'penalty of -perjury one'of the following declarations:^ �' r
Section 7000) of Division 3 ofthe Bus
s and Professionals Code,and my_License is in full force and effect. _ I have a6i elf
will maintain a certificate of.consentto s -insure for workers' compensation, as. provided
L/icense Clasx - t License No.: - - for by Secnon'3700 of the Labor Code for'the pe'rformanceof the work'for which this permit is
v ��� `' - -__.. issued:..
Date./ AGI 5� ontractoC Lhave and:will maintain workers' compensation -insurance; as required by Section 3700 of the Labor -
C�T .' t Code; for'the performanceof. the work for which this-permit'is issued. My workers' compensation
- O ER -BUILDER DECLARATION insurance carrier and policy number are: ,
I hereby affirm under penalty of perjury that I am exempt from iheContractoPs State License Law for the. Carrier B . - - Policy Number - -- - - ------------
- t
following reason (Sec. 7631-.5, Business and Professions•Code:. Any city or county that requiresa permit to _ I certify .that, in the�performance*of the work, for which this is.issued;:I: shall not employ any
construcf;' alter; iinprove,.demolish,. or repair any, structure, prior to its issuance, also requires the applicant for the person in -any manner so as to-beco a subject to the workers! compensation laws of California,
. permit to -file a"signed statement that he or -she is licensed pursuant to the provisions of the Contractor's State and agree that, if I shou d comes bject to the workers,.compensation provisions of Section
License Law (Chapter 9 (commeming*with; Section 7000) of Division 3 of the�Busm6ss andProfessions Code) or -3700: of the Labor ,,I hal i6' hwith comply with those provisions. '
that he or she is exempvOerefrom and thebasis for the alleged:6emption.. Any violation of .Section 7031..5 by
any applicant for.'a permit subjects the applicant to a civiPpenalty of not more than five hundred dollars ($500):: .DaAPPlican
(_) as,owner;of., the property,'ormy employees with:wagesas their sole compensation; ;will 'do the work, and ; , '
• the.struciure is not intended or offered for salo.i&c: 7044 Business and:Piofessions Code:: The - WARNING: FAILURE TO SECURE WORKERS' -COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law .does,not apply'to an owne'r'of property, who builds or.improves thereon, SUBJECT AN EMPLOYER 'TO CRIMINAL. PENALTIES AND -CIVIL FINES UP. TO ONE HUNDRED THOUSAND
and who does the work•himself or herself "through his or her own employeesi.provided that the. 'DOLLARS ($100,000).. IN ADDITION TO THE COST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN `
improvements are not intended.or offered for�sale: If, however; the building or improvement is sold within SECTION.3706 OF THE_LABOR`CODE, INTEREST, AND -ATTORNEY'S FEES.
one year of completion, the owner -builder will have theburden of proving that he or she didnot build or
improve for the purpose`otsale.). ^ - ',� .. APPLICANT ACKNOWLEDGEMENT -
(_ 1 I, as owner" of the property; am exclusively contracting with licensed contractois to construct the project (Sec. IMPORTANT Application is hereby. made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditionsand restrictions set forth on this' application.
property who builds'or improves thereon, and who contracts for the projects with a contiactor(s) licensed 1. Each person upon whose behalf this, application is made, each person at whose request and for
pursuant to the Contractors' State'License.Law.). - whose benefit work is performed under -or pursuant to any permit issued as a result of this application,
1 _ 1 I am exempt under Sec. 6.&P.C. for this reason 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 underor following issuance of this permit.
Date: Owner: 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
CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that'] have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec: 3097, Civ. C.1. city and cou y ordinances and state laws relating to buildi�constn uct'on,a d hereby authorize representatives
of this my to enter upon the above-mentionedprop /oses.
Lender's Name: 1—n-
Date�� `� ature (Applicant or Agen .
Lender's Address:
LQPERMIT
LQPERMIT
Application Number . . . . . 05-00003592
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 39.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 1625
Expiration Date . 2/07/06
Qty Unit Charge Per
Extension -
BASE.FEE
15.00_
12..00 2.0000 HND;. .:,BLDG 5.01-2;-000
24 00'
r
nm
----- --------------------------------------------------------------------
Special Notes and Comments'
6b.L.F. 6' PROPERTY LINE WALLS, PROTO
STANDARD..,.
summary, Charged Paid Credited
Due
E.
- - - - - - - - ------ - - - - ---- - - - - -
- ---
-- - - - - --
Permit Fee' Total 39.00 .00
.00.
39.00
Plan Check Total 00 00
:00
.00
Grand Total 39.00 .00
.00
39.00
r_•
LQPERMIT