05-5502 (CCOM)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
05'-00005502
77735 TRADITION DR
658-130-011-14 -31379 -
CARPORT - COMMERCIAL
LOW DENSITY RESIDENTIAL
3 62 82'
Architect or Engineer:
t4,
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT'
LICENSED CONTRACTOR'S. DECLARATION
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: k -B Micense No.: 825943
VOICE (760) 777-7012
FAX (760) 777-7011 -
- INSPECTIONS (760) 777-7153
Owner:
CENTEX HOMES
. 2275 ATE.CI#230
ENDERSONRSON, NV 89077 4
JAN 0 9 2006
ntractor:
OFLA NTA A pE� NTEX HOMES
FIS 1123 AURARIA PARKWAY, STE 400
DENVER, CO 80204
(720)279-6600 "
Lic. No.: 825943
-- 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 penalty of not more than five hundred dollars ($500).:
( 1 1, 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.).
(_) 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.).
I 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
Date: 12/20/05
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.
J—�.orbave 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-LQCKTON CO Policy Number . WC832209709
_ 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
/I 3700 of the Labor Code, I rthQkh corms w�th those provisions.
l, n
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 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 county ordinances and state laws relating to building construction, and hereby authorize representatives
of this cro ty enter
��'upon
�the above-mentioned propert for inspe(c/t�Ip�n p
Daie"l ,-6�signa_ tura (A-plicant or Agent): V� `
r ��.p
LQPERAIIT
1
Application Number 05-00005502
Permit CARPORT/GARAGE
Additional desc .
' Permit Fee 330.00 Plan Check Fee
53.63
Issue Date Valuation
36282
Expiration Date'. 6/18/06
Qty Unit Charge Per
Extension
BASE FEE'
252.00
12.00 6.5000 THOU BLDG 25,001-50,000
78-.00
Permit ELECTRICAL-CARPORT/GARAGE
Additional desc .
Permit Fee 69.56 Plan Check Fee
4.35
Issue Date . . . . Valuation
0
Expiration Date 6/18/06
QtyUnit Charge Per
Extension
BASE FEE
15.00
2728.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL
54.56
-----------------------------------------------------------------------------
Special Notes and Comments
TRELLISED CARPORT STRUCTURE LOT 14
•62 X 44 FT,2728 SF. -S-3 OCCUPANCY,,
TYPE V -N CONSTRUCTION, 2001=CODES.
PERMIT INCLUDES ELECTRICAL LIGHTING -.75%
REDUCED PLAN CHECK FEE FOR MULTIPLE
PLAN OF SAME TYPE
----------------------------------------------------------- -----------------
Other Fees . . . . . . ART IN PUBLIC PLACES -COM
161.41
' STRONG MOTION (SMI) - COM
7.61
Fee summary Charged. Paid Credited
Due
----------------- ---------- ----- ----- ---------- ----------
Permit Fee Total 399.56 .00 .0.0
399.56
Plan Check Total 57.98 .00 .00
57.98
Other Fee Total 169.02 .00 .00
169.02
Grand Total 6.26.56. .00 .00
626.56
LQPERAIIT
1