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06-1999 (BLCK)4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 5/15/06 Application Number: 06-00001999' Owner: Property Address: . 52255 SHINING STAR LN LENNAR HOMES APN: > 767-200-999-14 -312022- 40004 COOK STREET Application description: WALL/FENCE PALM_ DESERT, CA 92211 Property Zoning: LOW DENSITY RESIDENTIAL (760) 777-9920 Application valuation: 350 Contractor: Applicant: Architect or Engineer: LENNAR HOMES OF CALIFORNI 40004 COOK ST. D PPI,M DESERT, CA 92211 (/ ~' (760)601-3100 ZOOS Lic . No.: 728102 MAY 2 4 CITY Of hrA �y MTS► -------------------------------------------------- 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. Licensjt�lass: License No.: 728102 Date: © ontractor: WNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that am exempt from the Contractor's State License Law for the following reason ISec. 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 1$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 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, 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 _ 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: r LQPERNIIT WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ' I have and will maintain 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 OLD REPUBLIC IN Policy Number MWC11148500 . 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 /0'oef the Laborqodlshall forthwit comply with those provisions. icant: WARNING: FAIL RE TO SECURERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,0001. 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 c unt ordinances and state laws relating to building construction, and hereby authorize representatives of this t to an er upon the above-mentioned pro erty for inspectio purposes. ate: a (Applicant or Agent): LQPERMIT Application Number . . . . .. 06-00001999 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 15..00 Plan Check Fee .00 Issue Date . . . . Valuation 350 Expiration Date 11/11/06 Qty Unit Charge Per Extension BASE FEE 15.00 ------ ----------------------- Special Notes and -------------------- Comments -------=---- ------ --------- 14 L.F.'6' GARDEN-WALL,.ORCO SYSTEM Fee summary Charged Paid Credited Due ----------------- Permit Fee Total --------- .15.00 .00 .00 15*.00 Plan Check Total .0,0-- .00 .00 .00 Grand Total 1.5.00 .00 .00 15.00