05-1541 (BLCK)o
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 760 777-7012
OF78-495 CALLE TAMPICO FAX (760).777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number -05-0000154T Date 4/27/05
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Property Address . . . . . . 43210 PARKWAY ESPLANADE E
APN: 609-380-999-86 293234 -
Application description WALL/FENCE
Property Zoning . . . . . . LOW DENSITY RESIDENTIAL
Application valuation 1725
Owner Contractor
LENNAR HOMES.OF CALIFORNIA LENNAR HOMES OF`CALIFORNIAyINC•
78401 HIGHWAY 111, STE C 5000 CALLE SAN RAPHAEL, # C-5
-LA QUINTA, CA PALM SPRINGS, CA 92264
LA QUINTA, CA 92253 (951).817-3600
WCC: AON RISK SRVC
WC: MWC11114500 11/01/05
CSLB:' 728102 09/30/06
CCC: B
DUl
MAY 12 2005
CITY OF LA QUINTA
it
P.O. Box 1504 • /:.
w VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 05 —)S14 1 Date: J• ays
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under enalty 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 Licenis 'n full force and effect. �)
cense Class Ab
— icense No. (�---
v OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I xempt 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, 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 Contractors' 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).):
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 builds 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 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.).
U 1, 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.).
U 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:rt t• r j �!
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.
ha e and will maiyy��tain workers' compensation insurance, as required by Section 3700 of the Labor.Cbde; for the performance of the work for which this permit is
i ful(�wgfkers' compensation ' rice er n p i n e e / U'
arrier ��ll ��/ Policy Num J b y
_ I c rtify that, in the performance of the work for v�i�h t is permit is iss ed, I shall not employ aiiy,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 pfovi"sioris'of Section 3700 of the Labor Code, I shall
forthwith co ly withl os p ovisions. . •. a. -,Ili_ -t
ate ppl�K icant
WARNI G: FA URE TO SECURE WORK S' C PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THO 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 performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lenders Name
Lender's Address
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, an hereby thorize representatives of is y to enter upon the bove-mentioned property for inspection purposes.
D /Signature (Applicant or A
P g
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A lication Number
. . 05-00001541'
- Permit
WALL/FENCE PERMIT
Additional desc
Permit Fee
41.00
Plan Check
7ee
.00
Issue Date
Valuation
1725
Expiration Date
10/24/.05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
13.00 2.0000
HND BLDG 50172,000
26.00
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Special Notes and
Comments
69 L.F. 6' GARDEN
WALL, ORCO_SYSTEM
Fee summary
Charged Paid
Credited
Due
Permit Fee Total
41.00
.00
ob
41.00
Plan Check Total
.00
.00.
.00
.00
Grand Total
41.00
.00
.00
41.00