05-3072 (BLCK)P.O. BOX 1504" "
78-495 CALLE TAMPICO
LA QUINTA,: CALIFORNIA 92253
Application Number: l0!�__0.00A. 03 727
Property Address: 43210 PARKWAY ESPLANADE E
APN: 609-380-999-86 '-293234-
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 3825
Applicant: Architect or Engineer:
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LICENSED CONTRACTOR'S DECLARATION
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
LENNAR HOMES
HIGHWAY
� L INTA, CA
1111 �, INTA, CA
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busind Professionals Code, and my License is in full force and effect.
License I VIP License No.:
Date: Contractor:
It'ha
OWNER -BUILDER DECLARATION
I hereby off m under penalty of pem 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 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 _ 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
plUpUI ly WIIU UUaUs Or Improves thereon, ano wno contracts for tna projects win 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:
LQPERMrT
SEP 14 2008
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
OF CALIFORNIA
111, STE C
92253
3,DW@� HOMES OF CALIFORNIA INC
WCC: AON RISK SRVC
MWC11114500 11/01/05
CSLB: 728102 09/30/06
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WORKER'S COMPENSATION DECLARATION
Date: 7/21/05
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
Xissued.
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 B 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 so as to become subject to the workers' compensation laws of California,
Iagree that, if I s ould become subject to the workers' compensation provisions of Section
00 of Labor I shall forthwith comply with those provisions. .
at e4: k pplic
WARN G: AILURE TO SECURE KERS' 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. bach per -son upon Wh6se behalf this apphcatldn Is made, each person at whose request and f6r
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. 1 agree to comply with all
city and co ty ordinances and stale laws relating to wilding construction, and hereby authorize representatives
of this ty t enter upon the above-mentioned pr y for inspection purposes.
D e: ignature (Applicant or Age
_ Application Number . . . . . 05-00003072
.Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit.Fee 63.00
Plan Check
Fee ...
.00
Issue.Date
Valuation
3825
Expiration Date 1/17/06
Qty Unit Charge. Per
Extension
BASE FEE
45.00
2.00 9.0000 THOU BLDG 2,001-25,000
18.00
---------------------------------
Special Notes and Comments
153 L.F. 6' GARDEN BLOCK WALL, ORCO
SYSTEM.
Fee summary Charged. Paid
Credited
Due
--- ----------
Permit Fee Total 63.00
--------
.00
- - ----------
.00.
63.00
Plan Check Total .00
.00
.00
.00
Grand Total 63.00
:00"
.00
63.00