05-1540 (BLCK)L°'ol�'
z
BUILDING & SAFETY DEPARTMENT
c,w4 P.O. Box 1504
(760).777-7012
OFTt�9 78-495 CALLE TAMPICo FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760).777-7153
BUILDING PERMIT
Application Number . . 05-00001540. Date 4/27/05
Property Address . . . . . -432-38 PARKWAY ESPLANADE E'
AP N: 609 -380 -999 -85 -293234 -
Application description WALL/FENCE
Property Zoning . . LOW DENSITY RESIDENTIAL
Application valuation . . 1725
Owner Contractor
-
LENNAR HOMES OF CALIFORNIA LENNAR HOMES OF'CALIFORNIA INC
78401 HIGHWAY 111, STE C 5000 CALLE SAN RAPHAEL, # C-5
LA QUINTA, CA PALM SPRINGS, CA 92264
LA QUINTA, CA 92253 (95.1)817-3600
WCC: AON RISK SRVC
WC. MWC11114500 11/01/05
CSLB:, 728102 09/30/06
CCC: B
rM2 2005
CITY OF LA QUINTA
FINANCE DEPT.
P.O. B O X 1504 • 'G`���
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number: Q rj - 1540
Applicant:
Applicant's Mailing Address:
0
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
. Date:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
A)IA
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirmand alty of perjury that I am licensed under provisions of Cha ter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Code, and my Licen �y1I force and effect. �fl
nse Class / /Cicense No.
Do -
11J OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt 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 70.00) 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:
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.
/-I havp and will m intain workers' compensation ' surance, as required b Section 3700 of the Labor Code, for the performance of the work for which this permit is
is e w rkers' compensation i nce c>#{ti �dUdf;c�hur�bel
Y e� 1j `�1 �/
artier olicy Numb, , ^
_ I certify t at, i e 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 Sectfori 3700 of the Labor Code, I shall
forthwith comply with those provisions.
ate 6 1 4J 1A Applicant
WARNING: FAIL E TO SECURE WORKERS MPENSATION 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.
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 PIA—
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 Ouinta, its
officers, agents and employeesfor 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 te above information is correct. I agree to comply with all city and county ordinances and state laws relating to building
constructio ,and hereby auth size representatives of )'ipty to enter upon the above-mentioned property for inspection purposes.
Date Signature (Applicant or Ag
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Application Number 05-00001540
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Permit WALL/FENCE PERMIT-
Additional desc
Permit Fee . . . . 41.00
Plan Check
Fee
.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 501-2,000
26.00
--------------------------------
Special Notes.and Comments
69 L.F. 6' GARDEN WALL, ORCO SYSTEM
Fee summary Charged Paid
Credited
Due
Permit Fee Total 41.00
.00
00
41.00
Plan Check Total .00
.00
.00
.00
Grand Total 41.00
.00
C+0
41.00