05-1038 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Application Number: 05-,000b3.103 Owner:
Property Address: -79899PARKWAY ESPLANADE N LENNAR HOMES OF CALIFORNIA
APN: 609-380-999-10 -293234- 78401 HIGHWAY 111, STE C
Application description: WALL/FENCE LA QUINTA, CA
Property Zoning: LOW DENSITY RESIDENTIAL [t.S
6LA QUINTA, CA 92253
Application valuation: 3200
ep q t2OO5 Contractor:
Applicant: Architect or EngineeCf� 6 i LENNAR HOMES OF CALIFORNIA INC
f{ WCC: AON RISK SRVC
CffyopLAQUINTA; 1 WC: MWC11114500 11/01/05
FIRMCEV_MPT. CSLB: 728102 09/30/06
TKG-M�
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with
Section700 of Di 'sion 3 of the Business an Professionals Code, and my License is in full force and effect.
License Lic se No.:
ate: ontractor: /
WNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that 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 licensedpursuant 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 fora -permit subjects the applicant to a'civil penalty of not more than five hundred dollars ($500).:
(_) - 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 intendedor offered for sale. If, however, the.buildingor 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, 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:
LQPEn11T
Date: 7/21/05
--------------------------7--7-----------------
WORKER'S COMPENSATION DECLARATION
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, forthe 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 B Policy Number - - - - - - - - - - - - --
_ 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
37 0 of IhfiLabor C I shall forthwith comply with those provisions.
�AppliCa
WARNIN F ILURE-TO SECURE KERS' COMPENSATION OVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN.AODITIOWTO THE COST OF•COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNQ W LEDGEMENT
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 issuarice 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 buildi g construction, and her authorize representatives
of this co my an the the above-mentioned property spection purposes.
Date Signature (Applicant or Age 1,
LQPERMTT
Application Number . . . . . 05-00003103
Permit . . . . . WALL/FENCE
PERMIT
Additional desc .
Permit Fee. 63.00
Plan Check
Fee
.00
Issue Date
Valuation
. . .
. 3200
Expiration Date 1/17/06
-
Qty Unit Charge Per
Extension
BASE
FEE
45.'00
2.00 9.0.000:THOU BLDG
2,001-25,000
18.00
- .,
Special:: Notes and' -Comment's
-
...
128 L.F: 6' GARDEN BLOCK.WALLS,
ORCO
SYSTEM.-
YSTEM....Fee
...Feesummary Charged
Paid
Credited
Due
Permit.Fee Total .63.00
.00
.'00
63.00
Plan .Check Total ....00
00
.00
O
Grand Total 6.3..00
.00
.00
63.00
LQPERMTT