Loading...
05-3098 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Applicant: Architect or Engineer: CC) N Te/4 C To� LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT SEP 141005 I hereby affirm under penalty ofperjurythat_I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of,the Busine s d Professionals Code, and my License is in full force and effect. License CI • s License No.: Dpte: Contract t/ OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am 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 ofthe.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 civilpenaltyof not more than fivehundreddollars ($500).: (_ 1 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 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 propertywho 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 ISec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERAIIT QUINTA Owner: LENNAR HOMES 78401 HIGHWAY LA QUINTA, CA LA QUINTA, CA I OF CALIFORNIA 111, STE C 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Contractor: LENNAR HOMES OF CALIFORNIA INC WCC: AON RISK SRVC WC: MWC11114500 11/01/05 CSLB: 728102 09/30/06 WORKER'S COMPENSATION DECLARATION Date: 7/21/05 I hereby affirm under penalty of perjury one of the following declarations:. 1 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 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for whichthis 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, Ishall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if l sh Id become subject to the workers' compensation provisions of Section 0/ 3 0 of theta/bo/r C (I II forthwitl comply with those provisions. Date. - pplicaht: WARN( G: F (LURE TO SECURE W0�2 RS' 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 coun ordin ces and state laws relating to build' g nstruction, and hereby authorize representatives of this c ty o e r u eabove-mentioned grope f action purpo s. D •e: nature (Applicant or Agent):1�n - Application Number: 05 0000 Property Address:. 79926 PARKWAY ESPLANADE N APN: 609-380-999-5 -293234- Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 3000 Applicant: Architect or Engineer: CC) N Te/4 C To� LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT SEP 141005 I hereby affirm under penalty ofperjurythat_I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of,the Busine s d Professionals Code, and my License is in full force and effect. License CI • s License No.: Dpte: Contract t/ OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am 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 ofthe.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 civilpenaltyof not more than fivehundreddollars ($500).: (_ 1 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 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 propertywho 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 ISec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERAIIT QUINTA Owner: LENNAR HOMES 78401 HIGHWAY LA QUINTA, CA LA QUINTA, CA I OF CALIFORNIA 111, STE C 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Contractor: LENNAR HOMES OF CALIFORNIA INC WCC: AON RISK SRVC WC: MWC11114500 11/01/05 CSLB: 728102 09/30/06 WORKER'S COMPENSATION DECLARATION Date: 7/21/05 I hereby affirm under penalty of perjury one of the following declarations:. 1 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 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for whichthis 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, Ishall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if l sh Id become subject to the workers' compensation provisions of Section 0/ 3 0 of theta/bo/r C (I II forthwitl comply with those provisions. Date. - pplicaht: WARN( G: F (LURE TO SECURE W0�2 RS' 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 coun ordin ces and state laws relating to build' g nstruction, and hereby authorize representatives of this c ty o e r u eabove-mentioned grope f action purpo s. D •e: nature (Applicant or Agent):1�n - ^� e� Application Number . . . . . 05-00003098 ' Permit . . . . . . WALL/FENCE PERMIT Additional deoo . . Permit Fee . . ` . 54.00 gIao Check Fee . . .00 IDate . . . . Valuation . . . . z000 �piratioo Date . ,g . 1/17/06 ` Qty Unit Charge Per Extension ' Ba3o FEE 45.00 �.00. 9.0000 THOU aLoo 2'ou�-zs' onU 9.00 -----------------------_------------------------------------------------'-- s and Comments — 120 L.F. 6' GARDEN BLOCK WALL, DaCO ' SYSTEM. Fee summary Charged gaid___ _-------- ------- _Credited�_ -------- ____oue___ --- ------_--_-- - ----- Total ` .54.00. .00 .00 54.00 Total .Oo .00 .op .ou ^ � , G���d Total.. ' ' ' � `- ` s�.VO .00 ob- 54.00 . LQPERMIT