Loading...
05-4596 (BLCK)P.O. BOX 1504 4 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 05-00004596 Owner: Property Address: 52840 JALISCO TAYLOR WOODROW HOMES, INC APN: 767-200-011-45 -318741- 15 CUSHING Application description: WALL/FENCE IRVINE, CA 92618 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 7175 Contractor: Applicant: 'T Architect or gi eer: p TAYLOR WOODROW HOMES INC U 15 CUSHING OCT 1,� 2005 IRVINE, CA 92618 ' (760).275-0598 Lic. NO.: 352047 CITY OF LA gU1NTA f:1NANCE CEPT- -------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty 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 License is in full force and effect. License Class: B cen eNo.: 352047 Dateontractor: OW(NEDALDER DECLARA7also I hereby affirm under penalty of perjury that I am exempt from the Contractoense Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuanires 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).: (_) 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.). (_) 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 property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed , pursuant to the Contractors' State License Law.). - (_) 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: LQPERMIT VOICE (760) 777-70.12 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/14/05 ----------------------------------------------- WORKER'S 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 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 LIBERTY MUTUAL Policy Number WA765D283614055 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 1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Co/de, I shall forthwit m y—with those provisions. te:, f� - 5 plicant: WARNING: FAILURE TO SECURE WO KERS' COMP SATION COVERAGE IS UN FUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES�ND CIVIL FINES UP TO ONE UNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAM ES 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 county ordinances and state laws relating to building -construction, and hereby authorize representatives of tyis county to enter upo a above-mentioned property for inspectio !"s. Date i ignature (Applicant or Agentl: LQPERMIT . Application Number . . . . . 05-00004596 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 99.00 Plan Check Fee .00 Issue Date Valuation . . . . 7175 Expiration Date 4/12/06 Qty Unit Charge Per Extension BASE FEE 45.00 6.00 9.0000 THOU BLDG 2,001-25,000 54.00 ---------=------------------------------------------------------------------ Special Notes and Comments 287 L.F. 516" PROTO'II GARDEN WALLS 'Fee summary Charged Paid ------------------------------------- Credited -------------------- Due Permit Fee Total 99.00 .00 .00 99.00 Plan Check Total .00 .00 .00 .00 Grand Total. 99.00 .00 .00 99.00 LQPERMIT .