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05-0061 (BLCK)0000 0� u�i�,tcv V BUILDING & SAFETY DEPARTMENT cw4 P.O-Box '1504 (760).77777012 OFT9 .78-495 CALLS TAMPICO. FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application -Viftber 05-0 ----- 61 Date. ,. 1/06/05 Property Address K4462.5 VIA VENICE APN: 604-032-999-13 -305212- Application description WALL/FENCE Property Zoning . . . LOW DENSITY RESIDENTIAL. Application valuation 1275 Owner 'Contractor LENNAR HOMES OF.CALIFORNIA LENNAR HOMES OF CALIFORNIA INC 78401 HIGHWAY 111,- STE C 78401.HIGHWAY 111, SUITE C LA QUINTA, CA LA QUINTA, CA 92253 LA QUINTA; CA 92253 (951)817-3600 WCC: AON RISK SRVC WC: MWC11114500 11/01/05 CSLB: 728102 109/30/06 CCC: B ' D ------------------- JAN. 2005" CITY OF LA GIUINTA FINANCE Or -PT. P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: 04-0061 Applicant's Mailing Address: Architect or Engineer: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: It /o' O Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under p of perjury that I am licensed under provisions of Chap r 9 (co(((nnnmencing with Section 7000) of Division 3 of the Business and Professionals Coen, and my License force and effect. �� �/► rcense Class cense No. u OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjurythat 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 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).): 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' t, 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. , B.& P.C. for this reason Date 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. have and w��ill yy��aintain workers' compensation insurance, as required by Sec ion 00 of the Labor Code, for the performance of the work for which this permit is iss a (WYSvorkers' compensation insce cam o' n40WInot amer (VV P6licy NumberALJ ce ty that, in the performance o e work for which his permit is iemploy 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 3700 of the Labor Code, I shall }1 (forthwith comply with those p signs. fit .liApplicant I tj i / J Fr r f WARNING: FAILURE TO SECURE WORKERS' CO PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE.HUNDRED.THOUSA OLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE.L'ABOR 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 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. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby, authodz epresentatives of h' my to enter upon the above me tinned property for inspection purposes. Date4-4—Signature (Applicant or A .---------------------------------------------------------------------------- Application Number . . . . . 05-00000061 ---------------------------------------------------------------------------- Permit WALL/FENCE PERMIT Additional desc . . Permit Fee . . . . 31.00 Plan Check Fee .00 Issue Date . . . . Valuation . . 1275 Qty Unit Charge Per Extension BASE FEE 15.00 8.00 2.0000 HND BLDG 501-2,000 ---------------------------------------------------------------------------- 16.00 Special Notes and Comments 51 L.F. 6' BLOCK WALL, ORCO SYSTEM Fee summary Charged Paid --------------------------- Credited Due ---------- Permit Fee Total 31.00 ---------- .00 ---------- .00 31.00 Plan Check Total .00 .00 .00 .00 Grand Total 31.00 .00 .00 31.00