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�� BUILDING & SAFETY DEPARTM'EN'T
c 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 05-00-0-00056 Date. 1/06/05
Property Address . . . . 44665 VIA -VENICE
APN: 604-03-2`�-9-99111 305212 -
Application description WALL/FENCE
Property Zoning . . . LOW DENSITY RESIDENTIAL.
Application valuation . . 5425
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.QUINTAI CA 92253 (951)817-3600
WCC: AON RISK SRVC
WC:'" MWC11114500 11/01/05
CSLB: 7.28102 09/30/06
..
CCC: B
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number: v J "W'.5 (p
Applicant:
Applicant's Mailing Address:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: rt' to ' Off'
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
ISUIL UINU PERMIT DECLARATIONS
LICENSED CONTRA'S DECLARATION
I hereby= unde p of perjury that I am licensed u rovisio C) egejng with Section 7000) of Division 3 of the Business and Professionals
Code, and my Licen rs full force and effect. / -
J�c€nse 1Class1 icense No.
�e • `� I OntrectOf
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 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.).
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:
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 wi maintain workers' compensa n insurance, as required by Section 3 00 of the Labor Code, for the performance of the work for which this permit is
/ e y workers' compensation ' rance ca 'e n p li y u r
Gamer L 1 ' : r olicv Number
I certify that, in the performance of the work for, Number
this e u is issue sh 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 3700 of the Labor Code, I shall
..{
forthwith conSPly,with those rovisions.l
/bate 1. V Applicant'
WARNING: FAILURE TO SEC , RE: WORKERS' COMPENSATION 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 It
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. I agree to comply with all city and county ordinances and state laws relating to building
construction,, and hereby authorize re resentatives of hqnty to enter �uponeabove-mentioned property for inspection purposes.
ate `O �,/ Sie (Applicant or A
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Application Number . . . . 05-00000056
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Permit .WALL/FENCE PERMIT
Additional desc
Permit Fee . . . 81.00 Plan Check Fee .00
Issue Date . . . Valuation . . . . 5425
Qty Unit Charge Per Extension
BASE FEE 45.00
4.00 9.0000 THOU BLDG 2,001-25,000 36.00
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Special Notes and Comments
217 L.F. 6' BLOCK WALL,'ORCO SYSTEM
Fee summary Charged Paid Credited Due
Permit Fee Total 81.00 .00 .00 81.00
Plan Check Total .00 .00 .00 .00
Grand Total 81.00, .00 .00 81.00