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05-3001 (BLCK)(11 � r! r 3 _+. - 11: . . .�_: �4 P.O. BOX .1504. , .78-495 CALLE TAMPICO ` LA QUINTA, CALIFORNIA 92253'BUILDING &SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/19/05 -0 Application Number: 0500030.01 Owner. ' Property Address: 81862 VIDA BELLA DR K. HOVNANIAN FORECAST HOMES . APN: 764-010-011-36- -30092 = _4240 E.- JURUPA ST. STE. 402 Application description: WALL/FENCE CHINO, CA 91710 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: .2250 ) SEP SEP 21 2005 Contractor. ' Applicant: Architect or E ginK. HOVNANIAN FORECAST HOMES CITYOFLAQUINTA WCC: ZURICH INS CEDE WC: WC343666302 10/31/05 CSLB: 700788 10/31/05. r • LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION - I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: - • - r fessionals Code; and my'Licenseis in full force and effect. Section 7000) of Division 3 of the Business and PLicense / _ I have and will maintain a certificate of consent to self insure for workers' compensation, as provided Class: nse No.: for by Section 3700 of the Labor Code, for the performance of the work for which thispermit'is Dat,��Contractor - 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: • I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the -------------- Carrier B Policy Number --------------- following following reason (Sec. 7031 .5, Business and Professions Coder Any city or county that requires a permit to_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure,.prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if 1 should become subject to the workers' compensation provisions of Section • License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I sh II forthwi co ply with those provisions. ' 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 (55001: �r-2�, Date: =-�J5pticant: - 1 _ 1 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 WARNING: FAILURE TO SECURE WORKER COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL - Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND - and who does the work himself or herself through his or her own employees,'provided that the , DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sate. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 . APPLICANT ACKNOWLEDGEMENT - 1 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. - property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). - - whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_ 1 I am exempt under Sec. , B.&P.C. for this reason 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. Date: Owner:. 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, orcessation of work for 180 days will subject , CONSTRUCTION LENDING AGENCY permit to cancellation. - - - herebyaffirm under. penalty of perjury that there is a construction lending.agency for the performance of the - I certify that I have read this application and state that the above information is corr t. I agree to comply with all • work for which this permit is issued (Sec. 3097, Civ. C.). w - city and county ordinances and state laws relating to building co y -au prize representatives of this county to enter upon the above-mentioned property f r i 'e t pos - - Lender's Name: \ • Dat .Signature (Applicant or Agent)' - " i Lender's Address: - LQPERi111T .. Application Number . . 05.-00003001' .-Permit WALL/FENCE PERMIT , _. _ .. .. Additional desc.. - Permit Fee, 54.00 Plan Check Fee .00 Issue Date Valuation '2250 j Expiration.Date 1/15/06 .. Qty Unit- Charge' Per s. Extension BASE FEE 4S.00- 1..00 9.0000 THOU BLDG 2,001-25,000 + ------------------------- -- ----------------------------------------------- " Special'Notes and Comments -- --- --- --- -- -- - ---------- --- 90 L.F: 6' PROPERTY LINE WALLS FOR PROTO STANDARD. ' Fee summary Charged Paid Credited' Due ' Permit Fee Total- 54.00 _ ---------- .00 ..00 -- 54.00 Plan --Check Totai .00 .00 .00 .00 Grand Total 54.00 •.00 .00 54.00 t, LQPERAIIT