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06-0106 (BLCK)v P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA. 92253 _ 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 -Application Number: 0` 6-00.000106 Property Address: .52540 VINO APN: 767-200-011-12 -318741-. Application description: WALL/FENCE. Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 3675 Applicant: A BUILDING & SAFETY DEPARTMENT 'BUILDING PERMIT Owner: TAYLOR WOODROW HOMES, INC • .15 CUSHING IRVINE, CA 92618. ' • V 4 , l ____________________________-.�� 0�� LICENSED CONTRACTOR'S DEC �G I- here by affirm under penalty of perjury that I am licensed under provisions of Ch j ci Section 7000) of Division 3 of the Business and Professionals Code, and my License , u orc nd a ct License Class: B cert No -.--a-52047 D il Atractor Contractor: TAYLOR WOODROW HOMES INC 15 CUSHING IRVINE, CA 92618 - (760)275-0598 Lic. No.: 352047 VOICE (760) 777-7012' FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/10/06 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. 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: hereby affirm under penalty of perjury that I am exempt from the Contractor's'State License Law for the Carrier LIBERTY MUTUAL Policy Number WA765D283614055 following reason (Sec. 7031 .5, Business and Professions Code: 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 I should become sub'ect 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 boit ose provisions. 3700 of the L r Code, I shall forthwi o ly that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by I - 141 `O - any applicant for permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: 1 icant: 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 WOR ERS'(UMPEN TION COVE E 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 sale. 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.). - 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, - - I am exempt under Sec. , B.&P.C. for this reason - the owner, and the applicant, each agrees to, and shall defend, indemnifyand 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, or cessation of work for 180 days will subject. - CONSTRUCTION LENDING AGENCY - permit to cancellation. I hereby affirm 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 correct. I agree to comply with all '. work for which this permit is issued (Sec. 3097, Civ. C.). .city and county ordinances and state laws relating to building construction,�id her y eche ' e representatives of this county to enter upon Pe, above-mentioned p f i pection purp ,- - Lender's Name: IN- ' - te:ignature (Applicant or Agent): �- Lender's Address: ti JAC- - h LQPERMIT Application Number . . . . . 06-00000106 Permit ". WALL/FENCE PERMIT Additional desc . Permit Fee . .'. . 63.00 Plan Check Fee.00 Issue Date . . . . Valuation . . . . 3675 Expiration Date 7/09/06 Qty Unit Charge Per Extension BASE FEE 45.00 2.00 9.0000 THOU BLDG 2,001-25,000 18.00 ------------- ------------------------- Special Notes and Comments -------------------------- -Special 147 L.F. 6- GARDEN WALL, PROTO II SYSTEM Fee summary" Charged.. PaidCredited Due Permit Fee Total 63.00 .00 .00 63.00 _ Plan Check Total .00 .00 .00 .00 Grand Total 63.00 .00 .00 63.00 LQPERMIT _ ..