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05-1806 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 05-00001806 Property Address: 80760 VISTA BONITA TR APN: 772-280-0107 - - Application description: WALL/FENCE Property Zoning: . VERY LOW DENSITY RES Application valuation: 14250 Applicant: p , •0 • " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect or Engineer: Owner: ALAN AUSTIN 80-760 VISTA BONTIA TR LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Goiltroctor: HUDSON CONSTRUCTION,' INC., K.P 77622 COUNTRY''CLUB DR, STE M PALM DESERT, CA. 92211 (760)345-5154 Lic No.: 818121 LQPERMIT LICENS CONTRACTOR'S DECLARATION .WORKER'S COMPENSATION DECLARATION - ,- I hereby affirm under penalty of. perjury that I a censed under provisions of Chapter 9 (commencing with - I hereby affirm under penalty of perjury one of the following declarations: - Section 7000) of Division 3 of the Business a rofessionals Code, and my License is in full force and effect. I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided - License Class: • 13 License No.: 818121 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is _ ✓ _ / �— —=Date:„ OS" Contra t rr L� - - 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 at I am exempt from the Contractor's State License Law for the Carrier EXEMPT - Policy Number EXEMPT following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance ofhe 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 come 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 beff6me 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 all forthwith comply with those provisions. ' - that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by ,^,Date�� v t - any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (55001: - '��Applicant:- • (- ' 1 1, 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 W KERS' 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 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, 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, indemnify and hold harmless the City - .. of La Ouinta, 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 per , 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 a 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 build' g onstruction, and hereby authorize representatives of this county to enter upon the above-mentioned�prope r inspection purposes. Lender's Name:CSignature"(Applicant or Agen-- 'Lender's Address: � �� - �`~-- LQPERMIT Application Number `05-0000'1806 Permit WALL/FENCE PERMIT Additional desc Permit Fee ' .. 162.00 Plan Check Fee.. ;. _00 Issue Date Valuation . . 14250 Expiration Date 11/07/05 Qty Unit Charge Per Extension BASE FEE 45.00 13.00 9.0000 THOU 'BLDG 2,001-25,000 117.00. ----------------------------------------------------------------- Special Notes and Comments 7Q L,F. 6' HIGH BLOCK WALL SIDE P/L ti ORCO SYSTEM) Fee summary Charged Paid Credited Due ---------- Permit Fee Total 162.00 ---------- ---------- .00 .00 162.00 ' Plan Check Total .00 .00 .00 .00 Grand Total 162.00 .00 .00 162.00 LQPERMIT _ .. ..