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08-1106 (BLCK)414 P.O. BOX 1504 Ouba VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 6/27/08 Application Number.8-00001106 r-'7 Owner: Property Address: 49555 VISTA LUNA T D DESERT DEV APN: 602-180-999-5 -29457 - P O BOX 1716 Application description: WALL/FENCE LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 5250 Contractor: Applicant: Architect or Engineer: BARAJAS MASONRY INC 42901 LIMA HALL ROAD BERMUDA DUNES, C 2203 760 345- 1 � 912 ) 3 Lic.. No.: •863760 JUL 15 2W , ------------------- - -----------Q_EP'r e~r �wnir �t{7T. LICENSED CONTRACTOR'S DECLARATION - - WORKER'S OMPENSATIO��ECI'A�RAT10 ' 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 10wmg�ns: - - Section 7000) of Division 3 of the Business a?dProfessignals 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 CI 9 is 863760 - for by Section 3700 of the Labor Code, for theperformance of the work for which this permit is r ,i _ - issued. " ate: ?/7 ntractor. - - 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. ow IL ER DECLARATION - .insurance carrier•and policy number are: _ I hereby affirm under penalty of perjury that I am exempt fro a Contractor's State License Law for the Carrier ZENITH INS" Policy. Number Z069532601 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 00 of the Labor Code, all J4 ith hose provisions. that he or she is exempt therefrom and the basis for the alleged exemption- Any violation of Section 7031.5 by /��icaru , any applicant .for a permit subjects the applicant to a civil penalty of not more than five hundred dollars IS5001.: te: `:1, as owner of the property, or my employeeswith wages as their sole compensation, will do the work, andthe structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAITOSECRE WORKERS' COMPE ION 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 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 - (_•) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec.. 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—) 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 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 cons ucti n authorize representatives • - - of W��nterort the above-mentioned property for'cLender's Name: Dateature (Applicant or Agent): Lender's Address: - LQPERMIT Application Number . . 08-00001106 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . 81.00 Plan Check Fee .00 Issue Date . ... Valuation 5250 Expiration Date 12/24/08 Qty Unit Charge Per Extension BASE FEE 45.00 4.00 9.0000 THOU BLDG 2,001725,000 36.00 ------------------------------------------------- Special Notes and Comments -------------- 210 L.F. 6GARDEN WALL, PROTO II 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 LQrERMrr