BRES2017-020078,495-CALLE TAMPICO �i1tiINC(/
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BRE52017-0200 _
Property Address: 48789 LEGACY DR
APN: 658423007
Application Description: LEGACY VILLAS HOA /SLAB STABILIZATION(INTI&EXT. WORK)--- R�
Property Zoning: 2017
Application Valuation: $95,000.00 AUG Q
Applicant:
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LEGACY VILLAS HOA
48800 LEGACY DRIVE
LA QUINTA, CA 92253
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and'Professions Code,
and my License is in full force and effect.
License CI ss: License No.: 778157
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Dat 1 / Contr`actor:
OWNER -BUILDER DECLARATION
I hereby affirm under.penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, after, 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
Contractor's 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).:
(_) 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. 7044,13usiness 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 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.).
(_)1, 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.).
(_) I am exempt under Sec. B.&P.C. for this reason
Date:
Owner:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/8/2017
Owner:
iACY VILLAS MOA
300 LEGACY DRIVE
QUINTA, CA 92253
EAGLELIFT INC
10410 TRADEMARK STREET
RANCHO CUCAMONGA, CA 91730
(909)980-6222
Llc. No.: 778157
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificace 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 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:
Carrier: REDWOOD FIRE AND CASUALTY INSURANCE CO Policy Number:
I certify that in the performance o: the work for which this permit is issued, I
shall not employ any person in.any manner se as to become subject to the workers'
compensation laws of California, and agree &fat, if I should become subject to the
workers' compe sation provisions of Secti bor CLIshall forthwith
provisions.�Aool— icant: �%
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN.EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,0;)0). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FC32 IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
. APPLICANT ACKNCWLEDGEMENT
IMPORTANT: Application is hereby made to Ne Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this appl cation 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 eancEllation.
CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is correct.
I hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all city and county ord nances and state laws relating to building
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). .construction, and hereby authorize representatives of ter upo e
:Dat
e -men 'one property for inspection purposes.
Lender's Name:
Signature (A lican-aor Agent):
Lender's Address:
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Date: 8/8/2017
Application Number:
BRES2017-0200
Owner:
Property Address:
48789 LEGACY•IDR
LEGACY VILLAS HOA
APN:
658423007
48800 LEGACY DRIVE
Application Description:
LEGACY VILLAS HOA / SLAB STABILIZATION (INT. &EXT. WORK)
LA QUINTA, CA 92253
Property Zoning: .
Application Valuation:
$95,000.00
Applicant:
Contractor:
LEGACY VILLAS HOA
EAGLELIFT INC
48800 LEGACY DRIVE
10410 TRADEMARK STREET
LA QUINTA, CA.92253
RANCHO CUCAMIONGA, CA 91730
(909)980-6222
Llc. No.: 778157
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Detail: SLAB STABILIZATION TO UNITS 193 AND 194 PER ENGINEERED. DESIGN. 2016 CODES.
THIS PERMIT IS IN REFERNCE TO PERMIT BRES2017-0093. NO
FEES PER BURT.
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FINANCIAL,INFORMATION
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