BLCK (07-0736).•'. 'moi �
4
P.O. BOX 1504 - _1*. _ 0�^' 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: 4/06/07
C07--0-0990736Application Number: -00000736 Owner:
Property Address: 81100 MERV GRIFFIN WY MCCOMIC GRIFFIN LLC
APN: 767-320-999-M -32879 7979 IVANHOE AVE 4550
Application -description: WALL/FENCE LA JOLLA, CA 92037'
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 13650
Contractor.
Applicant: Architect or Engineer: TRANS WEST HO G, INC.
SET
AN2DIEGOENCA 2 31'^Qb 9 00
I� (858)653-3003
L i c. No . 701 3 9 CITY OF LA QUINTA
FINANCE DEPT.
---------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION- WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that -I a licensed 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 BuROWNEQILDER
Prof ionals Code, and my License is in. full force and effect. _ 1 have and will maintain a certificate of consent to self -insure, for workers' compensation, as provided "
License 1 s: B License. No.: 701039 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued: -
D O ntractor: -1 have and will maintain workers' compensation insurance, at required by Section 3700 of the Labor "
Code, for the performance of the work for which this permit is issued. My workers' compensation
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 STATE FUND Policy Number 1648813-2006
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 b come ject to ii a workers' "compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3 00 of the Labor Code, I all for wit o 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 (5500).: te: �. plicant:
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 WORKVIN
CV PENSA ON COVERAt�,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 CRIMINALLTIES 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, 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—) I am exempt under Sec. , BAP.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City -
Date: Owner:
CONSTRUCTION LENDING AGENCY
I'hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address: -
LQPERDIIT - '
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 cancellation. -
I certify that I have read this application and state that the, above information is coirect. I agree to comply with all
city and county ordinances and sta 'laws relating to bui ing construction, and hereby. authorize representatives
of this cou t to nter upon th ove-mentioned grope fpLi pec 'o purposes.
'Da . �1i ture (Applicant or Agent): '
o
Application Number. 07-00000736
Permit . . . WALL/FENCE PERMIT
Additional d"esc .
' Permit Fee . . . . 153.00
Plan Check•Fee
.. .00.
Issue Date . . . .
Valuation
. .
.13650
Expiration Date 10/03/07
Qty Unit Charge Per
Extension
BASE FEE
45.00
12.00 9;0000 THOU BLDG 2,001-25,000
108.00
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Special Notes and Comments
---------------
215LF GARDEN WALL/331LF RETAINING WALL
ASSEMBLED PER ORCO SPECIFICATIONS.
April 6, 2007 11:49:59 AM AORTEGA
Fee summary Charged Paid
Credited
Due
Permit Fee Total 153.00
.00
.00
153.00
Plan Check Total .00
.00
.00
.00
Grand Total 153.00
.00
.00
153.00
' LQPEPAIIT -
r. In city
of La Qulnta
Building U -Safety Division
• Permit # P.O. Box 1504, 78-495 Calle Tampico s
r' �. a +_
' La umta Vo
�ti Q , CA 92253= (760j 777.70121Build' .g Permit A
pplication and Tracking Sheet • 'I ;
Project Address:' _
Owner's Name:
A. P. Number. -
Legal Description:.: Address:
City, ST, Zip:
' Contractor.
Address:
Telephone: -
City, ST, Zip: Project Description:
Telephone:
State Lie. #
tY Lica#:
Arch., Engr//9
IX
Address: t t,� 1 4
City; ,Zip:
vt_ ! Gs
Telephone: 2�5LAU3If ?�MIRWJ
Construction Type: Oocupaacy:
State Lic. #:
Projeottype (circle one): New Add'n Alter Repair Deniq r
Name of Conta
Sq. Ft:: t
.. # Stories: �#Units:
Telephone of Contact Person: 3�
'Estimated Value ofProjem
APPUCANT: DO NOT,WRITE BELOW THIS UNE
# Submittal Req'd Recd
TRA(-IQNG PERMIT FEES
Plan Sets Plan Check submitted
�'/`d Amount
Structural CalaItem
ea,naidy . Review correct
� •
' fo ions 3 Plan Check Deposit
'Nass Calla. Called Contact Pets a. '
27 . ,anCLeekBalaace ,
Energy Cale. Plans Picked.aP n
J� 2_g Constractipu
Flood plain plan Plans resubmitted '
6. Mechanical
Grading.plain, Z'' Review, ready [or eorrectio
ae � '}• Electrical
$ubcontactor Li$t Called Contact Person -
Plumbing ,
Grant Deed Plans picked up
:v H.O•A. Approval • S.M L ..
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for.correctlons/issae
Developer Impact Fee
Planning Approval Called, Contact Person
A.LP.P.
Pub. Wks. Appr Date of permit issue
School Fees
Total Perto
Fccs