04-5316 (BLCK)BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number 04�E000.005317C Date 7/01'/04
Property Address 48308 BIG HORN DR
APN: 658-140-999-10' -29436 -
Application description WALL/FENCE
Property Zoning LOW DENSITY RESIDENTIAL
Application valuation 2750 '
Owner Contractor
IVANHOE LA QUINTA'COVE TRANS WEST HOUSING, INC.
C/O. R, BARRY.MCCOMIC 9'968 .HIBERT STREET, STE #102
797:9 ..'IVANHOE AVE-. STE. 550 --SAN DIEGO CA 92131
LA:.JOLLA.: CA. 92037 (858) 653-3003.
WCC• STATE FUND.
WC: 1648813 1.0/01/04
CSLB:::.7.0103'9 01/31/05
CCC:. B
Permit . . . . . .. WALL/FENCE PERMIT
Additional desc
Permit Fee 54.00. Plan Check Fee .00
Issue Date Valuation. 2750
Qty . Unit Charge: Per. Extension
BASE 'FEE 45.00
1.00 9:0000 THOU BLDG 2,001-25,000` 9:00
Special Notes and Comments
110 L..F.'6'-GARDEN WALL, ORCO SYSTEM
Fee .summary. Charged Paid Credited Due
Permit Fee.Total 54.00. '00 .00 54.00
Plan Check Total .00 00 00 QO
Grand Total 54.00 .00 .00 54..0.0
p Q �
JUL 0'8 2004
CITY OF LA QUINTA
P.O. Box 1504 VOICE (760) 777-7U12
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: Q �' J.3 J(V Date: 7_
Applicant: I Architect or Engineer:
Applicant`s Mailing Address:
Architect or Engineer's Address:
No.:
ADIA-'
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under rovisions of C ter 9(commenting with Section 7000) of Division 3 of fhe Business and. Pm%ssionals
_Code, and my License i n full force and effect h
,,,-License CIas3 License No.
/. Date to dor ' V V'(7 ► t
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 fire a signed
statement that he or she is licensed pursuant to the provisions of the Contractors' 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 appficant to a civil penalty of not more than five hundred dollars. ($500).)
U I, as owner of the property, or my employees with wages es their sole compensation, will do the work, and the structure is not intended or offered for sale (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 does the work
himself or herself or 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 cid not build or improve for the purpose of sale.).
U I, 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 contractors) licensed pursuant to
the Contractors' State License law.).
(_•) I am exempt under Sec. 4 . BA P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations: .
_ I have and will maintain a certificate of consent to self4risure.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 hive and will. maintain workers' compensation insurance, as required by Section 3 00 of the 17f�
Code. for the performance of the work for which this permit is
My work corm tion insurance carrier and policy number are:
�arter hcy Number -
I certify that, n ft Orfonnihce o work for which this permit is issued .l shall not 1 y any person in any.manner so as to become subject to the workers'.
compensation laws of Califom1a,.and agree that, If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions,
WARNIN F LURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN .
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
1 hereby affirm under penalty of perjury that there is a construction lending agency for the perfomhance of the work for which this permit is issued (Sec. 3097,'Civ. C.).
Lender's Name Q
Lenders Address `
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application 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 t)e 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
dessation 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 correct I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize. representatives of this county to enter upon the above-mentioned property for inspection purposes.
ate Signature (Applicant or Agent): Moor)—