04-5314 (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 .-L-04=00005314 Date 7/01/04
Property Address .. . . . . .
48420 BIG HORN DR
-APN:
658-140-999-6 -29436 -
Application description
WALL/FENCE
Property Zoning
LOW DENSITY RESIDENTIAL
Applicatiori:valuation
2750
Owner
Contractor
IVANHOE LA QUINTA COVE
TRANS WEST HOUSING,
INC.
C/OR BARRY.MCCOMIC
9968.HIBERT STREET,
STE #102
.7979 :.IVANHOE AVE . STE. .550.
SAN DIEGO
CA 92131 -
LA CA. 92037
(858') .65.3-3003.
WCC:. STATE FUND:._
WC: 164881.3
10/01/04
CSLB`r 70103.9
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 2,001-2$,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
.00
-Grand Total 54.00
:00 .00
54.00
I]
FL 0 8 1CO3 4 D
P.O. Box 1504 - VOICE (760) 777-7012
78-495 CALVE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 4 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: jQ53 14 Date: -7-7 _0y
Applicant: I Architect or Engineer:
Applicant! s Mailing Address:
Architect or Engineer's Address:
Uc. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (comm with Section 7000) of Division 3 of the Business and,Professionals.
CCyycldee and my License is ' 11 force and eked
,!Cicense Class /License No.
�— Date--c—ontract'r yy,
( OWNER43UILDER 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, alter, 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 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 pemrit subjects
the applicant m
plicant to a civil penalty of not more than five hundred dollars. ($500).):
U I, as owner of the properly, 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 Conbadors' State License Law does not apply to an owner of property who bwlds 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 cornpletion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sate.).
(, 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 contractors) licensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec. BA P.C. for this reason
Date . owner.
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate 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' compensatio insurance, as required by Section 3700 of Labor Code, for the performance of the work for which this permit is
ued. works ' oro tion ' nce carrier and m number are:LF olicy Number
2)
I certify in time pe fomman of the work for which ttds permit is issued, I shall not, opersn tfi an .manner so as to become subjectto the workers'
compensation laws of Califoragree a ree that, if I should become subject to the wo kers' coin any
manner
provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions: fifi
WARNING: IFAILURE 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 performance of the work for which this permit is issued (Sec. 3097.'Civ. C.).
Lenders Name
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 th)e work being performed under or following issuance of this permit
2. Any pemdt 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.
1 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 reby auttmorizesepresentatives of this county to enter upon the above-mermtioned property for inspection purposes.
nature (Applicant or Agent):