05-1988 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4'!t
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
-.O /1 Owner:
(� CALIFORNIA
0
8105 IRVINE
JUN 1 0 2005 IRVINE, CA
OF LAGUINTA
Applicant: Architect or
Pr
-----------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 700 1 of D'vision 3 of the Business and Pro ssionals Code, and my License is in full force and effect.
License CI s'':ll B ti lel 811053
Date:(J tJ ontractor:
VX OWNER- 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, 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 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).:
(_ 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
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 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_ 1 1 am exempt under Sec. , B.&P.C. for this reason _
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: �r
Lender's Address: 1
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/24/05
COVE @ L.Q. LLC
CENTER DRIVE # 880
92618
Contractor:
CALIFORNIA COVE COMMUNITIE INC
8105 IRVINE CENTER DR STE 800
IRVINE, CA 92618
(949)453-1775
Lic. No.: 811053
------------------
WORKER'S COMPENSATION DECLARATION
I 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' compensation insurance, as required by Section 3.700 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 STATE FUND Policy Number 1659679
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to beco a subject to the workers' compensation laws of California,
and agree that, if I ubject to the r ' compensation provisions of Section
3700 of th Labor od rith ose provisions.
"Date: Applicant:
WARNING: FAILURE TO SECUR ORKERS' COMP ERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CR MINAL 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.
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 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 160 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 co my or finances and state laws relating prto buildia ons�t!ct hereby authorize representatives
(s�pmy t
of thienter upon the above-mentioned opert rJ6[ection p es.
ignature (Applicant or Agentl:
Application Number:
-00001988
Property Address: 11
81775 BROWN DEER PARK
APN:
767-540-014- -
Application description:
WALL/FENCE
Property Zoning:
GOLF COURSE
Application valuation:
2925
T4'!t
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
-.O /1 Owner:
(� CALIFORNIA
0
8105 IRVINE
JUN 1 0 2005 IRVINE, CA
OF LAGUINTA
Applicant: Architect or
Pr
-----------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 700 1 of D'vision 3 of the Business and Pro ssionals Code, and my License is in full force and effect.
License CI s'':ll B ti lel 811053
Date:(J tJ ontractor:
VX OWNER- 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, 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 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).:
(_ 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
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 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_ 1 1 am exempt under Sec. , B.&P.C. for this reason _
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: �r
Lender's Address: 1
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/24/05
COVE @ L.Q. LLC
CENTER DRIVE # 880
92618
Contractor:
CALIFORNIA COVE COMMUNITIE INC
8105 IRVINE CENTER DR STE 800
IRVINE, CA 92618
(949)453-1775
Lic. No.: 811053
------------------
WORKER'S COMPENSATION DECLARATION
I 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' compensation insurance, as required by Section 3.700 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 STATE FUND Policy Number 1659679
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to beco a subject to the workers' compensation laws of California,
and agree that, if I ubject to the r ' compensation provisions of Section
3700 of th Labor od rith ose provisions.
"Date: Applicant:
WARNING: FAILURE TO SECUR ORKERS' COMP ERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CR MINAL 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.
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 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 160 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 co my or finances and state laws relating prto buildia ons�t!ct hereby authorize representatives
(s�pmy t
of thienter upon the above-mentioned opert rJ6[ection p es.
ignature (Applicant or Agentl:
Application Number . . . . . 05-00001988
Permit . . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 54.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 2925
Expiration Date . . 11/20/05
Qty Unit Charge Per
Extension
BASE FEE
45.00
1.00 9.0000 THOU BLDG 2,001-25,000
9.00
------------------------7---------------------------------------------------
Special Notes and Comments
" 117 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
LQPERMIT