05-1908 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05-00001908
Property Address: 55495 TURNBERRY WY
APN: 767-550-008-'
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 3,125
Applicant:
ffu FETY DEPARTMENT
MAY 19 2 0 6NVJ 11 YG PERMIT Owner:
7
CITY OF LA QUINTA CALIFORNIA COVE @ L.Q., LLC
FINANCE DEPT. 8105 IRVINE CENTER DR
IRVINE, CA 92618
Contractor:
Architect or Engineer: CALIFORNIA COVE COMMUNITIE INC
.8105 IRVINE CENTER DR
SUITE 800
IRVINE, CA 92618
Lic.. No.: 1659679-2005
VOICE (760)-777-7012
FAX (760) 777-7011
NSPECTIONS (760) 777-7153
0 1A
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 75 1 of D'lviosion 3 of the Busines fessWrals Code, !1��e is in full force and effect.
License C,� I . 53 OZI Lice0rl137.7—t,645.a6 73,T 2 0 0 5
P
tractor:_
VOWNER"BUILDER DECLARATION
hy
I hereby affirm under p n of perjurNCKat I am exempt from the Contractor's State License Law for the
following reason ISec. 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 ($5001.:
1 1, 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 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 p�ojects 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:
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: A) /Ar
LQPERMIT
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WORKER'S COMPENSATION DECLARATION
Date: 5/18/05
I hereby affirm under penalty of perjury one of the following declarations: .
I have and will maintaina 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 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 1775 Policy Number STATE FUND
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 become subject to the workers' compensation laws of California,
all 0agoree the" if I qnrF��ation provisions of Section
f the Labo ions.
te: Dlicant:
WAR ING: FAILURE TOSECURE S UNLAWFUL:, AND SHALL
ONE HU�
To - C tK
.SUBJECT AN EMP YER ' Cg NAL PTENALTIESAND CIVIL FINES UP T JDRED THOUSAND
ONTO E COST
DOLLARS ($100,0 0). IN A� ION 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 180 days will subject
permit to cancellation. 01
I certify that I have read this application and State that 'he ab.v.1 . pseYmation is correct. I agree to comply with all
cit d inances and State laws relatir to building Tstruction, jgp�pthorize representatives
Y
ter
Y and c rny t-yee oses.
of lhi.,�, up he above-menti�pe r in
eat ignature (Applicant r nt
Application Number
. . . . . 05-00001908
Permit . . . . .
. WALL/FENCE PERMIT
Additional desc
.Permit Fee . .
. 63.00
Plan Check
Fee
.00
Issue Date
Valuation
... .
. 3125
Expiration Date
11/14/05
Qty Unit Charge
Per
Extension
BASE FEE
45.00
2.00 9.0000
THOU BLDG 2,001-25,000
18.00
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Special Notes.and
Comments
125 L.F. 61 GARDEN
WALL,ORCO SYSTEM
Fee summary
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Charged Paid
----------- ----------
Credited
---------- ----------
Due
Permit Fee Total
63.00
.00
.00
63.00
Plan Check Total
.00
.00
.00
.00
Grand Total
63.00
.00
.00
63.00
LQPERMIT