05-1872 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
MAY 18
Applicant:
Architect or Engineer: .
p 114
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 700,0) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
LicenseCials: '834053 0, License No.: -'144Z6 7 9 - 2 0 0 5
& SAFETY DEPARTMENT
ILDING PERMIT
OWNER.BUILDZRQ�CLARA�N
I hereby affirm under penalty of pe; -r hat I am exempt from the Cofi—trac-fo—rs State'License Law for the
following reason fSec. 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 70001 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 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, as owner of the property, arii exclusively contracting with licensed contractors to construct the project (Sec.
7044 Business and Professions Code: The Contractors' State License Law does not appl� to an owner of
prope�y who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
-1 am exempt under Sec. B.&P.C. for -this reason
Date: Owner:
. CONSTRUCTION LENDING AGENCY
I hereby a�ffirm 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:
LQPER1%11T
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/17/05
Owner:
CALIFORNIA COVE @ L.Q. LLC
6105 IRVINE CENTER DRIVE
IRVINE, CA 92618
Contractor:
CALIFORNIA COVE COMMUNITIE INC
8105 IRVINE CENTER DR
SUITE 800
IRVINE, CA 92618
Lic. No.: 1659679-2005
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalt� 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 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,
and agree that, if I !��oulecome sgbiect to the w4i;LEL4:.j-�sation provisions of Section
ions.
37/10oftheLabors 12ary6with comply t
Oate3ant:
,L7&!5;rpli�c
WARNING: FAILURE TO SECURE VKRK ERS'%COM PEN SA��E-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.
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.
I . Each person upon whose b6half 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.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
. and couFty ci�dinances and state laws relati - building cospirm2Dn, and hereby authorize representatives
city coul _ eter p . n
of this upon the abo ;;ro erty fo c i n purpose
e�� -
A5—ate: ��ture jApl!111�A�
/ , / — I .00%0� (" — '.) -
L___C1V01FFL5A�QUl1T4TA
0EPT-
NCE P
�FINADE
Application Number: I:
05 00001872
?T- �?? 0
Property Address:
55585 TURNBERRY WY
APN:
767 -550 -011 -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
3000
Applicant:
Architect or Engineer: .
p 114
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 700,0) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
LicenseCials: '834053 0, License No.: -'144Z6 7 9 - 2 0 0 5
& SAFETY DEPARTMENT
ILDING PERMIT
OWNER.BUILDZRQ�CLARA�N
I hereby affirm under penalty of pe; -r hat I am exempt from the Cofi—trac-fo—rs State'License Law for the
following reason fSec. 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 70001 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 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, as owner of the property, arii exclusively contracting with licensed contractors to construct the project (Sec.
7044 Business and Professions Code: The Contractors' State License Law does not appl� to an owner of
prope�y who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
-1 am exempt under Sec. B.&P.C. for -this reason
Date: Owner:
. CONSTRUCTION LENDING AGENCY
I hereby a�ffirm 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:
LQPER1%11T
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/17/05
Owner:
CALIFORNIA COVE @ L.Q. LLC
6105 IRVINE CENTER DRIVE
IRVINE, CA 92618
Contractor:
CALIFORNIA COVE COMMUNITIE INC
8105 IRVINE CENTER DR
SUITE 800
IRVINE, CA 92618
Lic. No.: 1659679-2005
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalt� 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 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,
and agree that, if I !��oulecome sgbiect to the w4i;LEL4:.j-�sation provisions of Section
ions.
37/10oftheLabors 12ary6with comply t
Oate3ant:
,L7&!5;rpli�c
WARNING: FAILURE TO SECURE VKRK ERS'%COM PEN SA��E-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.
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.
I . Each person upon whose b6half 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.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
. and couFty ci�dinances and state laws relati - building cospirm2Dn, and hereby authorize representatives
city coul _ eter p . n
of this upon the abo ;;ro erty fo c i n purpose
e�� -
A5—ate: ��ture jApl!111�A�
/ , / — I .00%0� (" — '.) -
Application Number . . . . . 05-d0001872
Permit* . . . . . . WALL/FENCE PERMIT
Additional desc
Permit Fee 54.00 Plan Check
Fee
.00
Issue Date Valuation
3000
Expiration Date 11/13/05
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
120 L.F. 61 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