04-7496 (PC)TAW
°F 4Q"Ita
BUILDING do SAFETY DEPARTMENT
P.O. BOX 1504
78-495 CALLS TAMPICO (760),777-7012
FAX (760) 777-701.1
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number . . . . . 04-00007496
Property Address . . . . . . 48655 EISENHOWER DR
APN: 658-140-999-B 29.43
Application description . . PATIO"COVER - COMMERC
Property Zoning . . . . . . LOW DENSITY RESIDENTI
Application valuation . . . . 7421
Owner-
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IVANHOE LA QUINTA COVE
C/O R BARRY MCCOMIC
1979 IVANHOE AVE STE 5,50
LA JOLLA CA 92037
Date 1/27/05
FEB 2 51005
Contractor
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TRANS WEST HO �
9968 HIBERT STREET,
SAN DIEGO
(858) 653-30103
STE #1.02
CA 9213.1
WCC;: STATE FUND,
WC 1648813 1.0/01/015
CSLB:, 701039 01/31/05 -
CCC: B
Permit . . . . . . PATIO COVER PERMIT
Additional desc .
Permit Fee . . 99.00 Plan Check Fee 64.35
Issue Date . . . . Val-uation . . . . 7421
Qty Unit Charge Per Extension
BASE FEE 45.00
6.00 9.0000 THOU BLDG 2,001-25,000 54.00
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Special Notes and.Comments
free standing patiotrellis 558 sq. ft.
1/'27/015 10:01 :18 AM j j ohnson
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Other Fees . . . . . . . . . STRONG MOTION (SMI) - COM 1:55
Fee summary Charged
Permit Fee Total 99.00
Plan Check Total 64.3.5
Other Fee Total 1.55
Grand Total 164.90
Paid Credited Due
.00 .00 99.00
.00 .00 64.35
.00 .00 1.55
.00 .00164.9,0
Pi 0. Box 1.504 VOICE (760) 777-70x2
78-4Tuf
.95 CALLS TAMPICo FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDINGcit: SAFETY DEPARTMENT
Application Number: O moi- l' Date:
Applicant:. �'",at D?LC%�0�
Applicant's Mailing Address:
Architect or Engiineer.
Architect or Engineer's Address:
Lic. No.
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATioN
I herebyaffirm under penalty of penury to I am licensed' under provisions of Chapter 9 (commencing wllh Section 7000) of Division 3 of the Business and Profaasionals
Code. and my License ' 'n full force and effect. "'7d>/ O
License Class License No.
Coetisetor
OWNER -BUILDER DECLARATION
I hereby aftm under penaltyof perjury that.( am exempt from the Contractors' State License Law for the following reason (see. 70315, Busineas.and Pvotessions Code: Any
c ty.or county that requires a pemdt to construct. atter. improve. demolish. or repair any structure, prior to its issuance, also requires the applicant for the permit b file a eiiined
statement that he or she is licensed pursuant to the provisions of the Contractors' State license Law (Chapter9 (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 elbged exemption. Any violation of Section 7031.5 by any applicant for a parmitsubjects
the applicant to a,cMI penalty of not more:than five hundred dollars (S51x1).):
V 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 (See. 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 did notbuiid.or improve for the purpose of sale.).
U 1, as owner of the property, am exclusively contracting with licensed contractors to construct the pro1ect(Sec. 7044. Business and Protessions.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.).
U I.am exempt under Sec. , B.& P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
_ t.have and will maintain a certificate of consent to self4nsure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the petfmmanee
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 Lha work for which this parmlt is
res ed. ��k OWAmpensation insurance carrier and
�Iycyr rte,
Carrier Xe
Pdicy Number
_ I certify that, in the performance of the work for which this permit is issued, Fahatt—not employ any person in any manner so as to become subject: to 1*,woikers''
compensation laws of California, and agree that. If i should become subject to the workers' compensation provisions of Sectlon 3700 of the Labor Code, I OWN
forthwith comply with those provisions.
Date Applicant
WARNING: FAILURE TO. SECURE. WORKERS' COMP ATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS to 100.000). IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN
SECTION.3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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 tNs penult is issued:(See. 3097. Civ. C.). .
Lender's Name
Lendees 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 orpursuant to any permit
issued as a result of this application, the owner,.and the applicant, each agrees to, and shall, defend, indemnify and hold har less.the City"of La Qulrft 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 it work is not commenced wtMthn 180 days from date of issuance of
such pennll,•or
cessation of work for 180 daysvritl subject permit to cancellation.
I certify that,I have read this application and state that the above information is correct 1 agree to comply with all city and county ordinances and stale Ism relating to building
construction, and reby authorize representatives of this county. to enter upon the above-mentiaoad property for inspeclim purposes.
Date Signature (Appliicant.or Agent):