05-0517 (BLCK)T4hf 4 4Q"
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING PERMIT
Application Number:
Property Address
APN:
Application description
Property Zoning . . . .
Application valuation .
Owner
IVANHOE LA QUINTA COVE
C/O R BARRY MCCOMIC
7979 IVANHOE AVE STE 550
LA JOLLA CA 92037
11D��
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
05-00000517 Date
77858 GREY WOLF TR
658-140-999-94 -29436 -
WALL/FENCE
LOW DENSITY RESIDENTIAL
1398
I" L FEB 10 2005
-------------------------------mOF
Permit . . . . .
. WA D�IIT
Additional desc
�-
Permit Fee . . .
. 33.00
Issue Date . . .
.
Contractor
2/09/05
CALIFORNIA POOLS & SPAS
P.O. BOX 1280
COACHELLA CA 92236
(760) 398-9222
C: SEABRIGHT INS
BB1050510 01/01/06
LB: 656128 10/31/06
IC:
C8-C27-C29-053
---------------------------------
Plan Check Fee .00
Valuation 1398
Qty Unit Charge Per Extension
BASE FEE 15.00
9.00 2.0000 HND BLDG 501-2,000 18.Ob
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Permit . . . . . . WALL/FENCE PERMIT
Additional desc
Permit Fee . . . . 15.00 Plan Check"Fee .00
Issue Date Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 15.00
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Special Notes and Comments
40 L.F. 36" BLOCK WALL, CITY STANDARD.
35 L.F. 5' BLOCK WALL, CITY STANDARD.
Fee summary Charged Paid Credited Due
Permit Fee Total 48.00 .00 .00 48.00
Plan Check Total .00 .00 .00 .00
'Grand Total 48.00 .00 .00 48.00
P.O. Box 1504 • VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
o n�ri?.A c761)z
Date:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under isianfs of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Co , and my Lice i'3 I force and effect_ LI
ense Class
�� d � Canlract�
L�
OWNER -BUILDER 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, demollsh, or repair any structure, prior to Its issuance, also requires the applicant for the permit to fila 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 8usiness
and Professions Cade) or that lie or She is exempt [lierefrom and the basis for the alleged exemption. Any violation of Seotion 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars ($500).);
U I, as owner of the properly, or my employees with wages as their sole compensalion, wilt 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 or through his Qr her awn employees, provided that the improvements are no[ intended ar offered for sale. If, however, the bulid Ing or improvement is
sold within one year of completion, the owner -builder will have the burden of proving that he or she did not bulid or improve for She purpose of sale.).
U I, as owner of the property,' am exclusively contracting with [icensed contractors to construct the project (Sec.. 7044. Suslness 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.).
�} I am exempt under Sac. , B.& P.C. for this reason
Date
WORKERS' 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 main workers' compensation insuran e, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
c5 I ed� work 'compensation insurance r qhc r a
!Carrier Policy Number e��
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 i should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
r Dato � U�d`� Applicant r
WARNING: FAILURE TO SECURE WORK S' COMPENSA OVERAGE 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
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
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 s 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 cc ct. a ree to comply with all city and county ordinances and state laws relating to building
construction, and hereby aruthodze representatives of this county to enter upon th abov entioned property for inspection purposes.
gate �� 0 /,q a Signature (Applicant or Agent):