04-5235 (BLCK)Tilf 4 4 a"
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
BUILDING & SAFETY DEPARTMENT
(760) .777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
04-00005235 Date 6/29/04
77914 GREY WOLF TR
658-140-999-90 -29436 -
WALL/FENCE
LOW DENSITY RESIDENTIAL
2500
Contractor
TRANS WEST HOUSING, INC.
9968 HIBERT STREET, STE ##102
SAN DIEGO CA 92131
(858) 653-3003
WCC: STATE FUND
WC: 1648813 10/01/04
CSLB: 701039 01/31/05
CCC: B
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Permit . . _ . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee 54.00 Plan Check Fee .00
Issue Date Valuation 2500
Qty Unit Charge Per Extension
BASE FEE 45.00
1.00 9.0000 THOU BLDG 2,001-25,000 9.00
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Special Notes and.Comments
100 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
J i L 0 3 �' I
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: 0 25 I Date: ]' i— U y
Applicant:
Applicant's Mailing Addre :Jai
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 provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Cede, and my License to -in full force and effect.
License Class c nse No-
01 Date Contractor�� ro'� �i`
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 Ihat requires a permit to construct, alter, Improve, demolish, or repair any structure, prior to Its issuance, also requires the applicant for the permit to fit 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 Business
^nd Prof: ss:ons Ccda) or that he or she i5 exempt iherefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit sut5jects
the applicant to a civil penalty of not more than five hundred dollars (5500).):
U I, as owner of the property, or my employees with wages as their sale compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044,
Buslness 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 cr her own ampIDyees, 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 pu pose of sale-).
j I, as owner of the property, am exclusively'contracting with licensed contractors to construct the prej act (Sec. 7044, Business and Prof
State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects w: The Contractors'
ith caessions ions Codeadd licensed pursuant to
the Contractors' State License Law-).
I } I am exempt render 9er, , 8A P.C. for thin rcason
Date
Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the fallowing declarations:
I have and will maintain a certificate of cans ant to sell -insure for workers' compensation, as provided fur by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
i have and will mfi� wo ors'compensation insurance, as required by Section 3700 of the Labor Code, for the perfomtance of the work for which this permit is
s e - nnywecDm ensalionce carrier and policy number are:
Policy Number]r edify t at, in thorma a of the work for which this permit is issued, 1 shall n t empley�m�f porn in any manner so as to become subject to the workers'
compensation laws of Cal ifomia, and agree that, if I should became sub]act to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date Ape p[icant
WARNiN : FILU4 TO SECURE WORKERS' COMPENSATION COVERAGE 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 Appficati6; is hereby made to the Director of Building and 'Safety for a permit subject to the conditions and restricthns set forth pn this application.
1. Each person upon whose hehalf 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 Ihis application, Ifte owner, and the applicant, each agrees to, and shall, defend, indemnify and hold harmless the City of La ❑uinta, its officers, agents and employees for any act or omission related to the work being performed under or fallowing Issuance of this permit,
2. Any permit issued as a result of this application becomes suit and void if work is not commenced within 180 days from data of issuance of such permit, or
cessation of worts for 180 days will subject permit to cancellation.
I car* that I have read this application and state that the above information Is carrect, I agree to comply with all city and county ordinances and state laws relating to building
construction, nd h reby aulhodze representatives of this county to enter upon the above-nnentioned property for inspection purposes.
_E]ate Signature (Applicant or Agent):