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04-5233 (BLCK)Tityl 4 4 a" P.O. Box 1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760) .777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Application Number . . . . . 04-00005233 Date 6/29/04 Property Address . . . . . . 77942 GREY WOLF TR APN: 658-140-999-88 -29436 - Application description . . . WALL/FENCE Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 2500 Owner IVANHOE LA QUINTA COVE C/O R BARRY MCCOMIC 7979 IVANHOE AVE STE 550 LA JOLLA CA 92037 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 ---------------------------------------------------------------------------- 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 ----------------------------------------------------------------------------- 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 P --•r �• r nIF;•a pia 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: : roc , 4, Date: � — 7 - O y Applicant: Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under peg fty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and.my Licensen Full force and effect 1>cense Class -tr., No- d T ,---Date— lh(q .�raCtor A t .7 tJ 4u.�2 OWNER -BUILDER DECLARA4ION 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, 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 Contractors' 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 ($500) ): U 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 (Sec 7044, Business and Professions Code; The Contractors' Stale 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 not build or improve for the purpose of sale.). U I, 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 projects with a contractors) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , BA P.C. for this reason Date :Dwner 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 maintain workers' compensation insurance, as required by Section 370D of the Labor Code, for the performance of the work for which this permit is suet' world co bensationettfance carrier and policy number are: • ` 1 �r rrier_SL ollcy Number 1 ce ify that, in the erforma a of the work forwhich this permit is issued. I shall not employ any persorrin any manner so as to become subjectto the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions. Date WARNIN : F ILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FI ES 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 Di rector of Building and Safety for a permit subject to the conditlons and restrictions set forth on this application. 1. Each person upon whose behalf INN applIca lion 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. Z 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 Correa I agree to Comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to en upon the above -mentioned property for inspection purposes. r ,---Date Signature (Applicant or Agent):