06-3768 (BLCK) IIIIIIIIIIIIIIIIIIIIIIIII 03
P.O. BOX 1504 - IE 4 � VOICE 760 777-7012
78-495 CALLE TAMPICO FAX(760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING&SAFETY DEPARTMENT INSPECTIONS(760) 777-7153
BUILDING PERMIT
�a Date: 11/06/06
Application Number: 06-0.0003-7-68 �" Owner:
Property Address: 80957 CALLE AZUL PUERTA AZUL PARTNERS
APN: 762-243-003-H -300961- 17700 SW UPPER BOONES FERRY RD
Application description: WALL/FENCE SUITE 100
Property Zoning: PORTLAND, OR 97224
Application.valuation: 1350 P
Contractor: (� � t
Applicant: Architect or Engineer: TOP DOG CONSTRUCTION �a 2oOC
78365 HIGHWAY 111 STE ;182 U
LA QUINTA, CA 92253
(760)574-6364 �'�
Lic. No. : 828373
--- -- ------ ---- -- --- - - ---------- ---- --- ------- ---- - --- ------- ---- - ----- --- -- --------- ----- ---- -
LICENSED CONTRACTO 2tLARA N WORKER'S COMPENSATION DECLARATION
I hereby affirm under pe y of perjury that I am I' ensed and ro ' ions of apter 9(commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section00 )of Div' on 3 of the Business a rofession C e,and License is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided
Lice CI s: B ense : 828373 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is
issued.
T'Co —�^ _ I have and will maintain workers'compe n in�this
requiied by Section 0 of the Labor
G Code,for the performance oft ork for whimit is issued. My workers mpensation
OWNER-BUILDER DECLARATION insurance carrier and poli umber are: -
I hereby affirm under penalty erjury that I am exempt from the Contractor's State License Law for the Carrier GUARD INSURANCE Policy Number705603
following reason(Sec.7031. ,Business and Professions Code: Any city or county that requires a permit to _ I certify that,in the pe ormance of the for which this permit is i ued,I shall not a loy any
construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for the ars n in any mann so as to be e•subiact to the work c pensation laws o alifornia,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State an agree that,if I sh be ject to the worke pensation provisi of Section
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or 00 of the Labor Code with comply w' ose provisions.
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).: Da Applicant: TT
(_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 WA IN FAILURE TO SE ORKERS'COMPENSATI OVERAGE IS UNLAW L,AND SHALL
Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SU JE AN EMPLOYER RIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees,provided that the DOL S($100,000). IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If,however,the building or improvement is sold within SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
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.). APPLICANT ACKNOWLEDGEMENT -
(_1 I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044,Business and Professions Code: The Contractors'State License Law does not apply to an owner of conditions and restrictions set forth on this application.
(•u - property who builds or improves thereon,and who contracts for the projects with a contractor(s)licensed 1. Each person upon whose behalf this application is made,each person at whose request and for
pursuant to the Contractors'State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_1 1 am exempt under Sec. B.&P.C.for this reason 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.
Date: Owner: 2. Any permit issued as a result of this application becomes n void if wo)nommenced
within 180 days from date of issuance of such pe ,or cessation orkyswill subject
CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I ave read this application and state tha a above info, on i orrect. omply with all
work for which this permit is issued(Sec.3097,Civ.C.). city and cou y or ina es and state laws relating building const, do ereby aresentatives
of this cou y t upon the above-mentioned, roperty for i ec' p ses.
Lender's Name: /!
/D Signature(Applicant-or-Agent): /
Lender's Address:
LQPERMIT
Application Number . . . . . 06-00003768
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee . . 33 .00 Plan Check Fee 00
Issue Date . . . . Valuation . . . . 1350
Expiration Date 5/05/07
Qty Unit Charge Per Extension
BASE FEE 15.00
9.00 2.0000 HND BLDG 501-2, 000 18.00
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Special Notes and Comments
54 L.F. COMBO WALL AT TENNIS COURT: 2'
RETAINING, 2' GARDEN WITH 4 ' WROUGHT
IRON ON TOP, ORCO SYSTEM, PER 'C/D
APPROVED PLAN
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 33.00 .00 .00 33 .00
Plan Check Total .00 .00 .00 .00
Grand Total 33.00 .00 .00 33 .00
4.
ra
LQPERMIT '
Bin#
City of La Quinta
Building u Safety Division
Permit# P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: jQR—� 7 , Z�,/ Owner's Name: &d�tj_vv /
A.P.Number: V 6 Address: �`�—•
Legal Description: City,ST,Zip:
St
Contractor: / d Telephone:
Address: -
l� l8'l� Project Description:
City,ST,Zip:LTele o 6 /'
l�
State Lic. City Lic.#:
Arch.,Engr.,Designer:
Address:
City,ST,Zip:
Telephone: Construction Type: Occupancy:
State Lic.#: a Project type(circle one): New Add'n Alter Repair Demo
Name of Contact Person: Sq.Ft.: #Stories: #Units:
Telephone#of Contact Person: Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd_ Rec'd TRACKING. PERMIT FEES
Plan Sets Plan Check submitted Item Amount
Structural Calcs. Reviewed,ready for corrections Plan Check Deposit
Truss Calcs. Called Contact Person Plan Check Balance
Energy .Calcs. Plans picked up Construction
Flood plain plan Plans resubmitted Mechanical
Grading.plan 2nd Review,ready for corrections/issue Electrical
Subcontactor List Called Contact Person Plumbing
Grant Deed Plans picked up ,S.M.I.
H.O.A.Approval Plans resubmitted. Grading
IN HOUSE:- '`d Review,ready for correctionstissue Developer Impact Fee ,
Planning Approval Called Contact Person A.I.P.P.
Pub.Wks.Appr Date of permit issue.
School Fees
TO Permit Fees.. :.