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04-7670 (BLCK) IIIIIIIIIIIIIIIIIIIIIIIII 80 La' ,00i --�E - - -- 0`` � o 'it In BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760),777-7012 OF49 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, 'CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . . 04-00007670 Date -12/08/04 Property Address . . . . . . '8-0944 CALLE AZUL APN: 762-240-003-27 -300961- Application description . . . WALL/FENCE Property Zoning . . . . . . . MEDIUM DENSITY RES Application valuation . . 2208 Owner Contractor ------------------------ ------------------------ PUERTA AZUL PARTNERS DAVIS/REED CONSTRUCTION INC 17700 SW UPPER BOONES FERRY RD 169 SAXONY ROAD, STE #105 SUITE 100 ENCINITAS CA 92024 PORTLAND OR 97224 (760) 634-2350 WCC: STATE FUND WC: WC298892004 06/12/05 CSLB: 813480 10/31/06 CCC: B ------------------- ----------------------------------------------------- --- - Permit . . . . . . WALL/FENCE PERMIT Additional desc Permit Fee . . . . 54 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 2208 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 102 L. F. 5 ' GARDEN WALL, 5 L. F. , 21GARDEN• WALL, BOTH 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.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: oq-7(, ?D Date: 12 8- Oct Applicant: Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: o 7p- 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(co me Section 7000)of Division 3 of the Business and Professionals e,and ss 'cense�e�l II force and effect.License Class C LicenseNo. L/ + — /D"ate Contractor Wq S 4 OWNER-BUILDER DECLARA ON I hereb affi 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'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 saleIf,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 1,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 contractor(s)licensed pursuant to the Contractors'State License Law.). U I am exempt under Sec. ,BA P.C.for this reason Date Owner 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 fain workers'compensation insurance,as required by Section 3700 of the La r Code,for the performance of the N for which this permit is issue y workers'compensation in a carrier and policy number are: �G�� �errier icy Nu _I cer y in the performance of th or which this permit is issued, shall not employ any arson in any manner so a o become subject to the workers' ens 'on laws of Califo ' ,and agree that,if hould be ject'to the workers'compensation provisions of ction 3700 of the Labor Code,I shall fo comp th thos provisions. _22 Date Applicant 9 WARNIN FAL UR TO SECURE WORK S' PENSATI N COVERAGE IS UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FI TO ONE HUNDRED TH ND DOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,I TEREST,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 l�'\ 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,ea t-w uest and for whose benefit work is performed under or pursuant to any permit issued as a result of this application,the owner,and t applicant,each agrees to,an Il,defend,indemnify and hold harmless the City of La Ouinta,its officers,agents and employees for any act or omissi n related to the work being performed r or following issuance of this permit. 2. Any permit issued as a result of this application bec es null and void if ane within 180 days from date of issuance of such permit,or cessation of work for 180 days will subject permit to c ellation. I certify that I have read his application and state that the above info on is ce agreeto imply with ity and county ordinances and state laws relating to building constructiio�n,and er au horize representatives of this county to enter u e - ermsjiection purposes. ate L. gnature(Applicant or Agent: