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04-7671 (BLCK) IIIIIII VIII III VIII IIII 71 � O V BUILDING & SAFETY DEPARTMENT 4D�a P.O. BOX 1504 (760).777-7012 OF9 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . . 04-00007671 Date 12/08/04 Property Address . . . . . . 80938 CALLE AZUL APN: 762-240-003-28 -300961- Application description . . . WALL/PENCE Property Zoning . . . . . . . MEDIUM DENSITY RES Application valuation . . . . 1624 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) 634-23-50 WCC: STATE FUND WC: WC298892004 06/12/05 CSLB : 813480 10/31/06 CCC: B ----------------------------------------------- - ----------------------- ---- Permit . . . . . . WALL/FENCE PERMIT Additional desc Permit Fee . . . . 39 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation 1624 Qty Unit Charge Per Extension BASE FEE 15 . 00 12 . 00 2 . 0000 HND BLDG 501-2 , 000 24 . 00 ---------------------------------------------------------------------------- - Special Notes and Comments 75 L. F. 5 ' GARDEN WALL, 45. L.F. , 21GARDEN WALL, BOTH ORCO SYSTEM Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 39 . 00 . . 00 . 00 39 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 39 . 00 . 00 . 00 39 . 00 10J P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 04- 3(031 Date: Applicant: Architect or Engineer: Applicant's Mailing Address: 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(comma irtp with Section 7000 f Division 3 of the Business and Professionals C de,and my Li ense i ull force and effect. ense Class icense Noo. "C - /Date106, on/t; tractor 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,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 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 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 oft o which this permit is issued. I h and w' aintain workers'compensation insurd by y Nu P�A�mare: ction / 0�Labor Co foC-r�the perfgrtnan�c_e�/bme thefor which this permit is My workers'compensation in amer and otic (�'/L_l G/J—fnJ AC +� rier ertify that,in the performanc hew ork f h' this rrri s issued,I s all not employ any person in any manner so as tobject to the workers' c pensation laws oomiaand a e t if I oul ecom ubje to the workers'compensation provisions of Sectioe Labor Code,1 shall rth c Rly wit ose provisio ate t t pelican WARNI AILURE TO SECURE W S'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL F E UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 06 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_squest-an ose benefit work is performed under or pursuant to any permit issued as a result of this application,the owner,and the applicant,each Restornd shall,defend,' damnify and hold harmless the City of La Ouinta,its officers,agents and employees for any act or omission related to ork bormed under orf Ilowingissuance of this permit. 2. Any permit issued as a result of this application becomes nul d void ifcom in 180 days from date of issuance of such permit,or cessation of work for 180 days will subject permit to canc ation. I certify that I have read is application and state that the above i rmation is I ag with all city and county ordinances and state laws relating to building construction,and ere authorize representatives of this coun to enter up a Ov n property for inspection purposes. ate ©'nature Applicant or Agent):