05-5406 (BLCK) ( III�II�I�IIIIIIIIIIIIIIII � I -
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P.O. BOX 1504 60 VOICE(760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING&SAFETY DEPARTMENT INSPECTIONS (760)777-7153
BUILDING PERMIT
Date: 12/12/05
Application Number: L__0^5--00005406 Owner:
Property Address: 80927-CALLE`AZUL PUERTA AZUL PARTNERS
APN: 762-240-003-42 -300961- D 17700 SW UPPER BOONES FERRY RD
Application descriptions WALL/FENCE SUITE- 100
Property Zoning: MEDIUM DENSITY RES PORTLAND, OR 97224
Application valuation: 1250 DEC 2 2 2005
CITY OF LA QUINTA Contractor:
Applicant: Architect or Engineer: FINANCE DEPT DAVIS/REED CONSTRUCTION INC
169 SAXONY ROAD, SUITE 105
ENCINITAS, CA 92024
(760)634-2350
Lic. No. : 813480
CENSED C 'S ECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjur that I am ' e r isions of tapter 9(commencing with I hereby affirm under penalty of perjury one of the following declarations:
coon 7 01 of Division 3 of the B siness an 1 I ode,and m icense is in full force and'effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided
License lass: B for by Section 3700 of the Labor Code,for the performance of the work for which this permit is
issued.
/fl'he
- ntractor: I have and will maintain workers'compensation insurance,as required by Section 3700 of the Labor
Code,for the performance of the work for which this perms d.-tNy-vrorleers_co ensatOWNER-BUILDER DECLARATION ins rance carrier and policy number are:y affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the iCarrier TAT FUND Pol' mber WC298892005
ng reason(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to _ I ertify that,in the perfor anc a work for whit is issue ,(•shall not employ anyct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for the person i nn s s to become su ' t workers' mpensati laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that,if I shou •comes c o th orker ' pensatio rovisions of Section
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or 7 ��700 of the Labor Code,I shall h ply w se 16
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 155001.: e' A cant: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 RNING: FAILURE TO SECURE W OMPENSATION COVERAGE IS UNLAWFUL,AND SHALL
Contractors'State License Law does not apply to an owner of property who builds or improves thereon, BJECT AN EMPLOYER TO CRI L TIES 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 DOLLARS(S 100,000). IN ADDITION 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.
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 I am exempt under Sec. ,B.&P.C.for this reason the owner,and the applicant,each agrees to a 'ndemnify and hold harmless the City
of La Quinta,its officers,age mployees for any act or omission d to the work being
performed under or f ing issuance of this permit.
Date: Owner: 2. Any permit iss as a result of this application becomes n nd void if work is not mmenced
within 180 s from date of issuance of such permi a tion of work for 180 d ys will subject
CONSTRUCTION LENDING AGENCY permit to cance
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application an sta a ct. I agree to omply with all
work for which this permit is issued(Sec.3097,Civ.C.). city and county ordinances and state laws relating to d' ction,and hereby authors -UW-I—
of this ty to enter upon the above-mentioned p o spection purposes.
Lender's Name:
. _ a S' ture(Applicant or
Lender's Address: /'�
LQPERMIT
Application Number . . . . . 05-00005406
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . 31.00 Plan Check Fee 00
Issue Date . . . . Valuation . . . . 1250
Expiration Date 6/10/06
Qty Unit Charge Per Extension
BASE FEE 15.00
8.00 2 .0000 HND BLDG 501-2,000 16.00
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Special Notes and Comments
50 L.F. 6- GARDEN WALL, ORCO SYSTEM
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total '31.00 .00 .00 31.00
Plan Check Total .00 .00 .00 .00
Grand Total 31.00 .00 .00 31.00
LQPERMIT