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�,�,�4/•� BUILDING & SAFETY DEPARTMENT
Cw P.O. Box' 1504 (760).777-7012
OETt 9 78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
.. 4
Application Number . . . . . `.. 05-00001265 ' Date 4/05/05
Property Address . . . . 80920 CALLE AZUL
APN: 762-240-003-31 -300961-
Application description . . . WALL/FENCE
Property Zoning . . . . . . . MEDIUM DENSITY RES
Application valuation . . . . 1483
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
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Permit . . . . . WALL/FENCE PERMIT
Additional desc
Permit Fee . . . . 35 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 1483
Qty Unit Charge Per Extension
BASE FEE 15 . 00
10 . 00 2 . 0000 HND BLDG 501-2 , 000 20 . 00
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Special Notes and Comments
50 L. F. 5 ' ' GARDEN WALL, 25 L. F. 4 '
GARDEN WALL, 8 L. F. 2 ' WALL, ALL ORCO
SYSTEM
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 35 . 00 . 00 . 00 35 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 35 . 00 . 00 "^'. 00 35 . 00
D Q
APR 13 2005
CITY OF LA QUINTA
FINANCE®LpT
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 &i: SAFETY DEPARTMENT
Application Number: 0.6-- Date: -
Applicant: Architect or Engineer:
Applicant's Mailing Address: Architect or Engineer's Address:
10 A
C1t4V_ Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penal erjury that I am licensed under provisions of Chapter 9(com ci with Section 7000)of Division 3 of the Business and Professionals
Co ,and my icens is i II rce and effect. n
icense Clas t ense No.
X0
,B9te ractor r
/ M71
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 rive 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 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��h_iich this permit is issued.
ave a d itiTl�maintain workers'compensation insura rimed by Section 3700 of the Labor Code for the performance of the rk for which this permit is
iss d: w compensation ins arrier and policy num'Der�:�A �� ��
arrier Number j��/
I certif hat, n the performance o e work for whi i ermit is issued hall not employ any person in any manner to as to come subject to the workers'
co pensation laws of Calif ia,and agree t if ould become ject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall
forth t comply w' s rovisions.
�6ate scant
WARNI G: F (LURE TO SECURE WOR S'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES P TO ONE HUNDRED T USAND 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 A
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 re utest andel for whose benefit work is performed under or pursuant to any permit
issued as a result of this application,the owner,and the applicant, grebes I.
and shall,def�d,indemnify and hold harmless the City of La Quinta,its
officers,agents and employees for any act or omission rela o the work being performed under oTf Ilowin9 issuance of this permit.
2. Any permit issued as a result of this application become ull and void if work is not commenced within 80 days from date of issuance of such permit,or
cessation of work for 180 days will subject permit to can ellati.n.
I certify that I have read this application and state that the above info tion is c ect. agree to com I with all cit and county ordinances and state laws relating to-building
constructionAnd h reby authorize epresentatives of this county to enter upo ve entione( property for inspe tion purposes.
ate �Si� gnatu�re(Applicant or Agent):