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05-1279 (BLCK) p2 II�IIIII IIIIIIIIIIIIIIIII 44 IE � oz U � P.O. Box 1504 BUILDING & SAFETY DEPARTMENT OFTt9 78-495 CALLS TAMPICO (760).777-7012 FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . . 05-00001279, Date 4/05/05 Property Address . . . . . 80915 CALLE AZUL APN: 762-240-003-40 -300961- Application description WALL/FENCE Property Zoning . . . . . MEDIUM DENSITY RES Application valuation . . . . 1932 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 . . . . 45 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 1932 Qty Unit Charge Per Ektension BASE FEE 15 . 00 15 . 00 2 . 0000 HND BLDG 501-2 , 000 30 . 00 --------------------------------------------7------------------------------- Special Notes and Comments 70 L. F. 5 ' GARDEN WALL, 26 L. F. 4 ' GARDEN WALL, BOTH ORCO SYSTEM' Fee summary Charged Paid Credited Due Permit Fee Total 45 . 00 . 00 . 00 4.5 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 45 . 00 . 00 ,, •, 00 45 . 00 APR 13 2005 CITY OF LA QUINTA FINANCE DEPT. P.O. BOX 1504 • VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 Ot INSPECTIONS (760) 777-7153 BUILDING &C SAFETY DEPARTMENT Application Number: (� ✓' ' /;j 7�1 Date: Applicant: Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: /A Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of hapter 9(commencing with Section 7000)of Division 3 of the Business and Professionals Code,and my License i 11 force and effect. icense ClassicNo. IV ,/''_Date 2- ontractor O 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 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 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 1 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 fprwhrch,this permit is issued. .I have a d will aintam workers'compensation insurance,as required by Sec io 3700 of the Labor Code,for7z_�>J ormance of the work f ich this permit is is ers'compensation�lrance carrier P���cynnmb r �rrier Policy Numb S (x�/ I cert' that,i the performance of the o which this pe i I hall not emplo�rly person in any manneras to becom subject to the workers' o ens on laws of California r agree t I sh d ubj t to the workers'compensation provisions of Section 3700 of the Labor Code,I shall rthwith ompl�ose visions. /Plate Applicant WARN G: FAILURE TO SECUREW ERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRE HOUSAND 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 Q Lender's Address +r, 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 whgse=request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application,the owner,and the applicant, ach agrees to,and shall,defend,indemnify and hold harmless the City of La Ouinta,its officers,agents and employees for any act or omission relate t the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application become ull and void if w s t commen hin 180 days from date of issuance of such permit,or cessation of work for 180 days will subject permit to ca cellation. \ I certify that I hav read is application and state that the above in rmation is rre I agree t pl all city an unty Ordinances and state laws relating to building construction,a her 'y auutthjze representatives of this county to e n t oses. ate v/ $;ynature(Applicant or Agent):