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05-1267 (BLCK) 1111111 VIII III VIII IIII 41 IE U � W BUILDING & SAFETY DEPARTMENT P.O. BOX 1504 (760).777-7012 'OF T19 78-495 CALLS TAMPICO *' FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT. . Application Number . . . . . .05-00001267 Date 4/05/05 Property Address . . . . . . 80914 CALLE AZUL APN: 762-240-003-32 -300961- Application description . . WALL/FENCE Property Zoning . . . . . . . MEDIUM DENSITY RES Application valuation . . . . 217 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 . . . . 15 . 00 Plan Check Fee : 00 Issue Date . . . . Valuation . . .217 Qty Unit Charge Per -Extension BASE FEE 15 . 00 ------- ----------------------------------------- - ---------------------------- Special Notes and Comments 60 L. F. 2 ' GARDEN WALL, 10 L:F. 5 ' GARDEN WALL, BOTH ORCO SYSTEM Fee summary Charged Paid Credited Due ----------------- ---------- ---------- --------=- ---------- Permit Fee Total 15 . 00 . 00 . 00 15 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 15 . 00 . 00 . 00 15 . 00 D Q p APR 13 1005 CITY OF LA QUINTA FINANCE bEPT. 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 & SAFETY DEPARTMENT /L Application Number: _ 05- j,2 49 Date: �7 42, 03 Applicant: Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: N IA Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under pena f perjury that I am licensed under provisions of Chapter 9(commencing th S�ejon 7000)of Division 3 of the Business and Professionals Code,Raffirmunder is._, in f(II rce and effect. v /Licenicense No. / Dateractor �s� OWNER-BUILDER DECLARATION I herenalty of perjury that I am exempt from the Contractors'State License Law for thelollowing 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 of the work for which this permit is issued. lhave an,ga=aintain workers'compensation insurance,as required by Section 3700 of the Labor Code,fo the performance oft work for which this permit is isa My workers'compensation ins tier an po icy numb r . Z arstier icy Number I cepffy t t,in the perform a of the work for whi is permit is is shall not Icy any p son in any manner so a to become subject to the workers' �ompensatign laws alifornia,and agree I sh=bo the work s'compensation provisions of ction 3700 of the Labor Code,I shall f9fthwith 945mpl se provisions. ,,-Eate 0 p icant WARNI/ES FAIRE TO SECURE W RS'COMPE 10 ERAGE IS UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FI UP TO ONE HUNDRED THOUSAND 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 f Lender's Address A APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety fora 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 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,each agrees to,and shall,defend•indemnify and hold harmless the City of La Quinta,its officers,agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit,or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above inform orrec. gree to comply with all city and county ordinances and state laws relating to building construction,an ereb authorize representatives of this county t ter on ve-menti ned property for inspection purposes. ate � S�a(Applicant or Agent):