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05-1268 (BLCK) IIIIII�IIIIIIIIIIIIIIIIII 34 iE---- -- F oz 29 P.O. Box 1504 �,�'��� BUILDING & SAFETY DEPARTMENT C� ^u OF (760).777-7012Tt�9 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . 05-00001268 Date 4/05/05 Property Address . . . . . . 80908 CALLE AZUL APN: 762-240-003-33 300961- Application description . . . WALL/FENCE Property Zoning . . . . . . MEDIUM DENSITY RES Application valuation . . . . 2338 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 54 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 2338 Qty Unit Charge Per Extension BASE FEE 45 . 00 1 . 00 9 . 0000 THOU BLDG 2 , 001-25, 000 9 . 00 ---------------------------------------------------------------------------- Special Notes and Comments 70 L. F. 2 ' GARDEN WALL, 108 L. F. 5 ' GARDEN WALL, BOTH ORCO SYSTEM Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 54 . 00 . 00 . 00 54 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 54 . 00 . 00 00 54 . 00 D Q APR 13 1005 Clry Qs QUINTA FIN Ne (JE 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 Application Number: Date:1--22.2 Applicant: Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: on AtOW AJ �� Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLA5ATION I hereby affirm under pen f perjury that I am licensed under provisions of ChapJer 9(cgmme n th$Action 7000)of Division 3 of the Business and Professionals de,and License is in ul1 rce and effect. l hCG_ _1�`Jl1 License CI sZ ense No. Al-,-/Dateontractor OWNER-BUILDER DECLARATION I he eby affi under penalty of perjurythat 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 `' of the work for which this permit is issued. 791 have and WMiTURtain workers'compensation insurance,as required by Seck'o_n 3700 of the Labor Code,Xnvnmanner performance of the work for ich this permit is issu_ . y workers'compensation ins nce carrier and policy number ar�j� /�� -Z arner icy Number "'����/// G/�,/ /7 _I certif tha in the performance of rk for permit is issue t employ a pefserfi so as to be a subject to the workers' c pensatio laws of an a tha ' should beco s ject to the w compensation provisions of Section 700 of the Labor Code,1 shall hwith c pl those prr ons. Date pp' ant / WARN/INES FAI RE TO SECU OR ION COVERAGE IS UNLAWFUL,AND SHALL SUBJECT AW-EMPLOYER TO CRIMINAL PENALTIES AND CIVIL 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 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 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 Ouinta,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 beco v of commenced within 180 days from date of issuance of such permit,or cessation of work for 180 days will subject per . cancellatio I certify that I hav read thi pplication an above info i s correct. I agree to comp hall ounty ordinances and state laws relating to building construction,a herebyy uthod presentatives his count r upon the ab e-m tioned inspection purposes. Date (/ ignature(Applican or nt):