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05-1276 (BLCK) r tuM�' IIIIIIIIIIIIIIIIIIIIIIIII 23 IE------ o� /: U � W BUILDING & SAFETY DEPARTMENT cF 9 � P.O. BOX 1504 (760).777-7012 OF78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number 05-00001276 Date 4/05/05 Property Address . . . . . . 80897 CALLE AZUL APN: 762-240-003-37 -300961- Application description WALL/FENCE Property Zoning . . . . . . . MEDIUM DENSITY RES Application valuation . . . 1147 Owner Contractor ------------------------ ------------------------ PUERTA AZUL PARTNERS DAVIS/REED CONSTRUCTION INC 17700 SW UPPER BOONES FERRY RD 169 SAXONY ROAD, STE #1.05 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 . . . . 29 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 1147 Qty Unit Charge Per Extension BASE FEE 15 . 00 7 . 00 2 . 0000 HND BLDG 501-2 , 000 14 . 00 ---------------------------------------------------------------------------- Special Notes and Comments 53 L.F. 5 ' GARDEN WALL, ORCO SYSTEM Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 29 . 00 . 00 � . 00 29 :00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 29 . 00 . 00 D 29 . 00 APR 131005 CITY of F11ygNCp INTA P1 P.O. BOX 15044h 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: 105- /cA*7 6 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 penalt of perjury that I am licensed under provisions 9pphapter 9(comae ting with Section 7000)of Division 3 of the Business and Professionals Code,and my LicenseII force and effect. .,�ci `nense Class `cense No. LPI- ateor �U� r 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).): L) 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 which this permit is issued. 1 have and will ar Matm-workers'compensation insurance,as required by Section 3700 of the Labor Code,for the Performance of th ork for which this permit is arrier issued. kers'compensatiolipa&ance carrier and policy number are: , olicy Number S5 1 certify!,hel,int a performance ofthe work f ch this pe it is iss h II not employ �j person`n any manner so a o become subject to the workers' c nsation laws of California,anyr ee that,if 1 y11 beco e s ct e workers'compensation provisions of Section 3700 of the Labor Code,I shall omply with those provision �//w/ith Date 2?Applicant WARNING: FV/LURE TO SECURE WORKE MPENSATION COVERAGE IS UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOU ND 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 APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit su nditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made,each person ose request and for wh benefit work is performed under or pursuant to any permit issued as a result of this application,the owner,and the applica ach agrees to,and shall,defend,indemnify and hold harmless the City of La Quinta,its officers,agents and employees for any act or omission rela to the wo eing performed under or follo�ing issuance of this permit. 2. Any permit issued as a result of this application become null and v `hGvork is not commenced within 1,80 days from date of issuance of such permit,or cessation of work for 180 days will subject permit to c ncellatio . / I certify that I have ad this application and state that the above i on is correct. I agree to comply with all `ty and county ordinances and state laws relating to building construction,aln7 ereb authorise representatives of this county to er pon ove-mentioned propert r`nspe ses. a� re `' �Sig�Applicant or Agen .