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05-5387 (BLCK) -- IIIIIIIIIIIIIIIIIIIIIIIII 20 P.O. BOX 1504 - IE ^� VOICE(760)777-7012 78-495 CALLE TAMPICO FAX(760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING&SAFETY DEPARTMENT INSPECTIONS(760) 777-7153 BUILDING PERMIT '-- 7 Date: 12/09/05 Application Number: 05-00005387 / Owner: Property Address: 80896 CALLE AZUL PUERTA AZUL PARTNERS APN: 762-240-003-56 -300962- 17700 SW UPPER BOONES FERRY RD Application description: WALL/FENCE SUITE 100 Property Zoning: MEDIUM DENSITY-RES D PORTLAND, OR 97224 Application valuation: 1195 DEC 2 2 2005 Contractor: Applicant: Architect or Engi r: DAVIS/REED CONSTRUCTION INC CITY OF LAQUINTA 169 SAXONY ROAD, SUITE 105 FINANCE DEPT. ENCINITAS, CA 92024 (760)634-2350 LiC. No. : 813480 S.ICENSED TRAC S DEC RATION WORKER'S COMPENSATION DECLARATION hereby affirm unde enalty of perjur at I am I' en d un r ovisi s of Chapter commencing with I hereby affirm under penalty of perjury one of the following declarations: ' Sectio 7000)o ivision 3 of the siness and rof ssio I ode nd my Licen is in full force and effect. __ _ I have and will maintain a certificate of consent to ers'compensation,as provided Licen Class B i ice No.: 81 0 for by Section 3700 of the Labor Cod f r the performance of the wo or which this permit is issued. a Cont r ctor: I have and will maintain w rs'compensation insurance,as required by Sectio 3700 of the Labor Code,for the perf an of the work for which this permit is;issued. My wo ers'compensation / 0 ER-BUILDER DECLARATION ins nce carr' and policy number are: I ereby affirm under penalty of per' that I am exempt from the Contractor's State License Law for the, Carrier ST TE LND Policy N r WC2 92005 ollowing reason(Sec.7031.5,Bu ' ass and Professions Code: Any city or county that requires a permit to Ice ify th ,i erformance of the for ich is permit is issue shall not employ any construct,alter,improve,demolish,or repair any-structure,prior to its issuance,also requires the applicant for the ersy n any manner so as to e t t e workers'c ensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State /� an ag that,if I should Ic a workers' pensation provisions of Section License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or (' 3760 of the II mply w' ose provisions. 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).: e: ;cant: ( 1 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 I AR ING: FAILURE TOS ORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALLContractors'State License Law does not apply to an owner of property who builds or improves thereon, B ECT AN EMPLOYER CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees,provided that the DO LARS($100,000)- IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If,however,the building or improvement is sold within SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. 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.). APPLICANT ACKNOWLEDGEMENT (_) I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044,Business and Professions Code: The Contractors'State License Law does not apply to an owner of conditions and restrictions set forth on this application. - property who builds or improves thereon,and who contracts for the projects with a contractor(s)licensed 1. Each person upon whose behalf this application is made,each person at whose request and for pursuant to the Contractors'State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_1 I am exempt under Sec. ,B.&P.C.for this reason 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 o orad-Ee-td in performed under or following issuance of this pe�rryr t - Date: Owner: 2. Any permit issued as a result of this applic '... comes null and void if work is not commenced within 180 days from date of issua of such permit,or cessation of work far 180 days will subject CONSTRUCTION LENDING AGENCY permit to cancellation. - I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state at the above i �o c t. I agree to comply with all work for which this permit is issued(Sec.3097,Civ.C.). city and county ordina ces and state laws relating to bu resenfatwas of this county to ant upon the above-mentioned prop r, s o oses. Lender's Name: !/1 te: ature_16ppk'cant of Lender's Address: � r� � LQPERMIT r Application Number . . . . 05-00005387 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 29.00 Plan Check Fee 00 Issue Date . . . . Valuation . . . . 1195 Expiration Date 6/07/06 Qty Unit Charge ' Per Extension BASE FEE 15.00 7.00 2 .0000 HND BLDG 501-2, 000 14.00 ---------------------------------------------------------------------------- Special Notes and Comments 35 L.F. 6' GARDEN WALL, 20 L.F. 4' GARDEN WALL, 8 L.F. 2 ' GARDEN WALL, ALL 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 .00 29.00 LQPERMIT .