05-5390 (BLCK) n.�, I Ilillll VIII III VIII IIII 09
I E
P.O. BOX 1504 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
_
Owner: Date: 12/09/05
Application Number: 05-00005390
Property Address: _—_ 80884 CALLE AZUL PUERTA AZUL PARTNERS
APN: 762-240-003-58 -300962- 17700 SW UPPER BOONES FERRY RD
Application description: WALL/FENCE SUITE 100
Property Zoning: MEDIUM DENSITY RES a PORTLAND, OR 97224
Application valuation: 3625 D
DEC 2 2 2005 Contractor:
Applicant: Architect or Engineer DAVIS/REED CONSTRUCTION INC
C'TMorLA.pUINTA 169 SAXONY ROAD, SUITE 105
F1Np.NCEO ENCINITAS, CA 92024
(760)634-2350
Lic. No. : 813480
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LICENSED CO R' RATION WORKER'S COMPENSATION DECLARATION
I he by affir under,p Ity of rjury that I am lice d p v' ns of Chapter ommencing with I hereby affirm under penalty of perjury one of the following declarations:
Se tion 70 0)of vision 3 o he Business and Pr es' and my Li a is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided
ense ss: B for by Section 3700 of the Labor Code,for the performance of th'e work for which this permit is
1141 issued.
ontractor: •have a will maintain workers' pensation insurance,as re w
q y Section 3700 of the Labor
Co ,for the perform of the work for which this permit is issued. y workers'compensation
OWNER-BUILDER DECLARATION in rance carrie icy number ar
I reby affirm under penalty of perjur at I am exempt from the Contractor's State License Law for the Carrier S AT FLIM Po' Num er Q 298892005
following reason(Sec.7031.5,Bus' ss and Professions Code: Any city or county that requires a permit to I c ify ,in the performance of or o i this permit is issue ,I shall not employ any
construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for the p on in any manner so as to ecom c the workers'comp sation la 'f^•^'a
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State A aee that,if I should be ome s .I t e wor ion provisions of Section
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or /` 3 b of the Labor Code,I all f p y with those p isions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by l� /
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($5001.: at nt:
(_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 W RNIN FAILURE TO SECUeAL
S'COMPE COVERAGE IS UNLAWFUL,AND SHALL
Contractors'State License Law does not apply to an owner of property who builds or improves thereon, S BJEC AN EMPLOYER TOCENALTIES 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 DOLLARS(S 100,0001. IN ADDHE 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 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 as a result of this application,
(_) I am exempt under Sec. ,B.&P.C.for this reason the owner,and the applicant,each agree n shall defend,indemnify an -k1 harmless the City
of La Quinta,its officers,agents a ployees for any act or omission related to thework being -
performed under or ollowin uance of this permit.
Date: Owner: 2. Any permit issue as a re t of this application becom ull a all work is not com enced
it ' 180 da fro ate of iss rice of such i or n of work for 180 da will subject
CONSTRUCTION LENDING AGENCY
it wto can ellatio
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the 1 certify that ave read is ap ' on and state that a ova' r tion is ct. I agree to comply with
work for which this permit is issued(Sec.3097,Civ.C.). city a d cc ty ordin ces state la elating t 'ding str ction sentatives
oft ' cou ty to en upo he above-mentione n ecu purposes.
Lender's Name:
a ture(Applicant or g
Lender's Address: '
LQPERMIT
Application Number . . . . . 05-00005390
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee 63.00 Plan Check Fee .00
Issue Date . . . . Valuation 3625
Expiration Date 6/01/06
Qty Unit Charge Per Extension
BASE FEE 45.00
2.00 9.0000 THOU BLDG 2,001-25, 000 18.00
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Special Notes and Comments
145 L.F.. 6' GARDEN WALL, 45 L.F. 2'
RETAINING WALL, BOTH ORCO SYSTEM
Fee summary Charged Paid Credited Due
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Permit Fee Total 63 .00 .00 .00 63.00
Plan Check Total .00 .00 .00 .00 .
Grand Total 63 .00 .00 .00 63.00
LQPERMTT