05-5395 (BLCK) 77 ___ j
4
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
- Date: 12/12/05
Application Number: I 05_-00005395 1 Owner:
Property Address: 80872 CALLE AZUL PUERTA AZUL PARTNERS
APN: 762-240-003-60 -300962- 17700 'SW UPPER BOONES FERRY RD
Application description: WALL/FENCE D SUITE 100
Property Zoning: MEDIUM DENSITY RES r PORTLAND, OR 97224
Application valuation: 1195 DEC 2 2 �0�5
Applicant: Architect or En inee : CITY OF LA�IUINYA Contractor:
g FINAFCEOMNI- DAVIS/REED CONSTRUCTION INC
169 SAXONY ROAD, SUITE 105
ENCINITAS, CA 92024
(760)634-23 50
Lic. No. : 813480
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LICENSED T CTOR' ECLAR ON WORKER'S COMPENSATION DECLARATION
Ireby affir and of perjury that I am I' rise under visions Chapter 9 Icomme g with I hereby affirm under penalty of perjury one of the following declarations:
coon 70 Divis' 3 of the Business an rof onals ode,a my License is in f rce and effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided
icense C ss: 13 cans o.: 81348 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is
`f issued.
ate: K I have and will maintain workers'compensation insur�a CP.-as•regnired-by-5 tion 3700 of the Labor
Code,for the performance of the work is tFS�i his permit is issued. My wo s'compensation
OWNER-BUILDER DECLARATION insurance carrier and policy nu are:
I ereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number WC298892005
ollowing reason(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to f _ I certify that,in the p rmance of the work forich�peft' ' ued,I;p I not employ any
construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for the person in any nner so as to become su ' ct, theenSSa on laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and ;'if I should become su ct a wort(on provisions of Section
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or 00 o he bor Code,I shall fo w' omply wns.
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).: at pplic '
(_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 ARNING: FAILURE TO SECURE WO 1 ER MPENSATION COVERAGE IS UNLAWFUL,AND SHALL
Contractors'State License Law does not apply to an owner of property who builds or improves thereon, UBJECT AN EMPLOYER TO CRIMI L NALTIES 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($100,000). IN ADDIT 0 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 E,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
(_1 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 1 I am exempt under Sec. ,B.&P.C.for this reason the owner,and the applicant,each agrees to,ands al n ,indemni a d-h�Id harmless the City
of La Quinta,its officers,agents and empl��yeeffor any act or omission related tope work being
performed under or following issuan e-dTthis permit.
Date:• Owner: 2. Any permit issued as a result of s application becomes null and void if work is not com anted
within 180 days from dat issuance of such permit,or cessation of work for 180 day 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 applicatio nd state that the above info ion is correct. I agre comply with all
work for which this permit is issued(Sec.3097,Civ.C.). city and county ordinances and state laws r resentatives
of t is county to enter upon the above-mentioned property f' on purposes.
Lender's Name:
Date: ature(Applicant or Agent):
Lender's Address:
` LQPERMIT v '
�r •
Application Number . . . . . 05-00005395
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 29.00 Plan Check Fee 00
Issue Date . . . . Valuation 1195
Expiration. Date 6/10/06
Qty Unit Charge Per Extension
BASE FEE 15.00
7.00 2.0000 HIND BLDG 501-2,000 14.00
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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