05-5381 (BLCK) e, I III II I III III VIII IIII 74
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P.O. BOX 1504 — —T --- ^� 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: 12/09/05 .
Application Number: _05-00005381 Owner:
Property Address: C-80867-CALLE AZUL PUERTA AZUL PARTNERS
APN: 762-240-003-53 -300962- p 17700 SW UPPER BOONES FERRY RD
Application description: WALL/FENCE O SUITE 100
Property Zoning: MEDIUM DENSITY RES PORTLAND, OR 97224
Application valuation: 1150 DEC 2 2 2005
Applicant: Architect or Engine r: CITY OP LAQUIWA Contractor:
PINANCE�E� DAVIS/REED CONSTRUCTION INC
169 SAXONY ROAD, SUITE 105
ENCINITAS, CA 92024
(760)634-2350
Lic. No. : 813480
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LICEN CONTRACTOR'S D LA. WORKER'S COMPENSATION DECLARATION
I hereby affi un 6r penalty of perjury that I li ensed under pro 'ions of Chat cing.with I hereby affirm under penalty of perjury one of the following declarations:
Section 7 01 o ivi ion of the Business nd rofessio y icense is in full force and effect.- _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided
License ass: ense No.: 813480 for by Section 3700 of the Labor Code,for the perform hich this permit is
issued.
Contractor: I have and will maintain workers'com ation insurance,as required by Section 3700 o the Labor
/Ie
Code,forthe performance o work for which this permit is issued. My workers'co pensation
OWNER-BUILDER DECLARATION insurance carrierand pmber are:
b affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE UND Policy Numb 29 0ng reason(Sec.7031.5yBusiness and Professions Code: Any city or county that requires a permit to _ I c ify that,int performance of the war or which r s issued I not employ any
construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for the person in a ma ner so as to be lect to a rs'co sation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State d ,if I should beco to rs' enation provisions of Section
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or 00 of the h h 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).: te' Applicant:
(_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 AFINING: FAILURE TO SECU RKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL
Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO MINAL 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 DOLLARS($100,000). IN ADDITIO fO 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 COIF,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—1 1,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 contractorls)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,and shall defend indemnif and hold harmless the City
of La Quinta,its officers,agents and emplo y act or omission relate o being
performed under or following issue this permit.
Date: Owner: 2. Any permit issued as a result of th applicationbecomes null a oid if work is not commenced
within 180 days from date of iss nce of such permit,or io work f 80 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 that bov f is c ct. 1 agree to comply with a
work for which this permit is issued(Sec.3097,Civ.C.). city and county ordinances and state laws relating to buildin ereby authorize repre as
• of this county to enter upon the above-mentioned prope f s o
Lender's Name:
ate: ignature(Applicant or Agent ,
Lender's Address:
LQPERMIT
Application Number . . . . . 05-00005381
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 29.00 Plan Check Fee 00
Issue Date . . . . Valuation . . . . 1150
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
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Special Notes and Comments.
46 L.F. .6' GARDEN WALL, ORCO SYSTEM
Fee summary Charged Paid Credited Due
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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