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05-5396 (BLCK) 72 . P.O. BOX 1504 E 4 XP 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 =0 _ _ Date: 12/12/05 Application Number: 05- 005396`"] Owner: Property Address: 80866 CALLE-AZUL PUERTA AZUL PARTNERS APN: 762-240-003-61 -300962- 17700 SW UPPER BOONES FERRY RD Application description: WALL/FENCE SUITE 100 Property Zoning: MEDIUM DENSITY RES Q PORTLAND, OR 97224 Application valuation: 1925 D C 2 2 2005 Contractor: Applicant: Architect E gine DAVIS REED CONSTRUCTION INC C1TM a f QUJ%TA 169 SAXONY ROAD, SUITE 105 ENCINITAS, CA 92024 FAN H6 (760)634-2350. r ( Lic. No. : 813480 LIC SEDC TRA OR'S CLA ATION WORKER'S COMPENSATION DECLARATION I#air un er penalty of perjury th I am lit sed un r provi ons Chapter encing with I hereby affirm under penalty of perjury one of the following declarations: S1 of ivisio of the Business and P fes io s Code n s s in full force and effect. _ I have and will maintain a certificate of consent to se = z4oLW9rkers'compensation,as provided L : Lich 813 0 for by Section 3700 of the Labor Co to performance of thewor which this permit is issued. tract Yl have and will maintain ers'compensation insurance,as required by Sect pn 3700 of the Labor Code,for the pe once of the work for which this permit is issued. My orkers'compensation _71./1/OWNER-BUILDER DECLARATION insurance car' r and policy number are: I m under penalty of perjur at I am exempt from the Contractor's State license Law for the Carrier TATE D is - er WC298892005fson(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to Ice ify th ,in ante oft for whichthisper isissued shall not employ any cer,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for the pe ny manner so as to co a bjea to the wor 'compe [ion laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State a agree t ct tot a wor a comp ion pro 'on License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or s9 00 of the Labor Code, with comply w'Y t =.visions. 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).: ate: pplicant: (_) 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 NTNG: FAILURE TO SECU ORKERS'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 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 DOLLARS J$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 (_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 pur rmi i sult of this application, 1_1 I am exempt under Sec. ,B.&P.C.for this reason the owner,and the applicant,eac s to,and shall defend,indemnify and hold Harmless the-City of La Quinta,its officers, s and employees for any act or omission related to the work being performed under or owing issuance of this permit. Date: Owner: 2. Any permit issu as a result of this application becomes null and void if work is not commenced within 180 day from date of issuance of such permit,or cessation of work for 18 ays will subject CONSTRUCTION LENDING AGENCY permit to cancellatio 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 an s a e a e e i f ion iscorre agree to comply with a I work for which this permit is issued(Sec.3097,Civ.C.). city and county ordinances and state laws relatin t'o b ' g ction,and y authorize representatives of this county to enter upo the above-mentio d p rt I pecti ses. Lender's Name: (� afe: Signature(Applica or n Lender's Address: r� LQPERMIT Application Number . . . . . 05-00005396 PermitWALL/FENCE PERMIT Additional desc . '. Permit Fee . . . . 45.00 Plan Check Fee 00 Issue Date . . . Valuation . . . . 1925 Expiration Date 6/10/06 Qty Unit 'Charge Per Extension BASE FEE 15.00 15.00 2.0000 HND BLDG 501-2,000 30.00 --------------------------------------------------------------------=------- Special Notes and Comments 77 L.F. 6- GARDEN WALL, ORCO SYSTEM Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- -----_---- Permit Fee Total 45.00 .00 .00 45.00 Plan Check Total. .00 .00 .00 .00 Grand Total 45.00 .00 .00 45.00 LQPERMIT .