05-5364 (BLCK) ~ IIIIIIIIIIIIIIIIIIIIIIIII 641 .
�t P.O. BOX 1504 E �^i 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: 12/08/05
Application Number: 05AZUL
-00005364— Owner:
- _U
Property Address: 80855 CALLE n PUERTA AZUL PARTNERS
APN: 762-240-003-51 -300962- D [r� 17700 SW UPPER BOONES FERRY RD
Application description: WALL/FENCE SUITE 100
Property Zoning: MEDIUM DENSITY RES DEC 2 2 2005 PORTLAND, ' OR 97224
Application valuation: 2820
CITY OF LA QUINTA Contractor:
Applicant: Architect or En FINANCE DEPT. DAVIS/REED CONSTRUCTION INC
169 SAXONY ROAD, SUITE 105
ENCINITAS, CA 92024
(760)634-2350
Lic. No. : 813480
- -------- --- -- - -- - --- ---- - ------ - ----- ----------------- ------ ------------ ------------
LICENSE OR'S DECLARA WORKER'S COMPENSATION DECLARATION
I hereby affirm and penalty f pe u y that I am d u er proves' apter 9(commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000)of vision 3 t siness an r sit e,and icense is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers'comp tion,as provided
License C B License No• 813480 for by Section 3700 of the Labor Code,for-the—performance performance of the work for which is permit is
issued.
te: tractor: I have and will maintain workers'.c m6 pensation insurance,as required by Section 3700 o the Labor
of the work for which this permit is issued. My workers compensation
Code,for the performa�
OWNE -BUILDER DECLARATION insura. carri and olicy number are:
I her affir under p natty of perjur at I am exempt from the Contractor's State license Law for the Carrier STATE F D Policy Nu r WC2 892005
following rea n(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to — I certi that,' €performance of,the r hich issued,I shat of employ any --
construct,all r,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for the p rson i a manners o b o workers'compensate aws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State nd ag that,' oul a to orkers'compensa' provisions of Section
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or 370 of e,I all t h ly with those pr ions.
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 Iicant:
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 WARNI F LU TO SECUR ERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL
Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SUBJ T A EMPLOYER TO C AL 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 DOL RS 100,0001. IN ADD ION 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 SE 10 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 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 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.l. whose benefit work is performed under or pursuant to 0.e�.m�"'s�end as a result of this application,
(_1 I am exempt under Sec. ,B.&P.C.for this reason the owner,and the applicant,each agree�S2o, shald"— I defend,indemnify awn 'ho armless the City
of La Quinta,.its officers,agent employees for any act or omission related to thework being
performed under or folio issuance of this permit.
Date: Owner: - 2. Any permit issued result of this application becomes null and v pi6!! or is not menced
within 180 s from date of issuance of such permit,or e
CONSTRUCTION LENDING AGENCY permit to can ation. -
I hereby affirm under penalty of peijury that there is a construction lending agency for the performance of the I certify t at I have read this application and state that the ab o is corr I agree to comply with all
work for which this permit is issued(Sec.3097,Civ.C.). city an county finances and state laws relating to buildi n,and eby authorize representatives
of thi unty enter urfhe above-mentioned prope r' ion pur ses.
Lender's Name:
a nature(Applicant or Agen
Lender's Address:
T
n
LQPERMrr
Application Number . . . . . 05-00005364
Permit . . WALL/FENCE PERMIT.
Additional desc .
Permit Fee 54.00 Plan Check Fee .00
Issue Date Valuation . . . 2820
Expiration Date 6/06/06
Qty Unit Charge Per . Extension
BASE FEE 45.00
1.00 9.0000 THOU BLDG 2,001-25,000 9.00
-------------------------------------------------- -----------------------
Special Notes and Comments
100 L.F. 6' GARDEN WALL, 20 L.F. 4'
GARDEN WALL, 70 L.F. 2 ' -RETAINING WALL,
ALL ORCO SYSTEM
Fee summary Charged Paid Credited Due ,
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 54.00 00 .00 54.00 •
Plan Check Total .00 ' .00 .00 .00
Grand- Total 54.00 .00 .00 54.00
LQPERMIT