05-5398 (BLCK) :it. IIIIIIIIIIIIIIIIIIIIIIIII 62
( P.O. BOX 1504 - T- IE �'�I�N^� VOICE 760 777-7012
78-495 CALLE TAMPICO 4FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING&SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 12/12/05
Application Number:
�05-00005398 I Owner:
Property Address: 80854 CALLE AZUL PUERTA AZUL PARTNERS
APN: 762-240-003-63 -300962- 17700 SW UPPER BOONES FERRY RD
Application description: WALL/FENCE SUITE 100
Property Zoning: MEDIUM DENSITY RES PORTLAND, OR 97224
Application valuation: 2145 D
DEC 2 2 2005 Contractor:
Applicant: Architect or Engin DAVIS/REED CONSTRUCTION INC
169 SAXONY ROAD, SUITE 105
CITYFIN ANO QUI OF-PI ENCINITAS, CA 92024
(760)634-2350
Lic. No. : 813480
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LICENSED NTRA 'S DECLAR WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty perjury that I am li d u e pro'X o pter 9(commencing with I hereby affirm under penalty of perjury one of the following declarations:
io of Division of the Business and r i o ;and icense is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided
r 1 s. B is se N 813480 - for by Section 3700 of the Labor Code,for the performance of the work for which this permit is
1 �] issued.
Dat Contractor: I have and will maintain workers' ion insurance,as quir by Section 3700 of the Labor
Code,for the perfor a of the work for which this permit is issue workers'compensation
OWNER-BUILDER DECLARATION insurance ca i and policy number are:
1 ereby affirm under penalty of perjur at I am exempt from the Contractor's State License Law for the Carrier STATE F P icy Number Z 2005
I
(lowing reason(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to _ I art' at,in the performan f e work fo is is permit is issued,I;p51t not employ any
construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for the er n in a nner so comes Iec the workers'compen 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 ag a that,if I s I e su ct the workers'compe ion provisions of Section
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or or e all I III IN ''ons.
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).: Date, 11
( 1 1,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 S URE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL
Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SUBJEC 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($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 pursuant to an esult of this application,
(_1 I am exempt under Sec. ,B.&P.C.for this reason the owner,and the applicant,each agrees to,and defend,indemnify and h harmless the City
of La Quinta,its officers,agents and employ or any act or omission related to the work being
performed under or following issuance o is permit.
Date: Owner: 2. Any permit issued as a result of this plication becomes null and void if work is no commenced
within 180 days from date of iss nce of such permit,or cessation of work for 1 0 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 st a that the above infor on is correct. I ree to comply with all
work for which this permit is issued(Sec.3097,Civ.C.). city and county ordinances and state laws relatin building con i nd hereby thorize representatives
of this county to enter upon th above-mentioned property
Lender's Name:
ate: atur licant or Agentl: —'
Lender's Address:
vI
LQPERMIT
Application Number . . . . . 05-00005398
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . 54.00 Plan Check Fee 00
Issue Date Valuation . . 2145
Expiration Date 6/10/06
Qty Unit Charge Per Extension
BASE FEE 45.00
1.00 9.0000 THOU BLDG 2, 001-25,000 9.00
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Special Notes and Comments
76 L.F. 6' GARDEN WALL, 20 L.F. 4 -
GARDEN WALL, 8 L.F. 2' GARDEN WALL, 50
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