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05-5363 (BLCK) �� I IIIIIII VIII III VIII(III 60 I4 , P.O. BOX 1504 �----- -��E _ -- �� 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: 05-00005363 Owner: Property Address: 80849 CALLE=AZUL PUERTA AZUL PARTNERS APN: 762-240-003=50 -30096 17700 SW UPPER BOONES FERRY RD Application description: WALL/FENCE SUITE 100 Property Zoning: MEDIUM DENSITY RES PORTLAND, OR 97224 Application valuation: 2025 DEC 2 2 2005 CITY OF LA QUINTA Contractor: Applicant: Architect or ngineer:FINANCE DEPT. DAVIS/REED CONSTRUCTION INC -- 169 SAXONY ROAD, SUITE 105 ENCINITAS, CA 92024 (760)634-2350 Lic. No. : 813480 - --- - - ---- -- -- ----- - - ---- - --- - ---- ---- ---- - ------ ------------- ------------------- ----------- LICENSE O RACTO 'S DECLARATION WORKER'S COMPENSATION DECLARATION herv I eby a m and penalty 'ury that I a is�Se ride rovisions o (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 00)of ivi' f the Business d P ion o m ' rise is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided Li nse lass: ense N 3480 for by Section 3700 of the Labor Code,for the erf he work for which this permit is issued. ate Con I have and will maintain wo compensation insurance,as required by Section 0 of the Labor Code,for the pe ance of the work for which this permit is issued. My workers' ompensation OWNER-BUILDER DECLARATION insurance c er and policy number are: I ereby ffirm under penalty of erjury that I am exempt from the Contractor's State License Law for the Carrier STA F Policy N tuber WC A8892005 ollow' g reason(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to ce at,in the pe anc of the r this pe it is issued,I shall note ploy any con uct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for the per n in an Ie the ars comps California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State at,if I sh d b Ie o th ers.compensat visions of Sec License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or the Labor od rt th with thos 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).: ican. (_) 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 ARNIN FAILURE TO SEC 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 DOLLA S($100,0001 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 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 fora 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 Ay-per 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 rid shall defend,indemnify an Id harmless the City of La Quinta,its officers,agents a mployees for any act or omission related�notco rk being performed under or fallowing' ance of this permit. Date: Owner: 2. Any permit issued as a re of this application becomes null and voi work ismenced wi in 180 days from d to of issuance of such permit,or cessa' of rk for 180 days will subject CONSTRUCTION LENDING AGENCY rmit to Incellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify th I have ad this application state that the abov do orrect. I a o comply with all work for which this permit.is issued(Sec.3097,Civ.C.). city and unty o inanc and state laws rela orize representatives of th' ounty eyz upon "above-mentioned prope spe purpose Lender's Name: P I P-1 10 -7 Signature(Applicant or Age Lender's Address: LQPERMIT . Application Number . . . . . 05-00005363 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 54.00 Plan Check Fee .00 Issue Date Valuation 2025 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 -------------------- Notes and Comments 81 L.F. 6' GARDEN WALL, 52 L.F. 2 - RETAINING WALL, BOTH 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 LQPERR r