05-5360 (BLCK) �'w � I IIIIIII 1111111111111 IIII 44
P.O. BOX 1504 --- IE— ��^��N^� VOICE 760 777-7012
z � .. ( )
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: 10-5-00005360 Owner:
Property Address: 80831 CALLE AZUL PUERTA AZUL PARTNERS
APN: 762-240-003-47 -300962- 0 17700 SW UPPER BOONES. FERRY RD
Application description: WALL/FENCE SUITE 100
Property Zoning: MEDIUM DENSITY RES PORTLAND, OR 97224
Application valuation: 2475 DEC, 2 2 2005
CIN OF LA QUINTA Contractor:
Applicant: Architect or Engineer: FINANCE DEPT. DAVIS/REED CONSTRUCTION INC
169 SAXONY ROAD, SUITE 105
ENCINITAS, CA 92024
^ (760)634-2350
N I � Lio. No. : 813480
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LICENS RA OR'S DECLARATION - WORKER'S COMPENSATION DECLARATION
hereby aff'm u penalty of perjury that I a Iii d u er provisions enang with I hereby affirm under penalty of perjury one of the following declarations:
Sectio 7 01 ivision 3 of the Business d - e,and my Lice is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided
c License No.: 8 80 for by Section 3700 of the Labor Code,for th a work for which this permit is
vissued.
6te: ontractor: �I have and will maintain worke�npen.f.triowinsurance,as required by Section 3700 of the Labor
C de,for the performanchich this permit is issued. My workers'compensation
O - UILDER DECLARATION surance a rier and Iicy number are:
I h reby affirm under penalty of perjury thn1am'
exempt from the Contractor's State License Law for the Carrier STA FUN Policy Number W 29 892005
f lowing reason(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to _ certify at,in a perform. a of the work fo h' t ' permit is issued,I s all not employ any
construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for the per n in a m o as to become s workers'compensatio 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 agr t,if I should become s t orkers'cam n ovisions of Section
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or f the L e I shall c ply with th pro 'i
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 plicant:
1_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 ARNI FAILURE TO SECURE 'COM NSATION COVERAGE IS UNLAWFUL,AND SHALL
Contractors'State License Law does not apply to an owner of property who builds or improves thereon, UBJ T AN EMPLOYER TOC 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 DO RS($100,0001. IN AD I 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
(_) 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 any permit issued as a result of this application,
(_1 I am exempt under Sec. ,B.&P.C.for this reason the owner,and the applicant,each agrees to,and shall defend,indemnify and hold harmless the City
of La Quinta,its officers,agents and employees for any act or orris' e to the wor
performed under or following issuance of this permit.
Date: Owner: 2. Any permit issued as a result of this application bec null and void if work is not commenced
within 180 days from date of issuance of suc rmit,or cessation of ork for 180 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 tha the above i do s ect. I agree to comply with all
work for which this permit is issued(Sec.3097,Civ.C.). city and county ordinances and state laws relating to b 'ding c' ereby authorize representatives
of this c ty to enter upon the above-mentioned propert rposes.
Lender's Name:
{�" a nature(Applicant or Agen
Lender's Address: rte}
LQPERMIT - -
411
F Application Number . . . . . 05-00005360
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 54.00 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 2475
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
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Special Notes and Comments
83 L.F. 6- GARDEN WALL, 25 L.F. 4'
GARDEN WALL & 8 L.F. 2' GARDEN 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