05-5408 (BLCK) .Ib► I IIIIIII VIII III VIII IIII 31
IE ��1V{II{l�
r1lc' P.O. BOX 1504 T,&t 4
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/i2/05
Application Number: f —05-00005408 Owner:
Property Address: 80807 CALLE AZUL PUERTA AZUL PARTNERS
APN: 762-240-003-43 -300962- 17700 SW UPPER BOONES FERRY RD
Application description: WALL/FENCE SUITE 100
Property Zoning: MEDIUM DENSITY RES D PORTLAND, OR 97224
Application valuation: 1995 DECE2005 Contractor:
Applicant: Architect or Enginee DAVIS/REED CONSTRUCTION INC
CITY OF LAQUINTA 169 SAXONY ROAD, SUITE 105
FINANCE DEPT I ENCINITAS, CA 92024
(760)634-2350
Lic. No. : 813480
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LI NSED CONTRA R'S�DECLA ON WORKER'S COMPENSATION DECLARATION
ereby irmyrrd na y o perjury th I am licensed er pro iv signs hap comme with I hereby affirm under penalty of perjury one of the following declar
Sectio 0001 of Division 3 of the Business ofess' als ,a y Li is in f rte and effect. _ I have and will maintain a certificate of cons self-insure for workers ....QQQQmpensation,as provided
,{�/ Lice a Class: B se for by Section 3700 ofthefor the performance of the workkhich this permit is
/"r _ issued.
Gontractor: I have and will maintain, ation insurance,as required by Sectio 3700 of the Labor
Code,for the perfo ance of the work for which this permit is issued. My orkers'compensation
ER-BUILDER DECLARATION insu nce carri and icy number ar .
I hereby affirm under penalty of perjury t/,,,�mexempt from the Contractor's State License Law for the Carrier STATE UND Pol' umber WC 98892005
following reason(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to 1 ce ify tha,i e performance of e o o whit is permit is issue
construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for the erso ny manner so as to ec c comp sation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and ree ,if I shoul a to a rkers'compe tion provisions of Section
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or 0 t e a or ode,1 1 f mpi r with those isions.
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).: a Applicant:
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 WA NIN FAILURE TO SECURE ERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL
Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SU JEC 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 D LLARS($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 S CTION 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,
(_) 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 employe c or omission re a work being
.performed under or following issua is permit.
Date: Owner: 2. Any permit issued as a res is applicatiork.4ecomes null and void if work isnot com enced
within 180 days from to of issuance of it, cessation of work for 180 da 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 an t I abov information is correct. I a Jo•eo p y with all
work for which this permit is issued(Sec.3097,Civ.C.). city and county ordinances and state laws re i Idin onstruction,an orize representatives
• of thi unty to enter upon the above-m i ed� petty or inspec ion purposes
Lender's Name:
I Date: Si ure(App' an ent):
Lender's Address:
LQPERMIT ,
Application Number . . . . . 05-00005408
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 45.00 Plan Check Fee 00
Issue Date . . . . Valuation 1995
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
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Special Notes and Comments
67 L.F. 6' GARDEN WALL, 20 L.F. 4'
GARDEN WALL, 8 L.F. 2 - GARDEN WALL, ALL
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