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05-5405 (BLCK) �.► IIIIIIIIIIIIIIIIIIIIIIIII 23 P.O. BOX 1504 — IE 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 r - Date: 12/12/05 Application Number: 05-00005405 Owner: Property Address: ' 80789 CALLE AZULUFINANCE PUERTA AZUL PARTNERS APN: 762-240-003-40 -300962- 17700 SW UPPER BOONES FERRY RD Application description: WALL/FENCE SUITE 100 Property Zoning: MEDIUM DENSITY RES PORTLAND, OR 97224 Application valuation: 948 Applicant: Architect or En inLA Contractor: gDAVIS/REED CONSTRUCTION INC 169 SAXONY ROAD,. SUITE 105 ENCINITAS, CA 92024 (760)634-2350 Lic. No. : 813480 ------------- ---- --- ---- ---- ----- ---- ------ ---- -------------------- ----- - ----------- -------- ----- LICENSED C R CT ECLARATION WORKER'S COMPENSATION,DECLARATION hereby affirm under penal y of perjur .at I am Ii rise un r 'vs of Chapter 9(com encing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000)of Division 3 usiness an rof i I od and my License is in f force and effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided License Class: B Li s No.: 813480 for by Section 3700 of the Labor Code,for the performance.of the work for which this permit is �-`LLL! .� issued. - �.�`� L_� rector: I have and will maintain workers'compensatio ranee,as required by Sectio 700 of the Labor ///��� Code,for the performance of the wo r which this permit is issued. My work rs'compensation OWNER-BUILDER DECLARATION insurance carrier and policy nu r are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the — Carrier STATE FUND Policy Number WC298892005 following reason(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to _ I certify that,in the perfo ance of the w r which this it is issued,I sh not employ any construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for the person in any so as to bec bject to th orkers'compens ' n 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 a ee that,if I s bec ject to th orkers'comp ion provisions of Section License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or of=he bor Code,I ly-wit6_t _ rovisions. ' 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: pplicant: 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 WARNING: FAILURE TO RE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT 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 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 contractorls)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 rmii-issued-ase-ces f this application, I—) I am exempt under Sec. B.&P.C.for this reason the owner,and the applicant,each agrees to all defend,indemnify and hold harm e e City of La Quinta,its officers,agents and oyees for any act or omission related to the_ work bein • performed under or following is nce of this permit. Date: Owner: 2. Any permit issued as a resul of this application becomes null and void if work is not commenced within 180 days from date issuance of such permit,or cessation ork for 180 days will subje t CONSTRUCTION LENDING AGENCY permit to cancellation. 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 t fo a'on is ire agree to com ith all work for which this permit is issued(Sec.3097,Civ.C.). city and county ordinances and state laws relating to building co o e y au oriz esen a Ives' of this co y to enter upon the above-mentioned property fo a pu es. Lender's Name: \ e: gnature(Applicant or Agent): Lender's Address:�— LQPERMIT Application Number . . . . . 05-00005405. Permit WALL/FENCE PERMIT Additional desc . Permit Fee 25.00 Plan Check Fee 00 Issue Date . . . . Valuation . . . . 948 Expiration Date 6/10/06 Qty Unit Charge Per Extension BASE FEE 15.00 5.00 2 .0000 HND BLDG 501-2,000 10.00 ---------------------------------- --------------=---------------------------- Special Notes and Comments 29 L.F. 5' GARDEN WALL, 20 L.F. 4' GARDEN WALL, 18 L.F. 2 - GARDEN WALL, ALL ORCO SYSTEM Fee summary Charged Paid Credited Due Permit Fee Total 25.00 .00 .00 25.00 Plan Check Total .00, .00 .00 .00 Grand Total 25.00 .00 .00 25.00 LQPERMIT .