05-5403 (BLCK) wl�' IIIIIIIIIIIIIIIIIIIIIIIII 22
IE
c' P.O. BOX 1504 - `T- _ 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: U05-::.00005403- _� Owner:
Property Address: 80783 'CALLE AZUL D PUERTA AZUL PARTNERS
.APN: 762-240-003-39 -300962- DEC 2 2005 17700 SW UPPER BOONES FERRY RD
Application description: WALL/FENCE SUITE 100'.
Property Zoning: MEDIUM DENSITY RES PORTLAND, OR 97224
Application valuation: 2525 CITY OF 6.4QUINTA
FINANCP-OEP -
Contractor:
Applicant: Architect or Engineer: DAVIS/REED CONSTRUCTION INC
169 SAXONY ROAD, SUITE 105
ENCINITAS, CA 92024
(760)634-2350
Lic. No. : 813480
r
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LICENSED CO ACTOR'S/DE WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of, erjury that I am lic ed and r pro i to o apter 9 mencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000)of Divisi a and sio s C e License' in full force and effect. I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided
License Class: B 813 for by Section 3700 of the Labor Code,fo mance o t e wo ich this permit is
r issued.
Date�� ontractor: i11 have and will maintain wo s'compensation insurance,as required by Section 3700 the Labor
Code,for the perfor nce of the work for which this permit is issued. My workers'co pensation
OWNER-BUILDER DECLARATION `_ insurance carr ie nd policy number 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 Num e�, WC298892005
following reason(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to _ I certify that, performance of themwhich this permit is issued,I shall n employ any
construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for the p=�o n ny manner so as to bec „��{a yllSS1"ect to the whir vers'compensation s of California;
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State ��ntllagree tha,' o lu d beco subject to the ers'compensation visions of Section
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)ori 00 of the L bor Code,1 IIwith com
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: pplicant:
(_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 SEC 0 ERS'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 T IMI AL 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 ADDITI N 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 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 .employees for any act or omission related to the work being
performed under orf g issuance of this permit.
Date: Owner: - 2. Any permit' as a result of this application becomes null and void if work is not commenced
within 0 days from date of issuance of such per ',or cessation of work for 180 days will subject
CONSTRUCTION LENDING AGENCY +++++qqqqq to cancellation.
1 hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I t have r d this application and state that ,a ov fq n is correct. I gree to comply with all
work for which this permit is issued(Sec.3097,Civ.C.). l �i county finances and state laws relating t .1 i oopy�r ion,and hereby horize representatives
ti this county to enter upon the ove-mentione pe f ins ct n purposes
Lender's Name: - '
te: nature(Applicant 1:
Lender's Address:
LQPERMIT
Application Number . . . . . 05-00005403
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 54.00 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 2525
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
-------------------------------_---------------------------------------------
Special Notes and Comments
85 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
4.00Plan Check Total .00 .00 .00 . .00
Grand Total 54.00 .00 .00 54.00
LQPERMIT