05-0745 (BLCK)T_- • i. r • :
BUILDING & SAFETY DEPARTMENT
Ox 1504 (760).777-7012
F Lt�'��s 7 49., •CALLE TAMPICO FAX (760) 777-7011
LA Q NTA, CALIFORNIA 92253 WSRECT-ION REQUESTS (760) 777-7153
0�vBUILDING PERMIT
Application: Number . . 675 0.0:000:OR4,5 Date 3/03/05
Property Address. 5732-5--PASEO DEL L:AGO"�
APN: 762-240-003-.45-30<0961-
Application description ..--WALL/FENCE'.
Property Zoning ..ME'DIUM-DENSITY RES
Application valuation 23;82
Owner Contractor
—
--------------- —— —-— — —:oa' ----•--�=(—_--,--------------
PUERTA AZUL PARTNERS'''DAVIS/REED CONSTRUCTION INC
17700 SW UPPER. BOONE,S FERRY' RD.. .189 SAXONY ROAD/ STE #105
SUITE 10.0 ENCINITAS CA 92024
PORTLAND OR 972'24 (76.0) 6,34_23,50 .
WCC. STATE FUND.
WC:, WC298&92004 06/12/05
CSLB: .81.3:48;0 10/31/06
CCC B
Permit WALL/FENCE :rPERMIT.-
Additional desc
Permit Fee -. 54.0,0 '.Plan Check Fee .00
Issue Date ,'Valuation . . . 2382
Qty Unit Charge Per,: Extension
BASE FEE 45.00
n � ., fir,'
1.00 9 0 0 0'0 THOU . BLDG 2 '0 O l 2'5 , 0'0 0 '" 9.00
-- - - - - ---- -u- - ------- - - - - -- = -.-----------------------------
Special Note.s'andComments
110 LF 51 GARDEN WALL.,.,WI TH . 6 '
PILASTERS,ORCO STANDARD, GATES`ARE THE
ENTRY POINTS ADJACENT. TO B.OTH'�S,IDES''OF
THE. GREAT 'HOUSE•,, LOT.; 4.5 :'ALSO _:PER
APPROVEDPRECISE GRADING PLAN
Fee summary Chargedid ' PaCredited 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
P.O. BOX 1504 • VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 173' -0'7y -S I Date: 3 -3 -0 -3 --
Applicant:
Applicant's Mailing Address:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under enalty of perju that I am licensed under provisions of Chapter 9 (co menc' with Section 7000) of Division 3 of the Business and Professionals
Code, and my Li. n ct, F
License Clas License No.
`Date -04 Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or 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).):
U 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 Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work
himself or herself or through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is
sold within 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.).
U I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec. , B.& P.C. for this reason
Date
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate of consent to self -i ure-forwowe6rs' compeiisation,-as provided for by Section 3700 of the Labor Code, for the performance
of t wor for this permit is issued.
I ha and I m i t workers' com tion insurance, as required by Sec 'o of the Lab ro e, the performance of the rk for which this permit is
s r com n, insurance carrier and policy number 7
Carrier Policy Number G_
I �rfify at, in the pert ance of the work for this p s i 1 shall not employ any person in ny manner so as to ecome subject to the workers'
compensation la of California, and agr if I s ers' compensate provisions of Secti n 3700 of the Labor Code, I shall
forthwith comply ilh those nrnvisinn_
Date <.pplicant_
WARNING: FAILURE TO SECURE W6RKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name
Lenders Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application, the owner, and �aanch agrees to, and shall, defend, indemnify and hold harmless the City of La Ouinta, its
officers, agents and employees for any act or omissiwork being performed under or following issuance of this permit.
2. Any permit issued as a result of this application b d if work is not commenced within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject per to.
I certify that I have read this application anis state that the bove in s rcect. I e 6 th all city and county ordinances and state laws relating to building
construction, and hereby author esentatives of the co�en the ab roperfy for ins ection purposes.
Date '� ignature (Applicant or Agent):