05-3385 (BLCK)P.O..BOX 1504
`78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: `-05-000033-85-- -
Property Address: 80794 VIA PUERT
APN: 762-240-003-16i
Application description: WALL/FENCE
Property Zoning: MEDIUM DENSITY
Application valuation: 2175
Applicant:
I hereby affjhn in
Section 7 0) of
.. T4tyl- 4 4 Q"
BUILDING & SAFETY DEPARTMENT.
D BUILDING PERMIT
e
Owner:
UL PUERTA AZUL PARTNERS
- 009NiG 3 O 2005 17700 SW UPPER BOONES
SUITE 100
RES CIN OF PORTLAND, OR 97224
-�1 FINaN QIINTA
Architect or Engineer:
LICENSED C�erpr
that I am licencess and Pro
and effect.
OWNFa,BOILDER DECLARATION
I h eby irm under penalty oflip6d
at am exempt from the Contractor's State License Law for the
fo win reason (Sec. 7031.5, Professions Code: Any city or county that requires a permit to
c nstruct, alter, improve, demoair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statemenr she is licensed pursuant to the provisions of the Contractor's 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 1$500).: -
(_) 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 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 ofproving that he or she did not build or
improve for the purpose of sale.).
(_) 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.).
(_) I am exempt under Sec. , S.&P.C. for this reason
Date:
Owner:
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:
Lender's Address:
LQPERNIIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
FERRY RD
Contractor:
DAVIS/REED CONSTRUCTION INC
169 SAXONY ROAD, SUITE 105
ENCINITAS,- CA 92024
(760)634-2350
Lic. No.: 813480
WORKER'S COMPENSATION DECLARATION
affirm under penalty of perjury one of the following declarations:
Date: 8/03/05
I have an wi l-Mintain-a. certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for w ' rmi is is workers' compensation
insurance carrier and policy number
Carrier STATE FUND olicyNumber WC" 92UUS
ertify that -n the perfo nce of th ork for wh' this permi sued, I sh I not employ any
/'pC person any ma r so as to b me sub'e o the wor compensat laws of California,
/ ap ree tha should be ubject I the ywork compensa ' provisions of Section
0 of abor Code, I rthwi comply those cions.
WARNIN : FAILURE TO SECU RKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJE ER AN EMPLOYTO INAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 0100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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 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 omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application beco -and void if work is no commenced
wit ' ISO days from date of issuance of suc mit, or cessation of work for 1 0 days will subject
pe it to canc ation.
Icerti that I ave read application and stat at the information is correct. gree to comply with all
city ou y or - es and ate laws relati g to onstruction, and he authorize representatives
of thi n u r;fhe above-mentione or i spection es.
Dat Signature (Applicant
a Application Number . . 05-00003385
Permit . . . .
. WALL/FENCE
PERMIT
Additional desc .
.
Permit Fee . . .
. 54.00
Plan Check
Fee
.00
Issue Date
Valuation
. . .
. 2175
Expiration Date
1/30/06
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
87 L.F. 6' GARDEN
WALL, 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
LQPERAIIT