05-3382 (BLCK)PO. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
L
105-00003382
Property Address:
80812 VIA PUERTA AZUL
APN:
762-240-003-13 -300962-
Application description:
WALL/FENCE
Property Zoning:
MEDIUM DENSITY RES
Application valuation:
2466
P 111F
- -
:'J ► V'Y DEPARTMENT
�wPERMIT
• _c tfSll;�"r• D
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
PUERTA AZUL PARTNERS
17700 SW UPPER BOONES FERRY RD
SUITE 100
PORTLAND, OR 97224
Date: 8/03/05
Contractor:
Applicant: Architect or Engineer: DAVIS/REED CONSTRUCTION INC
169 SAXONY ROAD, SUITE 105
ENCINITAS, CA 92024
— / (760)634-2350
y/ l Lic. No.: 813480
----------------- ------------- -------------------------------------------------------------
LICENSED CON
I hereby affir nder pe Ity of rjury that 1 am licensed
Section 700 of Divi n 3 of he
and Professid
(commencing with
✓D7arm
�ontractWNER-BUI DERDECLARATION
I hpenalty of perjury am exempt from the Contractor's State License Law for the
foc. 7031.5, Busine 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 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 (55001.:
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
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 of proving that he or she did not build or
improve for the purpose of sale.).
(_ 1 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.).
(_ 1 I am exempt under Sec. , B.&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:
LQPERMIT
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have al maintain 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 wost
pensation insur res-r2g0IlE0'by5esti 3700 of the Labor
Code, for the performanwork is is permit is issued. My wor s' compensation
insurance carrier and polire:
Carrier STATE FUND olicy Nu WC 8 2005 1
I certify at, in the pe e w for whit i ermit is issued, I s II not employ any
pers in any ner soo subject to orkers' compens n laws of California,
greet I shoulu'. t to t rkers' compens n provisions of Section
0 Labor Code, th co with those pr ions.
ING: AILURE TO SECURE W S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
CT tN EMPLOYER TO CRI AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
YN 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 becomes null a -- .i work is not co menced
within 180 days from date of issuance of such perm�ion
ssat' of work for 180 ays will subject
permit to cancellation.
I certify that I h ve read this application and state that above is correct. I ree to comply with alcity and couny/ordinan,*s and state laws relating lding con, and hereb ahvesof this count�/-to ante pon the abovaraentione pr ertv for i
(Applicant or
Application Number . . . . . 05-00003382
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 54.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 2466
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
----------------------------------------------------------------------------
Special Notes and Comments
82 L.F. 6' GARDEN WALL, 26 L.F. 4 -
GARDEN WALL & 15 L.F. 2- WALL, ALL 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
LQPERNIIT