05-2820 (BLCK)P. 0-. 4Q_aY"1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05-00002820
Property Address: 80829 VIA PUERTA AZUL
APN: 762-240-003-78 -300962-
Application description: WALL/FENCE
Property Zoning: MEDIUM DENSITY RES
Application valuation: 2486
Applicant: Architect or
------------------ --- --
ICENS C�uer,
I hereby affirm under penalty of perjur that I lic Section 7000) of Division 3 of the sines nd P sLicense Class: B.
r
� e^ ontractoI
T414t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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
Contractor:
DAVIS/REED CONSTRUCTION INC
169 SAXONY ROAD, SUITE 105
JUL 4®� ENCINITAS, CA 92024
u (760)634-2350
Lic. No.: 813480
with
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's State
License Law (Chapter 9 Icommencing 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).:
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.).
(_) I am exempt under Sec. , BAP.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:
LQPER IIT
Date: 7/08/05
WORKER'S 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 -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 work nsation insurance, as req fired-b,1�Section 3700 of the Labor
Code, for the per nce of the work for which this permit is issued. �vlyworkers' compensation
insurance erer and the
rare:
Carrier STATE F Policy Numb WC
OS
I certify th in the performance of the wo hich this it is issued, I shall not a ploy any
person in a ner so as to bet a lett to the r ers' comp ion laws of lifornia,
and agree tha hou ec s let o rovisio f ection
/3700 a Labor Code, I all f hlyKhh co with tho rovisions.
WARNING: FAILURE TO SECYAE RKERS' CO`Y.61ISATION-eMERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TC&PKMINAL 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.
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 an et -oro ion re a dZo-M kear� being
performed under or following issuance of t ' mrt. \\
2. Any permit issued as a result of thiskation becomes null and void if work is not commenced
within 180 days from date of i ante of such permit, of es on of work f 1180 days VV -subject
permit to cancellation.
I certify that I have read eh a ate la n�ngt o the ng s anon is c t�,�resentatjves
h all
cit and count ordinances a to la relatin to building c coon, a ere h
of this county t9lnter u n the above -men ed propertyf r pection rpo
(Applicant or
LQPERMIT
Application Number . . . . . 05-00002820
Permit . . . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 54.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 2486
Expiration Date . . 1/04/06
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
53 L.F. COMBO WALL, 1' RETAINING,
6 -
GARDEN, 33 L.F. 6- GARDEN WALL,
15
L.F. 2' GARDEN WALL, 21 L.F. 4- GARDEN
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
LQPERMIT