05-2817 (BLCK)F -C-- BC•X 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number.
�Q5�00002817 -
Property' Address:
80842 VIA PUERTA AZUL
APN:
762-240-003-8 -300962-
Application description:
WALL/FENCE
Property Zoning:
MEDIUM DENSITY RES
Application valuation:
2300 IT,
Applicant:. Architect or I
T44t 4�
VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/08/05
Owner:
PUERTA AZUL PARTNERS
17700 SW UPPER BOONES FERRY RD
SUITE 100
PORTLAND, OR 97224
.iiia � � S�Q� Contractor:
er: DAVIS/REED CONSTRUCTION INC
f3VW00LAQUI A 169 SAXONY ROAD, SUITE 105
FIINANCr-OM ENCINITAS, CA 92024
(760)634-2350
Lic. N.O.: 813480
--—0affirm
tpeperjury
iamexempt
!the
————-•————————————————
E(C RAT N
I heons of apter 9 (commencing with
Sectd License is in full force and effect.
License 813480
LARATIONI hetractor'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 (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).:
(_) 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 _ 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 affirmunderpenalty 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,N11T
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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 ode-forthe•performance of the work for which this permit is
issued.
I have and i maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, or the performance of the work for which this permit is issued. My workers' compensation
insuran carrier and policy number are: �r
Carrier STATE FU ea, r 0298 5
_ I certify that, in the performance of the work f hich t shall not employ any
person in any manner so as to become ject tot rS' L�irrpensation laws liiornia,
and agree that, if I should become Iecf th compensation provisions of Section
37,Jb of th�or Code, I shall rt "`� c ith those provisions.
WARNING: FAILURE TO SECURE ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CR NAL 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 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 a I' ti ecomes null and void if work is n commenced
within 180 days from date of is � of such permit, or cessation of work for 180 d ys will subject
permit to cancellation.
certify that I have read this applicat n and state that the above inform correct. I agree to c ply with all
city and county ordinances and relating to building constr i , and hereby authorize resentatives
of th/is county to ter upon the above -men i
atm e: J�re (Applicant or Agent):
Application Number . . . . . 05-00002817
Permit . .
. WALL/FENCE
PERMIT
Additional desc .
Permit Fee . . .
. 54.00
Plan Check
Fee
.00
Issue Date . . .
.
Valuation
. . .
. 2300
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
92 L.F. 6' GARDEN
WALL, ORCO SYSTEM
Fee summary
-----------------
Charged
----------
Paid
Credited
Due
---------
Permit Fee Total
----------
54.00
----------
.00
7
.00
54.00
Plan Check Total
.00
.00
.00
.00
Grand Total
54.00
.00
.00
54.00
LQPERAIIT