05-2814 (BLCK)4 P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/08/05
Application Number: �O5 00002814 Owner:
Property Address: 80860 VIA PUERTA AZUL PUERTA AZUL PARTNERS
APN: 762-240-003-5 -300962- 17700 SW UPPER BOONES FERRY RD
Application description: WALL/FENCE ® SUITE 100
Property Zoning: MEDIUM DENSITY RES D PORTLAND, OR 97224
Application valuation: 2411
JUL 14 2005 Contractor:
Applicant: Architect or En nee : DAVIS/REED CONSTRUCTION INC
CliYOFLAQUINTA 169 SAXONY ROAD, SUITE 105
F1NAWCEDEP% ENCINITAS, CA 92024
(760)634-2350
PfLic. No.: 813480
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CENSED'CONTR DECLA . ION
I hereby affirm under penalty of perjur that I a livens rovisio hapter 9 mmencing with
Section 7000) of Division 3 of the sines ro Cod n y Licen in full force and effect.
License Class* B Lice o '
�Datel•�l ontract0r:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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 (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).:
(_ 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 _ 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
(_ 1 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:
LQPERMIT
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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 b Section 3700 of the Labor Code, for the erformance e.we r which this permit is
Y P
issued.
I have and will maintain workers' compensation' rance, as required by Section 3 00 of the Labor
Code, for the performance of the work which this ermit is issued. My worker compensation
insurance carrier and policy number e:
Carrier STATE FUND of Numbe '3T 98892005
_ I certify that, in the pe formanc of work thi ermit is issued, � iall not employ any
person in any manner so as satioa-laws.of California,
and agree that, if I should su t th orkers' ensation provisions of Section
70006 -rt -he Labor Cod wi c pl ose provisions.
Date:pplicant:
WARNING: FAILURE TO SECU E WORKERS' 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.
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, ind ' and hold harmless the City
of La Quinta, its officers, agents and employees for any r omission related to e. ork being
performed under or following issuance of this Perm
i
2. Any permit issued as.a result of this application b omes null and void if work is not commend
within 180 days from date of issuance of such p rmit, or cessation of work for 180 days will su jgct
permit to cancellation.
I certify that I have read this a lication and state that the above i ation is correct. I agree to comply with all
city and county ordina s and state laws relating to building cons io or - entatives
of this cou o enter upon th above-mentioned property fo ' pe o
9Vte: �VUIignature (Applicant or Agen
Application Number . . . . . 05-00002814
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 54.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 2411
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
83 L.F. 6' GARDEN WALL, 21 L.F. 4 -
GARDEN WALL, 15 L.F. 2' 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