05-2830 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: X05-00002830
Property Address: 80865 VIA PUERTA AZUL
APN: 762-240-003-84 -300962-
Application description: WALL/FENCE
Property Zoning: MEDIUM DENSITY RES
Application valuation: 3051
No
Applicant: Architect or
-
--- - - - - - - - - - - - - -------�3-
I hereby affirm under penalty of peri A that I
Section 7000) of Division of the usiness E
License
%Cia�'J, B
10
tractor
T4'!t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
e D
JUL 14 2005
OF LAQUINTA
inQ MriFh
and effect.
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).:
(_ I 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. , 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: a
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/08/05
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
ENCINITAS, CA 92024
(760)634-2350
Lic. No.: 813480
------------------
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
ssued.
v 1041 have and will maintain workers' compen, ' insuranc�asrequired by Section 3700 ofihe Labor
Code, for the performance of th r "for which this sued. My workers' corn gnsation
insurance carrier and policy mber are: "
Carrier STATE FUND Policy Number WC2.98 -%005
_ I certify that, in the per rmance of the k for whOR5
issued, I shall note ploy any
person in an ma er so as to be a sub'e om ensation law of California,
Y 1 P yy
and agree thz I should bec grsubjec nsation sons of Section
WARNING: FAILURE TO SECUWWORKERS' 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.
l.. 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 is ssaed-8s�resvl is application,
the owner, and the applicant, each agrees to, and a end, indemnify and hold harmless City
of La Quinta, its officers, agents and em )I for any act or omission related to the work being
performed under or following issuan this permit.
2. Any permit issued as a result o is application becomes null and void if work is not commenced
within 180 days from(ds issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this applicnd state that the ab in rmation 'rre gree to ply with all
city and countyy ordinances and sta relating to buil ' constructio nd y aut representatives
of thip;countlAo entaf uupon the ab
(Applicant or
Application Number . . . . . 05-00002830
Permit . . . WALL/FENCE
PERMIT
Additional desc . .
Permit Fee . . . . 63.00
Plan Check
Fee..
.00
.Issue Date.
Valuation
. . .
. 3051
Expiration Date 1/04/06
Qty Unit Charge Per
Extension
BASE
FEE
45.00
2.00 9.0000 THOU BLDG
2,001-25,000
18.00
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Special Notes and Comments
64 L.F. 6' GARDEN WALL, 50 L.F.
2'
GARDEN WALL, 67 L.F. COMBO WALL,
2'
RETAINING, 3' GARDEN, ALL ORCO SYSTEM
Fee summary Charged
-----------------
Paid
Credited
Due
--------------------
Permit Fee Total 63.00
----------
.00
----------
.00
63.00
Plan Check Total .00
.00
.00
.00
Grand Total 63.00
.00
.00
63.00
LQPERMIT