05-2829 (BLCK)P.O.-80X 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Applicant:
I hereby affirm under penalty of perjury that
Section 7000) of Division 3 of the Busing
License Claw. B
/DaI ntractor:
T414t 4 4 Q"
Architect or Engineer:
SIA
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/08/05
Owner:
RTA AZUL PARTNERS
D TLAND, OR 97224 00 SW UPPER BOONES FERRY RD
TE 100
JILL 14 2005
with
pv,lfid aceme is in full force anf9ct-
13480
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 (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 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:
LQPERAIIT
LA UINTA�o tractor:
DE®E". D IS/REED CONSTRUCTION INC
9 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
�/ issued.
-1have and will maintain w ers' compensation insur e, as required by Section 3700 of the Labor
Code, for the pert ance of the work for which this rmit is issued. My workers' compensation
insurance carrier nd policy number are:
Carrier STATE FUND Policy ber 92005
I certify that, in the pe rmance of th k for w ' i e it is issued, I shall not employ any
person in any manner s to b o subje o orker ' compensation laws of California,
and agree that, if I should bec enation rovisions of Section
3700 a Labor Code, I al hw' with th provisions.
Datt7��ant:
WARNING: FAILURE TO SECUR RKERS' OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO INAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001. IN AD ITION 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 defe i y an o ss the City
of La Quinta, its officers, agents and employees for act or omission related to the work g
performed under or following issuance of th,
rmit.
2. Any permit issued as a result of this ap ' ation becomes null and void if work is no menced
within 180 days from date of issu ce of such permit, or cessation of work days ' rsubje
permit to cancellation.
I certify that I have readers application and that the above r.Vation is c agr omply with I
city and county ordinprfces and state laws relating to ui mg ns u ion, an a on rep s es—
of this county tpoeS up the above-mentioned property r in c
ignature (Applicant or Agent):
Application Number:
05" 6` 002829,�,y2 i
Property Address:
80871' VIA PUERTA AZUL
APN:
762-240-003-83 -300962-
Application description:
WALL/FENCE
Property Zoning:
MEDIUM DENSITY RES
Application valuation:
2336
Applicant:
I hereby affirm under penalty of perjury that
Section 7000) of Division 3 of the Busing
License Claw. B
/DaI ntractor:
T414t 4 4 Q"
Architect or Engineer:
SIA
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/08/05
Owner:
RTA AZUL PARTNERS
D TLAND, OR 97224 00 SW UPPER BOONES FERRY RD
TE 100
JILL 14 2005
with
pv,lfid aceme is in full force anf9ct-
13480
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 (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 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:
LQPERAIIT
LA UINTA�o tractor:
DE®E". D IS/REED CONSTRUCTION INC
9 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
�/ issued.
-1have and will maintain w ers' compensation insur e, as required by Section 3700 of the Labor
Code, for the pert ance of the work for which this rmit is issued. My workers' compensation
insurance carrier nd policy number are:
Carrier STATE FUND Policy ber 92005
I certify that, in the pe rmance of th k for w ' i e it is issued, I shall not employ any
person in any manner s to b o subje o orker ' compensation laws of California,
and agree that, if I should bec enation rovisions of Section
3700 a Labor Code, I al hw' with th provisions.
Datt7��ant:
WARNING: FAILURE TO SECUR RKERS' OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO INAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001. IN AD ITION 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 defe i y an o ss the City
of La Quinta, its officers, agents and employees for act or omission related to the work g
performed under or following issuance of th,
rmit.
2. Any permit issued as a result of this ap ' ation becomes null and void if work is no menced
within 180 days from date of issu ce of such permit, or cessation of work days ' rsubje
permit to cancellation.
I certify that I have readers application and that the above r.Vation is c agr omply with I
city and county ordinprfces and state laws relating to ui mg ns u ion, an a on rep s es—
of this county tpoeS up the above-mentioned property r in c
ignature (Applicant or Agent):
Application Number . . . . . 05-00002829
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 54.00
Plan Check
Fee
.00
' Issue Date . . . .
Valuation
. . .
. 2336
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
-----------'-----------------------------------------------------------------
.Special Notes and Comments
33 L.F. 6' GARDEN WALL, 21 L.F. 4 -
GARDEN WALL, 6 L.F. 2' GARDEN WALL, 47
L.F. COMBO WALL, 1- RETAINING, 6'
GARDEN, 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
LQPERAIIT