05-2810 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05-00002810
Property Address: 80884 VIA PUERTA AZUL
APN: 762-240-003-1 -3009
Application description: WALL/FENCE
Property Zoning:. MEDIUM DENSITY RES
Application valuation: 1586
Applicant: Architect or &
Ti"!t 4 s(P Q"
BUILDING & SAFETY DEPARTMENT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Owner:
® PUERTA AZUL PARTNERS
17700 SW UPPER BOONES FERRY RD
SUITE 100
JUL 1 4 2005 PORTLAND, OR 97224
coF JNVE EPT.A Contractor:
DAVIS/REED CONSTRUCTION INC
169 SAXONY ROAD, SUITE 105
ENCINITAS, CA 92024
(760)634-2350
Lic. No.: 813480
Date: 7/08/05
-- - - - - - - - - - - - - - - - - - - -y- - - - - - - - - - - - -------------------------------------------------------- - - - - - —
I hereby affirm under
Section 700) of Div
License CI ss: B /
/Date!
OWNER -BUILDER DECLARATION
I ereby ffirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
ollowing 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 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.).
(_) I am exempt under Sec. , B.&P.C. for this reason
Ity of perjury that
3 of the Business
Chapter 9_Jicafnmencing with
.icens in full force and effect.
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
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 workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performanceof ork" arf wFic' tgis permit-is.issued. My workers' compensation
insurance carrier an icy number are:
Carrier STATE FLTND Policy Num WC29889 005
I certify tha n the performance of the wo or which this it is is , I shat not employ any
perso in any mann o as to beco ubiact to the ers' ensation la s of California,
and ree th should becom t to the ers' c ensation pr ons of Section
o i com ith th provision
15ate: �- /' icant:
000
WARNING: FAILURE TO SECURERKERS' COMPENSATION P AGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TOC INAL 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 application beco i i commenced
within 180 days from date of issuance of s ermit, or cessation of work for 180 will subject
permit to cancellation.
I certify that I have read this application and s e that the abov, ' formation is agree ly with all
city and county ordinancesd sate ate laws ret ting to buildi nstruct n reb nze entatives
of this unty err// on the above -menti ed prop in io rpo
Date ignature (Applicant or -Ag`
Application Number . . . . . 05-00002810
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 37.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 1586
Expiration Date 1/04/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
11.00 2.0000 HND BLDG 501-2,000
w
22.00
----------------------------------
Notes and Comments
50 L.F. 6' GARDEN WALL, 21 L.F. 4'
GARDEN WALL, 6 L.F. 2' GARDEN WALL, ALL
ORCO SYSTEM
Fee summary Charged Paid Credited
---------------------------
Due
--------------------
Permi t Fee Total 37.00 .00
----------
.00
37.00
Plan Check Total .00 .00
.00
.00
Grand Total 37.00 .00
.00
37.00
LQPERMIT