04-7668 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
Application Number . . . . . 04-00007668 Date 12/08/04
Property Address . . . . . . 80889 VIA PUERTA AZUL
APN: 762-240-003-17 -300961-
Application description . . . WALL/FENCE
Property Zoning . . . . . . MEDIUM DENSITY RES
Application valuation . . . . 3615
Owner
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PUERTA AZUL PARTNERS
17700 SW UPPER BOONES FERRY RD
SUITE 100
PORTLAND OR 97224
Contractor
DAVIS/REED CONSTRUCTION INC
169 SAXONY ROAD, STE 4105
ENCINITAS CA 92024
(760) 634-2350
WCC: STATE FUND
WC: WC298892004 06/12/05
CSLB: 813480 10/31/06
CCC: B
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Permit . . . . . . WALL/FENCE PERMIT
Additional desc
Permit Fee . . . . 63.00 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 3615
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
115 L.F. 5' GARDEN WALL, 45 L.F. COMBO
WALL, 2' RETAINING, 4' GARDEN, ALL ORCO
SYSTEM
Fee summary Charged Paid Credited Due
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Permit Fee Total 63.00 :00 .00 63.00
Plan Check Total .00 .00 .00 .00
Grand Total 63.00 .00 .00 63.00
P.O. Box 1504 •
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
Date: / 2- ?l 0
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm und%4pewe y of perjury that I am licensed under provisions of Chapter 9 (commen ' Section 7000) of D' ision 3 of the Business and Professionals
Pede, and my Lic nse i i full force and effect.
License Class License No.
�
T
Date $ F,1 ontractor
OWNER -BUILDER DECLARATION
Ihereby 4. bder penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).):
U 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 or 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.).
U 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.).
U I am exempt under Sec. , BA P.C. for this reason
Date Owner.
WORKERS' 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
�ofth woh this permit is issued.
I h id' I 'ntain workers' compensation insurance, as required by Secti n 3700 of the Labor Co e, f the performance of work for which this permit is
y workers' compensation i � carrier an cy number ar .
rrier cfy Number-
-t- (J/d�gt �7`"/w�j
I - rtify th t, in the performance a work for this p it•i is ued, I sh II not employ any person i'n any manner so as to become subject t th
I o e workers'
co ensation laws of Calif ia, and agre t, if I s Id me ubject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
f�wjM corpply with tho provisions. ZI
/ D
WARNING: F URE TO SECURE WOR COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINS TO ONE HUNDRED THQkISAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTIO 37 6 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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
Lenders Address
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 perso est and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application, the owner, and the , each agrees to, an II, defend, indemnify and hold harmless the City of La Ouinta, its
officers, agents and employees for any act or omi ' related to the work being erformed der or following issuance of this permit:
2. Any permit issued as a result of this applicati ecomes null void if wo t commen ' within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subje ermit to canc on.
I certify that I ave read this application and state at the above i ation is agree to y with all city and county ordinances and state laws relating to building
construction and hereby authorize represen ti sof this cou �rfter upo ve-men ' ed property for inspection purposes.
(Applicant or