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04-7669 (BLCK)BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . 04-00007669 Date 12/08/04 Property Address . . . . . .80895 VIA PUERTA AZUL APN: 760-240-003-18 -300961- Application description . . . WALL/FENCE Property Zoning . . . .. . . . MEDIUM DENSITY RES Application valuation . . . . 2035 Owner PUERTA AZUL PARTNERS 17700 SW UPPER BOONES FERRY RD SUITE 100 PORTLAND OR 97224 Contractor DAVIS/REED CONSTRUCTION INC 169 SAXONY ROAD, STE #105 ENCINITAS CA 92024 (760) 634-2350 WCC: STATE FUND WC: WC298892004 06/12/05 CSLB: 813480 10/31/06 CCC: B ----------------------------------------------- ----------------------------- Permit . . . . . . WALL/FENCE PERMIT Additional desc . . Permit Fee . . . . 54.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 2035 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 94 L.F. 5' GARDEN WALL, 5 L.F., 21GARDEN WALL, BOTH ORCO SYSTEM Fee summary Charged ----------------- ---------- Permit Fee Total 54.00 Plan Check Total .00 Grand Total 54.00 Paid Credited Due ---------- ---------- ---------- .00 .00 54.00 .00 ..00 .00 .00 .00 54.00 771 P.O. BOX 1504 • '�C��� 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: %(o (p 1( Applicant: Applicant's Mailing Address: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: / 2 O `i Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under f perjury that I am licensed under provisions of Chapter 9 (commencing 'th Section 7000) of ision 3 of the Business and Professionals e, and my Lic se i3 i f force and effect. / License Class License No. -111iVL,01 ateContractor OWNER -BUILDER DECLARATION I herebyaffirm under 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 1, 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 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 of the work for which this permit is issued. have and in workers' compensa on insurance, as required by Secti 37 0 of the L5rgq the performance work for which this permit is issu d'My orkers' compensatiourence caner and policy number areC Cartier P� olicy Nu ` �Q�! I certif at, in he performance of th or whic ermit is is I s of employ any person in any manner as to become subject to the workers' compensation laws of Califo , and agree t , if I ould b bject to workers' compensation provisions Section 3700 of the Labor Code, I shall f h comply with th provisions. ate A' pplicant WARN G: AILURE TO SECURE ER COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL IN UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SEC ION 3706 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 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, eachgrees to, d shall, defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission relate rforned under or following issuance of this permit. 2. Any permit issued as a result of this application beco ull a oid if wo no menced within 180 days from date of issuance of such permit, or cessation of wo or 180 days will subject permit t ancee I o . I certify that 1/andh d thi application and state that the abo a inf n is gree to ply with all city and county ordinances and state laws relating to building construction,by uth ereresentatives of this coun r up a ve m oned property for inspection purposes. Signature (Ap licant or A P 9