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04-5580 (BLCK)T4hf .. 4 4 Q" BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) .777-7153 BUILDING PERMIT Application Number . . . . . 04-00005580 Date 7/20/'04 Property Address . . . . . . 80901 VIA PUERTA AZUL APN: 762-240-003-19 -300961- Application description . . . WALL/.FENCE Property Zoning . . . . . . . MEDIUM DENSITY RES Application valuation . . . . 2338 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 10/31/04 CCC: B ----------------------------------------------- '---------------- 7 ----------- Permit . . . . WALL/FENCE PERMIT Additional desc Permit Fee . . . . 54.00 Plan Check Fee .00 Issue Date Valuation . . 2338 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 82 LF 5' GARDEN WALL/26 LF 51. TRASH ENCLOSURE PER APPROVED PRECISE GRADING PLAN. Fee summary. Charged Paid Credited Due ----------------- ---------- ------- - -- ---------- ---------- Permit Fee Total 54.00 .00 .00 54.00 Plan Check Total .00 .00 .00 .00 Grand TotaD n a 5-4-.-t 00 .00 54.00 JUL. 2-1 2004 CITY OF LA QUINTA FINANCE DEPT. P.O. BOX 1504 ot 78-495 CALLE TAMP.ICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: _ Dy— 5 j ,fo Applicant: Applicant's Mailing Address: Architect or Engineer: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7^00— D Architect or Engineer's Address: Lic. No.. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapterr76 g with Section 7000) of Division 3 of the Business and Professionals Code, and my License isja.fu force and effect. License OlayLicense No. Date / b Contractor OWNER -BUILDER DECLARATION I hereby affirm 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,diowever, 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 self4nsure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the wo for which this permit is issued. —I ha a and I maigta5workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance oYe thefor which this permit is s ed. wo rs' compensation insurance varier and policy number are: G �� Cartier Policy Number _ 1 ceify that, in t e perfo ce of the work for which this permit is issued, I shall not employ any person In ny m Hoer so as oubject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, l shall rthwith comply with those provisions. Date Applicant ' WAR G: FA LURE TO SECURE WORKERS' 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 3708 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 perfonnarice of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's 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, each agre rtil shall; -defend, indemnity and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to theeing performed under or. following issuance of this permit. 2. Any permit issued as a result of this application becomes null a old if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancell on. certify that I have read this application and state that the above info ation is ce I ag rth city and county ordinances and state laws relating to building construction, a here authorize representatives of this county to en upo abov i rope or inspection purposes. Date / gignature (Applicant or Agent):