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04-6783 (BLCK)T4hf 4 4 Qab& � Box 1504 )5 CALLE TAMPICO UINTA, CALIFORNIA 92253 BUILDING PERMIT mber . . . Property Address . . . . APN: Application description Property Zoning . . . . . Application valuation . . Owner PUERTA AZUL PARTNERS 17700 SW UPPER BOONES FERRY RD SUITE 100 PORTLAND OR 97224 BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 04-00006783 Date 10/14/04 80902 VIA PUERTA AZUL 762-240-003-12-300961- WALL/FENCE MEDIUM DENSITY RES 866 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 23.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 866 Qty Unit Charge Per Extension BASE FEE 15.00 4.00 2.0000 HND BLDG 501-2,000 8.00 ---------------------------------------------------------------------------- Special Notes and Comments 40 L.F. 5' BLOCK WALL, ORCO SYSTEM Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 23.00 .00 .00 23.00 Plan Check Total .00 .00 .00 .00 Grand Total 23.00 .00 .00 23.00 s P.O. sox 1504 �� VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: QG%- & 183 Applicant: Applicant's Mailing Address: Date: / D • /4q' G N Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty o perjury that I am licensed under provisions oyChapter 9 commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my 'cense is i orce and effect. ((�j✓✓Ir (\// / License%Class j License No. / Date r Contractor Y / OWNER -BUILDER DECLARATION I hereb 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 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 sate.). 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 Yof he wo for this permit is issued. , I ha a and ill maint workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performan of th��WWWork for which this permit is i s worke s' compe --Poli urance carrier and policy number are: �rrier /Policy Number I certify thal, in the performance of the work f Bch this itis issued, I shall not employ any person m any manner so as to become subject to the workers' coWhpensation laws of California, and a that, if I become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall witb4omply with those Drovis' WARNI G: FAILURE TO SECURE WOR1ktRS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL INES P 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. 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 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 becomes null and voi s no .commence tin 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellaf I certify that I have r ad thispplication and state that the above in f ation is correct. I agree to ly with all ' and county ordinances and state laws relating to building construction, and reby orize representatives of this county o enter upon t e -menti pro ert inspection purposes. Date A�ignature (Applicant or Agent): a� CITY OF LA QUINTA ' ~ BUILDING & SAFETY DEPARTMENT cam' F 777-7012 INSPECTION REQUEST UNE 7777153 Owner PyTFRTA AZATI, P TN'PEtS, Ll C Contractor DAVISRx ri n C"n�v��,l7YTfTiQN Permit Number. —04 6781 — - POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 80-902 VIA PlIESTA AZIll, 40 L.F. , S' GARDEN 'WALL, ORCO SYSTEM TEN SET TYPE OF INSPECTION I DATE I INSP. / GROUNDING DO NOT POUR CONCRETE UNTIL ABOVE SIGNED ROOF NAIL / PRE -ROOF MIN_ G (COM )UGH ELEC INSULATION COVER NO WORK UNTIL ABOVE SIGNED INTERIOR GYP BD- (DRYWALL) SEPTIC ABANDONMENT / GREASE INTE MASONRY INSPECT ON FOOTINGS / STEEL BOND BEAM POOL / SPA / WATER FEATURE INSPECTIONS PRE-GUNITE I SETBACKS U/G PLUMBING U/G ELECTRICAL PRE -PLASTER (ALARMS/ BARRIERS PLUMBING _MECHANICAL F IC WORKS DEPARTMENT 0�_vWUNITY DEVELOPMENT DEPT. FINAL / JOB COMPLETED ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING LSbTLtL99L ZE:9T S00Z/ZT/T0