Loading...
04-6774 (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 . . . . . 04-0-0-006774 Property Address . . . . . . `'.80944_ VIA PUER APN: 762-240-003-5 Application description . . . WALL/FENCE Property Zoning . . . . . . . MEDIUM DENSITY Application valuation 1407 Owner PUERTA AZUL PARTNERS 17700 SW UPPER BOONES FERRY RD SUITE 100 PORTLAND OR 97224 Contractor =Datle 0,x4/04 00961- T 2004 Or- LA 1dUI CITY ®— DAVIS/REED CONSTRUCTION INC 169 SAXONY ROAD, STE #105 ENCINITAS CA 92024 (760) 634-2350 WCC: STATE FUND WC: WC298892004 0'6/12/05 CSLB: 813480 10/31/04 CCC: B ---------------------------------------------------------------------------- Permit . . . . . . WALL/FENCE PERMIT Additional desc . . Permit Fee . . . . 35.00 Plan Check Fee .00 Issue Date . . . . Valuation 1407 Qty Unit Charge Per Extension BASE FEE 15.00 10.00 2.0000 HND BLDG 501-2,000 20.00 Fee summary Charged --------------------------- Paid Credited Due Permit Fee Total ---------- 35.00 ---------- .00 ---------- .00 35.00 P1an'Check Total .00 .00 .00 .00 Grand Total 35.00 .00 .00 35.00 P.O. Box 1504• � w VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 T-Ot INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: Date: /D ' lq- 0 Architect or Engineer: Architect or Engineer's Address: Lic. No.: /A BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under pe4l of perjury that I am licensed under provisions of Chaptr 9 ( Code, and ll force and effect. com ncj vyit i Section 7000) of Division 3 of the Business and Professionals my icense u , --,License ass Class—< -cense No. ate ntrector > vJ OWNER -BUILDER DECLARATION I her y aff 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 co ty 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 p malty of perjury one of the following declarations: I hav and 'll m in a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance the r rk for hich this permit is issued. I h ve a will aintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perfortganc of the work for which this permit is is ue My dD`n satio�surance carrier and r are: f \ �er � /Policy Number `�Li C>v Ice ify that, in the pe arca of the work for this pe s issued, shall not employ any person in any manna o as to become subject to the workers' compensation laws of California, and ,-" at, jYl sJao comms subje to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith�6mply with those provisions � �� � Data/ WAR,MNG: AILURE TO SECURE WORKRTRYVOMPENSATION COVERAGE IS LINlA1PFdL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FIWS UP TO ONE HUNDRED THWSAND 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 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, 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_perfonned under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null an oidif"work is not - enced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to can5gflaittodn. I certify that I have read t 's application and state that the above 'nfornation is r, I o co with all city and county ordinances and state laws relating to banding construction, nd ereb authorize representatives of this c t to enter upo a ab nt' property for inspection purposes. /nate Signature (Applicant or Agent .