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05-3394 (BLCK)T4'y� 4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 'LA QUINTA,•CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 t'1) BUI NG -ERMIT Date: 8/03/05 Application Number: 05_ 000.03394 ;U+ Wrier: Property Address:" 57377 VIA VISTA UU AUG � :�PUERTA AZUL PARTNERS ��� APN: 762-240-003-27 -300962-' tJIM 9� X17700 SW UPPER BOONES FERRY RD Application description: WALL/FENCE' a'SUITE 100 Property Zoning: MEDIUM DENSITY RES �OF�Qu��TPORTLAND, OR 97224 � Application valuation: 2075 g4ceD�pp A Contractor: + Applicant: Architect or Engineer: DAVIS/REED CONSTRUCTION INC WCC: STATE FUND WC: WC298892005 06/30/06 . • �1.. /Cts 813 . iCSLB 480 10/31/06 L D CO CTOR'S DEcL,RATI WORKER'S COMPENSATION DECLARATION b I hereby a rm un enalty f perjury t I m lice under provisions of pier 9 (commencing with I hereby affirm under. penalty of perjury one-of the following declarations: - Section 00) ivi ' of the Bu es Pro io is in u orcean a ect.- _ f have and will maintain a certificate of consent to self-insure for workers' compensation, as provided Lic e I ss', License for by Section 3700 of the Labor Code, fort . _ the work for which this permit is issued. Da ContrI have and will maintain wo- compensation insurance, as required - ection 3700 of the Labor Code, for the pert n - of the work for which this pe it is issued. y workers' compensation. OWNER-BUILDER DECLARATION insurance ca and policy number are* I. ereb ffirm under penalty perjury that I am exempt from the Contractor's State License Law for the �rier B P ' umb - - - - - - - - - - - - - ollowing reason.(Sec. 7031.5, Business and. Professions Code: Any city or county that requires a permit to - - - _ .I c f at, in the performance wor his permit is' ed, I shall not employ any _ construct, alter, improve, demolish, or repair any structure; piior to its issuance, also requires the applicant .for the - - rson in any manner so as com a .the worker ' mpensation laws of California, .. permit to file a signed 'statement that he or she is licensed pursuant to the provisions of the Contractor's State . • ndthat, if I sho rovisions of Section - License Law (Chapter 9(commencing with Section-7000) of Division 3 of the Business and Professions Code). or - o e a or C 11 c ith those provisions. _ r . - that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by • - any applicant for apermit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: pplica , (_ 1 1, as owner of the property; or my employees with wages as their solecompensation, will do the work, and - thestructure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WAR G: FAILURE TO S WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL - - . Contractors' State License Law does not apply to an owner of property who builds or improves thereon, ' SUBJ CT AN EMPLOYER T CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOL RS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN • 'improvements are.not intended or offered for sale. - If, however, the building or improvement is sold within SEC ION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. - - 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.). - - APPLICANT ACKNOWLEDGEMENT 1—) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the . 7044, Business and Professions Coder The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth *on this application. . property who builds or improves thereon, and who contracts for the projects with a.contractorls) licensed - 1. Each person upon whose behalf this application' is made, each person at whoserequest and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any per It of this application, (_ 1 I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall nd, indemnify and ho11 - armless the City of La Quinta, its officers, agents and employees f ny act or omission related to th work being performed under or following-issuance of thi ermit. Date: Owner: - 2. Any permit is d as a result of this appli ion becomes d void if rk is not ommenced wi n •180 s from date of issuanc of such perm' , or ssation ork for 1 days will subject CONSTRUCTION LENDING AGENCY - peapplication l . _ • I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify a hand state the work for which this permit is issued (Sec. 3097, Civ. C.). ' - city an - mynd state laws relating to buil ng struct , and he y authorize representatives ' _ - of thi tythe above-mentioned prop yp�� purp s. Lender's Name:Dat re (Applicant or Agen - Lender's Address: - LQPERMIT Application Number . . 05-00003394 Permit WALL/FENCE PERMIT . Additional desc . • Permit Fee 54.00 Plan Check Fee 00 Issue Date Valuation 2075, Expiration Date 1/30/06 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 --------------- 83 L.F. 6' GARDEN .WALL, ORCO SYSTEM. Fee summary Charged Paid- Credited Due Permit Fee Total. 54.00 .00 .00 •54.00 . Plan Check Total -. .00 .00, .00 .00 Grand Total 54.00 .00 00. • 54.0.0 .. LQPERMIT - - -