06-1250 (CONR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT_
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/14/06
Application Number: 06-00001250 Owner:
Property Address: 57390 -VIA VISTA PUERTA AZUL PARTNERS
APN: 762-240-003-72 -300962- .17700 SW UPPER BOONES FERRY.RD
Application description: NEW COMML - OTHER NON-RESIDENTIAL SUITE 100
Property Zoning: MEDIUM DENSITY RES PORTLAND, OR 97224
Application valuation: 125000
Contractor:
Applicant: ' Architect or Engineer: DAVIS/REED CONSTRUCTION INC D
169 SAXONY ROAD, -SUITE 105
L ENCINITAS., CA ,92024 APR
PR
.634-2350 1 200C
LiC. No.: 813480 1 U
iryo—
�. CSC
----- --- -- --- - - = -- - -- - ---- --'------------ ---- ------ -A -1--
' LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION -
�, I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: -
_ Section 7000) of Division 3 of the Business. and Professionals Code, and my License is in full force and effect. I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
Licens lass: 13ense No.: -813480 - for by Section 3700 of the Labor Code; for the performance of the work. for which this permit is
issued.
' j.DaJ ��Contractor: = I have and will maintain workers' compensation insurance, as required by Section 3700 6f the Labor -
Code, for the performance of the work for whic " is issued.. My workers' compensation -
OWNER -BUILDER DECLARATION - insurance carrier and policy number are -
I hereby affirm under penalty of perjury,that'I am exempt from the Contractor's State License Law for the t ;?Carrier STATE FUND P y Number WC298892 —05 -
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to - _ I certify that, in the performance the work for which this permit is sued, I shall not employ any
• construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the . person in any A
me subject to the workers' co --- ns
laws of California,
• permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State ^ and agree thatubject to the workers' compe ation provisions of Section `
4 License Law (Chapter'9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the.Lh 'th comply with those pr isions. - 'F
;.that he orsheis 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):: ^ Dat Applicant: -
" 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 WARNING: FAILURE TO SECPENSATION COVERAGE IS UNLAWFUL, AND SHALL ,
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, - SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND / -1
- and who.does the work himself or herself through his or her own employees, provided that the - DOLLARS 1$100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN:'•
improvements are not intended or offered for sale. 1f, however, thebuildingor improvement is soldwithinSECTION 3706 6PTHE LABOR CODE, INTEREST, AND ATTORNEY'S FEES..
one year of completion; the owner -builder will have.theburden of proving that he or she did not build or
-• improve for the purpose of sale.l. - APPLICANT ACKNOWLEDGEMENT -
(_) I, 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 Code: 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 contractor(s) licensed - 1 . Each person upon whose behalf this application is made, each person at whose request and for -
pursuant to the Contractors' State License Law.). - whose benefit work is performed under or pursuant to any permit issued as a result of this application, _
( .) I am exempt under Sec. , B.&P.C: for this reason - 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 . 1.
performed under or following issuance of this permit.
Date: Owner: _ 2. Any permit issued as.a result of this application becomes null and v ' ' work is not commenced ..
- within 180 days from date of issuance of such permit, orc i rleiv ays will subject
CONSTRUCTION LENDING AGENCY permit to cancellation. l
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I ave re d this application and state that the abo ormati correct. I agree to comp with all
work for which this permit is issued (Sec. 3097, Civ. C.). - city and cou y ordi antes and state laws relating to buil ' onstruc ' and her by authorize represe atives -
- of*h10 ter upon the above-mentioned pro r or inspe purp
Lender's Name: _0�".Dature (Applicant or AgeLender's Address:.
LQPERMIT
Vii,. � •
_ •
Application Number 06-00001250
Permit ELEC-MISCELLANEOUS
Additional desc
Permit Fee 33.50 ;;' Plan Check Fee
8.38
9Issue Date Valuation 1.
0
Expiration Date:. 10/11/06
Qty Unit Charge Per
Extension
BASE FEE
15.00.
1:00 18.50,00 EA ., ELEC SVC.<=600V/<=200A
18.50 ".
Permit '.. PLUMBING
Additional..desc .:
Permit Fee 33.00 -Plan Check Fee `.
8.25
Issue Date, Valuation
0
Expiration Date 10/11/0.6
:. Qty Unit Charge Per
Extension
BASE FEE:
15.00
100 15.'0000 -EA PLB BUILDING SEWER
15:00
1..00 .. 3.0000 EA PLB WATER INST/ALT/REP,
_,
3.00
Permit TEMP TRAILER./MOBILE HOME
Additional desc
Permit Fee 200.00: Plan'Check Fee
.00
;.Issue Date Valuation
125000
Expiration Date.. 10/1.1/,06,;
Qty. iJnit C harge, Per.
Extension,
BASE FEE
. .
200..00
.. -y
71-
Special Notes and•Comments,
•,
PRE -FAB RESTROOM•/OCCUPANCY GROUP.B,
TYPE II -N CONST ,
----Other Fees STRONG MOTION .(.SMI) - COM
26 '25
Fee summary Charged Paid Credited
Due -
-------
Permit•Fee Total 26.6.50 '.00 .00 •:266.50
-
Plan Check Total 16.63 00 :00
16.63
Other Fee Total, 26.25 00 .00
26..25 ..
Grand Total :. 309.38 .00 .00-
309.38
LQPERMIT
_ -