05-3398 (BLCK)0 Aim
BOX 1504 "'
VOICE (760) 777-7012 '
�y 7:95 CALLE TAMPICO D d
I 'FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 . •' BUI V
Y DEPARTMENT. INSPECTIONS (760) 777-7153
AU& 3 N�D
PERMIT'
ON
Daie: 8/03/05-
F-
Application Number: 05=00003398 Cffy®F
-Owner:
®UINTA
• -Property Address: 57401 VIA VISTA �0��9cE
PUERTA 'AZUL PARTNERS
APN: 762-240-003-31 -300962- ®E
17700 SW UPPER BOONES FERRY RD -.
Application description: WALL/FENCE -
- SUITE 100.
Property Zoning: MEDIUM DENSITY ,RES
• PORTLAND, OR 9.7224 j R
rt'
- Application valuation: 875 -'
„
Contractor:
Applicant: - Architect or Engineer.
DAVIS/REED CONSTRUCTION .INC
WCC: STATE -FUND
>..
WC: WC298892005 06/30/06 .• -.. .
CSLB: 813480 10/31/06 �-
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;. LICENSED TRAC 'S DECLA -
,. •. - .. - WORKER'S COMPENSATION DECLARATION
I hereby aft' under nalty of perjury that I icensed er ovisio pter 2jagghencing with -
I hereby affirm under penalty of perjury one.of 'the following declarations: -
- Section 7 01 of Di on 3 of t usine nd Profe 'nal ode, d ice ull force and effect. -
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
Lice ass: icens
_
- for by Section 3700 of the Labor Code, for r ormance. of t rk for which this permit is. '
-
issued. ..
_ ontre r: ..
ave -and will maintain worker ' mpensation insurance, as required by S coon 3700 of the Labor
.t:
' - `i - - • .
_ _
- Code, for the Performa of the work for which this permit is issued. y workers' compensation -
NER•BUILOER DECLARATION - -
insurance carrier a policy number are: '
1 ereby irm under penalty of. perju am exempt from the Contractor's State License Law for the
.Carrier B Polic er - - - - - - - - -
'.followi reason (Sec. *7031.5, Busi ss d Professions Code: Any city or count that requires a permit to
` - ' I certify that, ' the. performance of for which f p , I shall not employ any
construct, alter, improve, demolish, or r pair any structure, prior to its issuance, also requires the applicant for. the .' :
erso� ny manner s ' s to o subject to e w ierstion laws of California, - -.
�pensa
permndto file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and a that, i ould b m ubject to wo _js'__c _provisions of Section
License Law (Chapter. 9 (commencing with Section 7000) of Division 3 of. the Business and Professions Code) or -
370bor Code, h wi _ith se .
- ; 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).:
Dal p ca _
9 -.1 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work,. and r
-
• .the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
_
WAR F URE TO SECU ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL - <
- ? Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
-SUB CT A MPLOYER TO MINAL 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
DO RS ( 00,000). 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 '�
SE TION O6 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-
' (_) 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 being
-
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 c menced
. -
within 1130 da rom'date of issuance of.such rmit, or c ation of work for 1 days will subject -
' - CONSTRUCTION LENDING AGENCY - -
per t to c el anon.
. 1 hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the - -
1 certify that I ave re this appli - and state t the above i r anon is c ct. agree to comply with all -
work for which this permit is issued (Sec. 3097, Civ. C.L.
city and c y ordi nces state laws relatin to building s on, and re authorize representatives
- - - -
of th#• u on the above-mentione rope y i o pur se '
Lender's Name:
- •
-Dat nature (Applicant or Age
Lender's Address: -
LQPERI%lfT -
Application Number _ . . 05-00003398
_.
Permit . . . WALL/FENCE PERMIT
Additional desc . .°
Permit Fee 23.00 Plan Check
Fee
.00
- Issue Date` Valuation
875
Expiration Date.. 1/30/06
Qty Unit.Charge Per
Extension
BASE FEE
15.00
.•4.00 2.0000 HND BLDG 501-2;000
8.00
- ---------------------------
Special.Notes'and Comments
-
35 L.F. 6' GARDEN WALL, ORCO SYSTEM.
:. Fee summary Charged Paid Credited.
Due.
Permit Fee Total 23.00 .00
.00
23 - bo
Plan Check Total- 00 :. :00 '.00-
.00
Grand Total 23.00 .00
.00
23.,00
LQPERMIT
. .