04-6245 (BLCK)60252 Angora Ct
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BUILDING & SAFETY DEPARTMENT
. Box 1504 - (760).777-7012
-495 CALLE TAMPICO ` FAX (760) 777-7011
QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number . . . . .
Property Address . . . .
APN:
Application description . . .
Property. Zoning . . . . . . .
Application valuation . . . .
04-00006245Date \ 9/10/04
60252 ANGORA CT
764-270-999-118 -300233-
WALL/FENCE
MEDIUM HIGH DENSITY RES
3485
Owner Contractor
SHEA LA QUINTA SHEA HOMES, INC.
C/O JEFF MCQUEEN 81260 AVENUE 62
8800 N GAINEY CENTER 350 LA QUINTA CA 92253
SCOTTSDALE AZ 85258 (760) 777-6005
WCC: NTL UNION INS
WC: 6436568 08/01/05
CSLB: 672285 06/30/05
CCC: B
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Permit . . . . . . WALL/FENCE PERMIT
Additional de"sc
Permit Fee . . . . 63.00 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 3485
Qty Unit Charge Per Extension
BASE FEE 45.00
2.00 9.0000 THOU BLDG 2,001-25,000 18.00
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Special Notes and Comments -_
85 L.F. 6' GARDEN WALL, 85 L.F. 3' ,
RETAINING WALL, BOTH ORCO SYSTEM
Fee summary Charged
Permit Fee Total 63.00
Plan Check Total .00
Grand Total 63.00
Paid
----------
..00
.00
.00
Credited Due
.00 63.00
.00 .00
.00 63.00
P.O. Box 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: o 4- &,�zI5 I Date:
Applicant:
Applicant's Mailing Address:
LO
C,P
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under a ally of perjury that I am licensed under provisi ns of Chapter 9 (comm ncing with Section 7000) of Division 3 of the Business and Professionals
e, and my Licens 'i full force and effect.
License Class icense o.
,,--Tate q— �- ontractor
OWNER43UILDER DECLARATION
I hereby 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 fora 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
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
of the eor4for which thi permit is issued.
I a e ari w I maintain w kers' compensation insurance, as squired by Sectio 3700 f e Labor Code, for the performance of the work for which this permit is
ued. orkers' c pensation i ance ca r ' lii�nu tbpr
er olicy Number 9 1/
certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Califo 'a, and agree that,;1ould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those vision
—')/bate plicant
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP 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 pedury 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
r
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 actor omission related to the work beim performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if wo of commenced within 180 days from date of issuance of such permit, or
cessation of work for 180 days will sub' ectpermit t ancellation.
I certify that I have read this application and state that the ab
ov 'nformati is cored. I nee to comply with all city and county ordinances and state laws relating to building
construction,
Ian`d'(��/hereby a thodze representatives of this count r pon thea a mentioned property for inspection purposes.
Date ` 1 70
ignature (Applicant or AgerUT-