BLCK (11-0033)Application Number: 11=00000033- . _y
Property Address: 61025 LIVING STONE DR
11-0033
APN: 764-270-999-42 -300234-
Application description: WALL/FENCE
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 1750
ADDlicant:
Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with -
Section 7000) of Division 3 of the eusinisandProfes ionals Code, and my License is in full force and effect.
License lass: License No.: 672285
4
/D tae tractor: (P— .
OWNER -BUILDER DECLARATION r
I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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)•:
1 _ I 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 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.).
(_ 1 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.).
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
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:'--
Lender's
ame:Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:. 1/10/11
Owner'
SHEA LA QUINTA
60800 TRILOGY PARKWAY
LA QUINTA, CA 9 D
Contractor: JAW 21 26iI I. �
SHEA HOMES, INC
60800 TRILOGY P RK C1TY4fdAQlS4dITA
LA QUINTA, CA 9 53 RNANCE
(760)777-6032
Lic. No.: 672285
-----------------------------------------------
WORKER'S 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 work for which this permit is.
issued.
I have and will maintain workers' compensation insurance, as required by Section 3760 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier LIBERTY MUTUAL Policy Number WA266D066115030'
I 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 California,
and agree that, if I should beOalli,
come subject to th - workers' mpensation provisions of Section
3700 of the Labor de, I " rtiwith c�mply with th s provisions.
r
ate: pplicant:
WARNING: FAILURE TO SECURE WO KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMI AL 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.
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 Quima, its officers, agents and employees for any act or omission related,to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject.
permit to cancellation. ,
I certify. that I have read this application and state that the above information is corre t. I agreeto comply with all
�etea
d county ordinances and state laws relating to building construction, and hereb author' representatives 4
Pne(A
he above-mentioned pr pity fo �nsp coon purpo S.
`) pplicant or Agent):'
Application Number . . .. . . 11-00000033
Permit . . WALL/FENCE-PERMIT.
Additional desc .
Permit Fee . . . . 41.00 Plan Check
Fee
.00
Issue Date Valuation
1750
Expiration Date 7/09/11 ,
Qty Unit Charge Per
Extension
BASE'FEE
15.00
13:00 2.0000 HND BLDG 501-2,000
26.00
Special Notes and Comments
70 L.F. COMBO WALL, 3' RETAINING,. 6'
GARDEN, ORCO SYSTEM. 2010 CODES. THIS
REPLACES PERMIT #.05-5217 WHICH WAS
BUILT IN WRONG LOCATION:
-----------------.--------------------------------------------------------
Other Fees BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
--------------------------
Permit Fee Total 41.00 .00
.00
41.00
Plan Check Total .00 .00
.00
.00
Other Fee Total 1.00 ..00
:00
1.00.
Grand Total 42.0.0 00
00
42.00
LQPERMIT
B`"#
'� G City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
1 I •J
`
Project Address: 61025 Living Stone Drive
Owner's Name: Shea Homes
A. P. Number:
Address: 60918 Desert Rose Drive
Legal Description: Trilogy @ La Quinta Annex
City, ST, zip: La Quinta, CA 92253
Contractor: Shea Homes
Telephone: 760-777-6032
-
Address: 60918 Desert Rose Drive
Project Description: Lot 42
City, ST, zip: La Quinta, CA 92253 -
-Orco`Combo Wall - 70 If x 6' & 3'
Telephone: 760-777-6032
Reviewed, ready for corrections
State Lic. # : 640934
City Lic.#:�
Arch., Engr., Designer.
JAN 1 Q 2011 I Ij
Address:
1_
City, ST, Zip:
i4•j _
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Gabbie Nieto
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 760-777-6032
Estimated Value of Project:
APPLICANT: 00 HOT WRITE BELOW THIS LINE
#
Submittal.
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2od Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
drd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A. 1. P. P.
Pub. Wks. Appr
Date of permit issue
School Fees
r
Total,Permit Fees