BLCK (09-0718)61205 Living Stone Dr
09-0718
Application description:
Property Zoning:
Application valuation:
Applicant:
,,09=0000071$, 3
61205 LIVING STONE DR
764-280-999-1 300236-.
WALL/FENCE
MEDIUM HIGH DENSITY RES
2250
c&ht 4 4 Qum&
Architect or Engineer:
NIS
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 8.5258
0 Q fl
Contractor:
SHEA HOMES, INC. OCT n
60800 TRILOGY PARK J 2009
LA QUINTA, CA 9225
(760)777-6005 CtT'lt}r�iNi�
Lio. No.: 672285
Date: 10/08/,09
-----------------------------------------
• 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 7 3 of the Business3 of the Business Professional C e, 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
Licen.,C` - L' en a o.: 672285
- for by Section 3700 of the Labor Code, for the Performance of the work for which this permit is
V
te:
Ws:ision
on
i5r:
issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit 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
Carrier NTL UNION INS Policy Number WC6987825
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, 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 manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he.or she is licensed pursuant to the provisions of the Contractor's State
anq agree that, if I should come su t to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
I/,3 f the Labor Code sh I forth co ly with those provisions. -
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
`J'� I _ -
-
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
ate: p scant:
(_ 1 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 SECURE WOR '-COMPENSATION 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
and who does the work himself or herself through his or her own employees, provided that the
' DOLLARS ($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
SECTION 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.).
( 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
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 Address: �. '
LQPERMIT
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 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 his application and state that the above informati n is correct: I agree to comply with all
city and cou ty ordinanc s an d state laws relating to building constructio d hereby au thorize.representatives
of this oupt t - e ter u o the above-mentioned property o in ecti ses.
at te: /]u\ re pplicant or Agent):
Application Number . . . . 09-00000718
Permit. . . . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 54.00 Plan Check Fee
.00
Issue Date • . . . ." 7/28/09 Valuation'
2250
Expiration Date 1/24/10
Qty Unit Charge Per
Extension .t
BASE FEE
45.00
1.00 - .9.0000 THOU BLDG 2,001-25,000
9.00
--------
Special Notes„and'Comments
y
`90 L.F.,6' GARDEN WALL, ORCO SYSTEM.
2007 CODES.
CHANGE OF CONTRACTOR FEE ASSESSED TO
„
INSERT SHEA HOMES INC. AS NEW CONTRACTOR
OF RECORD.
-----------------------------------------.------------
•Other Fees _. . . BLDG.STDS ADMIN (SB1473)
1.00
CHANGE OF CONTRACTOR
4.50
Fee -summary Charged Paid Credited
---- - - - - -- ----
Due
-- - - - - - - - - - - - - - --
Permit Fee Total 54.00• 54.00 .00
.00
Plan Check Total .00 .00 .00
.00
,Other Fee Total 5.50 1.00 .00
4.50
Grand Total 59.50 55.00 .00,
4.50
LQPERMIT