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BLCK (09-0436)61265 09-0436 _. Date: 5/11/09 Application Number: 09 0000043_6 Owner: y4, ti r Property Address: 61265 LIVING STONE DR SHEA LA QUINTA APN: 764-280-999-4 1.-300236- C/O JEFF MCQUEEN Application description: WALL/FENCE 8800 N GAINEY CENTER 350 Property Zoning: MEDIUM HIGH DENSITY 'RES r SCOTTSDALE, AZ 85258 Application valuation:1625 Contractor: Applicant: Architect or Engineer: SHEA HOMES, INC. 60800 TRILOGY PARKWAY LA QUINTA, CA 9225 (j (.760) 777-6005 Lic. No.: 672285 r t----� a - ------------------=----------------------------------------------------- - eI �;-4L'A-a�'t, -- --- LICENSED CONTRACTOR'S DECLARATION WORKER'S CO PENSATIa C 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 follo in declaratio - Section 7 001 of Division 3 of,the B and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consen to self-insure for workers' compensation, as provided - License ss: B �. �" _ Li ense No.: 672285 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is 1l issued. actor: • �� . V 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 Lawforthe Carrier NTL UNION INS Policy Number WC1894819 -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 orLkes' coensation 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 that, if I sh Id b c me s bjels to the wor e mpe s tion provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Codel or 11 3700ofthe Laborod , I sha fort wi o with t - ' that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by 6N� any applicant for a permii subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: licant: f _J� - ( 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: A�URETPOPSECURE� KERS' 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.). - 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 r 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. , S.&P.C. for this reason" - the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City - ' of La Ouinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. • Date: Owner: 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 CONSTRUCTION LENDING AGENCY permit to cancellation. r - • I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of. the I certify that I have read this application and state that the above information is correct. I agree to comply with all - work for which this-permit is issued (Sec. 3097, Civ. C.). city and c my dinances and state laws relating to building con truction, and ereby authori�resentatives .of this cou ty to rr upon the above-mentioned prop .for ins ctio purpos Lender's Name: - / - Da � - ture (Applicant or Agent): l 11����" Y ' Lender's Address: - LQPERDIIT - .,Application Number 09 -00000436 - Permit . . . WALL/FENCE PERMIT : Additional desc . Permit Fee 39.00 Plan Check Fee .00 Issue"Date '. Valuation, 1625 Expiration Date.. 11/07/09 Qty V Unit Charge Per Extension BASE FEE 4 " . 15.00. 12•.00 2.0000 HND BLDG 501-2'1000 24.00 ---------------- Special Notes and Comments 65 L.F. COMBO WALL, 3' RETAINING, 6' GARDEN, ORCO SYSTEM 2007. CODES Other Fees . . . .'. . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 39.00 .00 .00 39.00 Plan Check Total .00 .00. .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 40.00 .•00 .00 40.00