BLCK (06-2687)Aftr
4
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 06-00002687 Owner:
Property Address: 81555 MONARCH CT SHEA LA QUINTA
APN: 764-280-999-6 -300237- C/O JEFF MCQUEEN
Application description: WALL/FENCE 8800 N GAINEY CENTER 350
Property,Zoning: MEDIUM HIGH DENSITY RES SCOTTSDALE, AZ 85258
Application valuation: 3750
Applicant: Architect or Engineer:
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perju that I am li ens under provisions of Chapter 9 (commencing with
Section 000) f Division 3 of the u ess and Pr essi nals Code, and my License is in full force and effect.
Licen s
s"
License No.: 672285
t,
OWNER -BUILDER DECLARATION
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, BusinessandProfessions 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 70001 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, 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.).
I—) I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm underpenaltyof perjury that there is a construction lending agency for the performance of the
work for which this permit is issued ISec. 3097, Civ. C.). '
Lender's Name:
Lender's Address:
LQPERMIT
Contractor:
SHEA HOMES, INC.
81260 AVENUE 62
LA QUINTA, CA 92-)53
(760)777-6005
LiC. No.: 672285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/17/06
n
JUL 2 2006
CITY OF LA QUINTA
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WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
Ihave 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.
1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
TTTT Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier AMERICAN HOME Policy Number 1247619
I certify that, in the perfor nce of the work for which this4p,it is issued, I shall not employ any
///►►►person in any manners s to become subject to the ws' compensation laws of California,
land agree that, if I s f me su ct to the workermpensation provisions of Section
I'3700 of th�bor ode; h I fortv h comply with tprovisions.
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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Directorof 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 f such permit, or cessation of work or 180 days will subject
P mit to cancellation.
I c*dn
ave read this application and state that he above in mation is correct. gree to comply with all
cit t ordinances and state laws relatin 'd�.ze representatives
of tter upon a above -mention pro rt
te: Si nature (Applicant or nt
Application Number
. . . . . 06-00002687
Permit . . . . .
WALL/FENCE PERMIT
Additional desc•.
Permit Fee . . . .
63.00
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 3750
Expiration Date
1/13/07
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
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55 L.F. COMBO WALL,
6- GARDEN, 3'
RETAINING, 99 L.F.
6- GARDEN WALL, ALL
ORCO SYSTEM
Fee summary
Charged Paid
Credited
Due
Permit Fee Total
63.00
:00 .00
63.00
Plan Check Total
.00
.00 .00
.00
Grand Total
63.00
.00 .00
63.00
LQPERMIT