09-0739 (BLCK)Applicant:
Architect or'Engineer:
PIP
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereb affirm under penalty of perjur th I am licensed under provisions of Chapter 9 (commencing with
Sectio 7000) of Division 3 of the B si s and Professioals Code, and my License is'in full force and effect.
rc s •I Li a se No.: 672285
a ontractor:
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, 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).:
(_) 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, 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 contractors) licensed
pursuant to the Contractors' State License Law.).
( ) I am exempt under Sec. I , 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 Address: A
LQPERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85
u l�
Contractor: ,
SHEA HOMES, INC.
60800 TRILOGY PARI(p A
LA QUINTA, CA 92253
(760)777-6005
Lic. No.: 672285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760),777-7153
OCT 19 2099
v' ..HS �r,;V,IW
Date: • 10/07/09
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 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.
1 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.
insurance carrier and policy number are:
Carrier NTL UNION INS Policy Number WC6987825
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 gree that, if I should become subj t to the workers' compensation provisions of Section
70Labor C sh I forthw comply with those provisions.
i
e: p cant:
WARNING: FAILU� SECURE WORK '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 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 Ouinta, 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 correct. I agree to comply with all
city and cou ty ordin nces and state laws relating to buildin construction, d hereby authorize representatives
of I!, coQ t o t n the above-mentioned property or 'nsp tion p oses.
We n ure (Applicant or Agent):
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA
92253
Application Number:
`_09.00000739
Property Address:
81322 RUSTIC CANYON DR
APN:
764-280-999-177 -300236-
Application description:
WALL/FENCE
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
1680
Applicant:
Architect or'Engineer:
PIP
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereb affirm under penalty of perjur th I am licensed under provisions of Chapter 9 (commencing with
Sectio 7000) of Division 3 of the B si s and Professioals Code, and my License is'in full force and effect.
rc s •I Li a se No.: 672285
a ontractor:
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, 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).:
(_) 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, 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 contractors) licensed
pursuant to the Contractors' State License Law.).
( ) I am exempt under Sec. I , 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 Address: A
LQPERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85
u l�
Contractor: ,
SHEA HOMES, INC.
60800 TRILOGY PARI(p A
LA QUINTA, CA 92253
(760)777-6005
Lic. No.: 672285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760),777-7153
OCT 19 2099
v' ..HS �r,;V,IW
Date: • 10/07/09
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 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.
1 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.
insurance carrier and policy number are:
Carrier NTL UNION INS Policy Number WC6987825
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 gree that, if I should become subj t to the workers' compensation provisions of Section
70Labor C sh I forthw comply with those provisions.
i
e: p cant:
WARNING: FAILU� SECURE WORK '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 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 Ouinta, 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 correct. I agree to comply with all
city and cou ty ordin nces and state laws relating to buildin construction, d hereby authorize representatives
of I!, coQ t o t n the above-mentioned property or 'nsp tion p oses.
We n ure (Applicant or Agent):
LQPERMIT
Application Number . . 09-00000739
Permit . . . WALt/FENCE PERMIT
Additional desc ...
Permit Fee . . . . 39.00 Plan Check Fee
.00
Issue Date 7/29/09 Valuation . . .
1680
Expiration Date 2/15/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
•12.00 2.0000 HND BLDG 501-2,000
24.00
-----------------------------------------------------------------------------
Spediai Notes and Comments
105 L.F. 3' RETAINING 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 39.00 39.00 00
-- ---
.00
Plan Check Total .00 .00 .00
.00
Other Fee Total 5.50 1.00 00
4.50
Grand Total 44.50 40.00 .00
4.50
LQPERMIT
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
ppligation .,alwationi
Applicant:
09-00000739 — --
81322 -RUSTIC CANYON DR
764-280-999-177 -300236-
WALL/FENCE
MEDIUM HIGH DENSITY RES
1600
Architect or Engineer:
pip,
BUILDING. & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258 a
Contractor:
SHEA HOMES LIMITED
60800 TRILOGY PKWY/
LA QUINTA, CA 9225,
(760)777-6032
Lic. No.: 855368
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/28/09
------------------------------------------------------------------------------------ ------
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:
Se ion 700 I of Division 3 of the e ess and Prof ssi nals Cade, and my License is in full force and effect.
1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
Lic s la B ., License 5368
_
for by Section 3700 of -the Labor Code, for the performance of the work for which this permitis
t ontractor:
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 WC1894819 '
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
1 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
d agree that, if I should become su
ject to the workers' compensation provisions of Section
License Law IChapter9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or6St00
of the Labor C I sh�forthithomply
v
with those provisions.
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 (5500).:
D A scant:
1 _ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure isnot intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAIL E TO SECURE WORK S' 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
'I ' I h h h h 'I
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. '
one year of completion, the owner-bw der wil ave t a burden Of proving t at a or she did not bw d or
improve for the purpose of sale.).
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 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: /yL�
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 forany 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 certi y that I ave read this application and state that the above information is correct. I agree to comply with all
eand state laws relating to building construction, and hereby authorize representatives
A�apancpos
runte above-mentioned proper for inspectionSi ture (Applicant or Agent):
Application Number .
. . . . 09-00000739
Permit . . . . .
WALL/FENCE
PERMIT
Additional desc .
Permit Fee
39.00
Plan Check Fee'.
.00
Issue Date* . . . .
Valuation . . .
. 1680
Expiration Date
1/24/10
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
12.00 2.0000
HND BLDG
501-2,000
24.00
-- -
Special Notes and Comments-----------..___
---'______________________
105 L.F. 3' RETAINING
WALL,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
LQPERIIIT
#
Bin#
City of Lal 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 #
�(
Project Address:
�Z2.
Owner's Name: Shea Homes
A. P: Number:
Address: 60-800 Trilogy Parkway
Legal Description: Trilogy @ La Quinta
City, ST, zip: La Quinta, CA 92253
Contractor:. Shea Homes
Telephone:
Item
Address: .60-800 Trilogy Parkway
Project Description: Lot Z
_ City, ST, zip: La Quinta, CA 92253
Oreo Combo Wall - If x 6' & 3'
Telephone: 760-777-6032
City tic. #:
Oreo Garden Wall - . if x 6'
State Lic. #: 640934
Orco Retaining Wall - LVilf x 3'
Arch., Eng`.' Designer:
Oreo Knee Wall - If x 4'
Address:
City, ST, Zip:
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 NOT WRITE IELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIUNG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Energy Cafes.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd 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:-
'rd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
TotalTermit Fees
o