09-0737 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO '
LA QUINTA, CALIFORNIA 92253
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
----------------- ---------------------------------
LICENSED CONTRACT R'S DECLARATION
I hereby of irm and penalty of perjury t I am licensed and pvisions of Chapter 9 (commencing with
Sectiggqqn 70 1 1 3 of the Busin s a ' Professionals od , and my License is in full force and effect.
License I - 'ens 672285
ata:111`y Con actor:
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.).
(_ 1 I am exempt under Sec. , BAP.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:—PA
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (160) 777-7153
Date: 10/07/09
Owner:
SHEA LA QUINTA Dn
C/O JEFF MCQUEEN (i1�
8800-N GAINEY CENTE 0
SCOTTSDALE, AZ 8525` 20
5
9
I
Contractor: V (1,p A (°wftd A
SHEA HOMES, INC.
60800 TRILOGY PARKWAY
LA QUINTA, CA 92253
(760)777-6005
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 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 be subject to the workers' compensation laws of California,
agree that, if I should become s ject to the workers' compensation provisions of Section
4K,
0 of the Labor , shall fort ' h c mply with those provisions.
WARNING: FAILURE TO SECURE ORK RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMI 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 behalfthis 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 th t I -have r ad this application and state that the above information i correct. I agree to comply withal)
city and c my ordi antes and state laws relating to building construction, a hereby authorize representatives
of t 's cou t LCAn r n the above-mentioned grope or in ection pu oses.
Dat //v-14 Si toe (Applicant or Agent):
Application Number:
�_ 09-00000737__;
Property Address:
81337 RUSTIC CANYON DR
APN:
764-280-999-38 -300236-
Application description:
WALL/FENCE
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
2880
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
----------------- ---------------------------------
LICENSED CONTRACT R'S DECLARATION
I hereby of irm and penalty of perjury t I am licensed and pvisions of Chapter 9 (commencing with
Sectiggqqn 70 1 1 3 of the Busin s a ' Professionals od , and my License is in full force and effect.
License I - 'ens 672285
ata:111`y Con actor:
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.).
(_ 1 I am exempt under Sec. , BAP.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:—PA
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (160) 777-7153
Date: 10/07/09
Owner:
SHEA LA QUINTA Dn
C/O JEFF MCQUEEN (i1�
8800-N GAINEY CENTE 0
SCOTTSDALE, AZ 8525` 20
5
9
I
Contractor: V (1,p A (°wftd A
SHEA HOMES, INC.
60800 TRILOGY PARKWAY
LA QUINTA, CA 92253
(760)777-6005
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 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 be subject to the workers' compensation laws of California,
agree that, if I should become s ject to the workers' compensation provisions of Section
4K,
0 of the Labor , shall fort ' h c mply with those provisions.
WARNING: FAILURE TO SECURE ORK RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMI 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 behalfthis 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 th t I -have r ad this application and state that the above information i correct. I agree to comply withal)
city and c my ordi antes and state laws relating to building construction, a hereby authorize representatives
of t 's cou t LCAn r n the above-mentioned grope or in ection pu oses.
Dat //v-14 Si toe (Applicant or Agent):
Application Number 09-00000737
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 54.00 Plan Check Fee
.00
Issue Date . . . . 7/29/09 Valuation
2880
Expiration Date 1/25/10
Qty Unit Charge Per
Extension
BASE FEE
45.00
1.00 9.0000 THOU. BLDG 2,001-25,000
---------------------------------------------------------
9.00
Special Notes and Comments.
180 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, 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
r
LQPERMIT
'P-.0. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: �09=0.0000737
Property Address: 81337 RUSTIC CANYON DR
APN: 764-280-999-38 -300236-
Application description: WALL/FENCE
Property Zoning: MEDIUM HIGH DENSITY RES.
Application valuation: • 2000
Tdlvl..4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner.
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTE
SCOTTSDALE, AZ 8525
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/28/09
Contractor: 1 f
Applicant:' Architect or Engineer: SHEA HOMES LIMITED ARTNE$,P ?
60800 TRILOGY PKWY
LA QUINTA, CA 92253 r 't/frY f.
11 n (760) 777-6032r�'N�.4.
Lic. No.: 855368/ ----------------------------------------------------------------------------------------------
J
LICENSED CONTRACTOR'S DECLARATION
I ereby ffirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
coon 00) of Division 3 of, the Business and Prof ssi nals Code, and my License is in full force and effect.
i e A, B icense No.: 855.368
e: tractor:
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).:
(_ 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.17044, 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.).
(_) 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
.).
Lender's Name:
Lender's Address:
LQPERAIIT
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 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 WC1894819
_ 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 be me subject to the workers' compensation laws of California,
and agree that, if 2hould beco ubject to the workers' cpmpensation provisions of Section
,10ofthe Labode, I shall or hwith comply with those provisions.
1.
te: A 'cant:
WARNING: FAIL RE TO SECURE WERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMIN 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 tothe
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 h e read this application and state that the above i f rmation is correct. I agree to comply with all
n oun rdinances and state laws relating to building con tr ction, and hereby authorize representatives
of t s u e r upon the above-mentioned pr erty for ins a tion purposes.
D iggnat/urpppplicant or Agent)
Application Number. . . . 09-00000737
Permit. . . . WALL/FENCE
PERMIT"
Additional desc .
Permit.Fee: 54.00
Plan -Check Fee
.00
Issue•Date
Valuation . . .
. 2880
Expiration Date 1/24/10
Qty Unit Charge. Per
Extension
BASE
FEE
45.00
1.00. 9.0000 THOU BLDG
2,001-25,000
9.00
------------------------'"______________________________,______
Special Notes and Comments
J 180 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 54.00
00 .00
54.00
Plan Check -Total .00
.00 .00
.00
Other Fee Total 1.00.
.00 .00
1.00
Grand Total- 55,00
.00 .00
55.00
Bin#
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 #
-, \
:Project Address:
?1,3,;q V-itr CN
,1
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: 760-777-6032aim-
M,
Address: .60-800 Trilogy Parkway
Project Description: Lot 3�
City, ST, zip: La Quinta, CA 92253
Orco Combo Wall - If x 6' & j'
Telephone: 760-777-6032
p
Oreo Garden Wall - . if z 6' -
State Lic. #: 640934
City Lic. #:
Orco Retaining Wall -1-01f x 3'
Arch., Engr., Designer:
Orco 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:
APPLICAMT: 00 NOT WRITE BELOW THIS LIME
# Submittal
Plan Sets
Structural Calcs.
Truss Caics.
Energy Cates.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
Req'd Rec'd TRACIQNG
Plan Check submitted
Reviewed, ready for corrections
Called Contact Person
Plans picked up
Plans resubmitted
2nd Review, ready for corrections/issue
Called Contact Person
Plans picked up
Plans resubmitted
'`d Review, ready for corrections/issue
Called Contact Person
Date of permit issue
PERMIT FEES
Item
Plan Check Deposit
Plan Check Balance
Construction
Mechanical
Electrical
Plumbing
S.M.I.
.Grading
Developer Impact Fee
A.I.P.P.
Total Permit Fees
Amount
55 _-J _..