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08-1370 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 ' Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 08�000Q13.70 81361,RUSTIC CANYON DR 764-280-999-40 .-300236- WALL/FENCE MEDIUM HIGH DENSITY RES " • 2250 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT , Owner SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER 350 SCOTTSDALE, AZ 85258 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 . Date: 8/11/08 AUG 18 2008 _ CITY OF LA QUINTA FINANCE DEPT. - LICENSED CONTRACTOR'S DECLARATION Contractor: Architect or Engineer: SHEA HOMES, -INC. ' Section 7 00) of Division 3 of the Business nd Prof si-nals Code, and my License is in full force and effect. 60800 TRILOGY PARKWAY Lice I s: License No.: 672285 LA-QUINTA, CA 92253 (760)777-6005 �\ I LiC. No.: 672285 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 . Date: 8/11/08 AUG 18 2008 _ CITY OF LA QUINTA FINANCE DEPT. - LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby a firm 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 00) of Division 3 of the Business nd Prof si-nals Code, 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 Lice I s: License No.: 672285 _ - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. to ractor: - Y 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 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 _ 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 .. and agree.that, if Ishould beco subject 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 700 of the Labor Code, I shall fo w'h comply with those provisions. that he or.she is exempt therefrom and the basis for. the alleged exemption. Any violation of Section 7031.5 by / 0 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate. plicant: (_ 1 1, 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 W 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 conditidns 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. - - 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—) I am exempt under Sec. , B.&P.C. for this reason 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. - 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. • .l hereby affirm under penalty of perjury that th'ere.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.). str city and c my rdinances and state laws relating to building constru� ion, and hereby authorize representatives 'enter upon the above-mentioned property for in ti n rposes. Lender's Name: . • D ig ture (Applicant or Agent): Lender's Address: LQPERMIT LQPERMIT Application Number . . . . . 08-00001370 Permit". . . WALL/FENCE PERMIT Additional desc . Permit Fee 54.00 Plan Check Fee .00 Issue Date . . Valuation 2250 Expiration Date 2/07/09 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 90 L.F. 6' GARDEN WALL, ORCO SYSTEM Fee summary Charged Paid Credited Due Permit Fee Total 54.00 .00 .00 54.00 Plan Check Total .00 .00 .00 .00 Grand Total 54.00 .00 .00 54.00 i .