08-1332 (RER)P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO . FAX (760) 777-7011
LA QUINTA; CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/06/08
Application Number: 08-000-01_ 33 2-'). !
Owner:
(81433
Property Address: RUSTIC CANYON DR
SHEA LA QUINTA
APN: 764-280-999-46 -300236-
Application description: REMODEL - RESIDENTIAL -
C/O JEFF MCQUEEN - - ---
8800 N GAINEY CENL
Property Zoning:MEDIUM HIGH DENSITY RES
SCOTTSDALE, AZ 85Application
valuation: 16141
12 2
Contractor:
Applicant: Architect or Engineer:
SHEA HOMES, INC.
60800 TRILOGY PARFLAQUIPITA
FINANCE DEPT.
LA QUINTA, CA 922
(760) 777-6005
r•
Lic. No.: 672285
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. LICENSED CONTRACTOR'S -DECLARATION `
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of per'ury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations: -
Sectio 700 9) of Division 3 of th B i ess and Proles ionals 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 ,
Li Clas B License No.: 672285
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.Q�sI
- at ractor..
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
_ 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
nd agree that, if I should become subs t to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code) or
L 0 of the Labor Code, I'shall forth it 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
rOJ ,
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
e. 4 scant:
( - ) 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: FA URE 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
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.)
(_ I 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:
a 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:
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 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 hat I have read this application and state that the above infor anon is correct. I agree to comply with all
city ounty rdinances and state laws relating to building constru i n, and hereby authorize representatives
of�IP�Z
4ature
n the above-mentioned proper y for inspect purposes.
(Applicantor Agent):
LQPERMIT J
Application Number . . . 08-00001332
Permit BUILDING PERMIT
Additional. desc -
a
Permit Fee . . . . 180.00
Plan Check
Fee
117.00
Issue Date . . . .
Valuation
. . .
. 16141 r
Expiration Date 2/02/09
r
Qty Unit Charge Per
Extension
BASE
FEE
45.00
15.00 9.0000 THOU RT,nr.
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2„nni -
135.00
Permit . . . SOLAR PERMIT
Additional desc .
Permit Fee . . . . 22.50
Plan Check
Fee
5.63
Issue Date . . . .
Valuation
. . .
. 16141
Expiration Date 2/02/09
Qty Unit Charge Per
Extension
BASE
FEE
15.00_
1.00 4.5000 EA SOLAR
COLLECTOR < 1000
4.50
1.00 3.0000 EA SOLAR
EQUIP.MISCELLANEOUS
=
3.00
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Special Notes and Comments
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REVISION WHILE UNDER CONSTRUCTION
-
INSTALL PHOTOVOLTAIC SYSTEM 1.3C
- 5KW.
PLAN 4515C.
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Other Fees . . . . . . . ENERGY
-------------------------------
REVIEW FEE
11.70
Fee summary Charged
Paid Credited
Due
Permit Fee Total 202.50 l
.00
.00
202.50
Plan Check Total 122.63
.00
.00
'122.63
Other Fee Total 11.70
.00
.00
11.70
Grand Total 336.83
.00
.00
336.83
LQPERMIT J