08-0866 (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:
`08-00000,866---
81541
866-81541 RUSTIC CANYON DR
764-280-999-53 -300236-
WALL/FENCE
MEDIUM HIGH DENSITY RES
2445
c&ht 4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY.CENTER 350
SCOTTSDALE, A$ 8525$
Contractor:
SHEA HOMES, INC.
60800 TRILOGY PARKWAY
LA QUINTA CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/16/08'
May 2gzooa
D'
1 e✓�
I U
(760) 777'-6005 qu1NTA
/�
OF
LiC. No.: 672285 CITY 07.
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FiBp_
lye
LICENSED CONTRACTOR'S DECLARATION
* -------------------------------------
WORKER'S COMPENSATION DECLARATION
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:
Section 7000) of Division 3 of the Busin ss and Professionals 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
Licenqg
Class:
I,License No.: 672285
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
'/ issued.
a
ractor:
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor '
T
TTT'"' 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 than am exempt from the Contractor's State License Law for the
Carrier AMERICAN HOME Policy Number CA 1593364 '
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, 1 shall not employ any
-the
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 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 I should beco a subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 70001 of Division 3 o the Business and Professions Code) or
7 0 of the Labor Code, I shal f"rthwith 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
1
1
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
ate: plicant:
(_ 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.
WARNING: FAILURE TO SECURE. WO ERS' 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.).
(_ 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.).
( 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 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 that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of
IN GO ty to tter upon the above-mentioned propeertyy for ins action purposes.
atD e: lure (Applicant or Agent): lC�
,,.
Application Number. . . 08-00000866
Permit . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 54.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
2445
\ Expiration Date 11/12/08
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
85 L.F. COMBO WALL, 3' RETAINING, ,6'
GARDEN & 20 L.F. 3' RETAINING WALL, BOTH
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
LQPER M