08-0788 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoninq:
Application valuation:
--08-000007887
81565 RUSTIC CANYON DR
764-280-999-55 -300236-
.WALL/FENCE
MEDIUM HIGH• DEN$I TY RES
2615 .
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
grnTTgn]1T,R, A7 9$25@ ,
VOICE (760) 777-7012 t
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/07/08.
a Q
MAY 15 2008
1
Contractor: C7F/,q
FIIyARICE
Applicant: Architect or Engineer:
- SHEA HOMES, INC. "SPT
60800 TRILOGY PARKWAY
LA QUINTA, CA.92253
(]
(760) 777-6005
r�
Lica No.: 672285
---------------7-----------------------
" 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:
Sect' n 7000) of Division 3 of the Busi ess and Profess ovals 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
' Licen Class License No.: 672285
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is .,
Cissued.
a v actor:
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 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, I shallnot 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 I should become subject the workers' compensation provisions of Section
I
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
,. ( 3700 of the Labor Code hall forthwith o ly with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
to 11 -
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001::
te: 'cant:
(_ 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: FAIL E TO SECURE WOR ' 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
conditions 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 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
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
of La Qu'nta,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 car 'fy that I have read this application and state that the above informati is correct. I agree to comply with all
city d co ty ordinances and state laws relating to building constructio d hereby authorize representatives
' t mer upon the above-mentioned property for inspection u oses.
e � nature (Applicant or Agent):
Application Number . . . 08-00000788
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 54.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 2615
Expiration Date 11/03/08
Qty Unit Charge Per
Extension
BASE FEE
45.00
1.00 9.•0000 THOU BLDG 2.001.-25,000
9 nn
Special' Notes and Comments
95 L.F. COMBO WALL, 3' RETAINING & 6 -
GARDEN, 15 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