07-0472 (BLCK):rte.,- - a k;, -
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: k07--000604.1'2`
Property Address: -81637 RUSTIC CANYON DR
APN: 764-280-999-31 -300237-
Application.description: WALL/FENCE-
Property Zoning: MEDIUM HIGH DENSITY RES.
Application valuation: 3085
Applicant:
Tit�/
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
p1x)-
Owner:
SHEA LA QUINTA
/O JEFF MCQUEEN
800 N GAINEY CENTER 350
p,ATOTTSDALE, AZ 85258
�EV .
C
ontr\ctor:
a4 SHE -A - HOMES, INC.
6�roN�EQ��' 60800 TRILOGY PARKWAY
LA QUINTA, CA 92253
(760)777-6005
Lic. No.: -672285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777 -7153 -
Date: 2/13/07
LICENSED CONTRACTOR'S DECLARATION ,.
WORKER'S COMPENSATION DECLARATION
1 hereby ffirm nder penalty of perjury that I am licensed rider provisions of Chapter 9 (commencing with -
I hereby affirm under penalty of perjury one of the following declarations:
Section 000) f Division 3 of the Bus' and Profes d aIs 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 lass: icense N .: 672285
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
�[ issued.
Da
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 1247619
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 I sh Id ecom subject t . the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor I h III h those provisions.
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 (5500).:
at scant",
(_) I, as owner of the property, ormy employees with wages as their sole compensation, will do the work, and 1-1
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The -
WARNING: FAILURE TO SECURE WORKERS' 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 1$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
(_ 1 1, 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 contractorlsl 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
•
of La ouinta, 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.
I hereby affirm under penalty of perjury that there is'a construction lending agency for the performance of the
nave read this application and state that the ve information ' correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.).
y ordinances and state laws relating to but ng on coon, 'd hereby authorize representatives
*iy
to enter upon the above-mentioned.prop r i p c on p
Lender's Name:nature
(Applicant or Agent):
Lender's Address:
LQPERMIT
Application Number . . . 07-00000472
Permit . . . . . WALL/FENCE PERMIT
Additional desc
Permit Fee . . . . 63.00
Plan Check
Fee
.00
Issue Date . . .
Valuation
3085
Expiration Date 8/12/07
Qty Unit Charge Per
Extension
BASE
FEE
45.00
" 2,00 q QQQQ THOT BLDG
2,001-25;000
-
18.00
-------------------------------------------
Special Notes and Comments
---------
85 L.F. COMBO WALL, 3' RETAINING,
6'
GARDEN,60 L.F. 4- KNEE WALL, BOTH
ORCO
SYSTEM
Fee summary Charged
Paid
Credited
Due
Permit Fee Total 63..00
.00
.00
63.00
Plan Check Total .00
00
.00
.00
Grand 'Total 63.00
.00
.00
63.00
LQPERMTT