07-1790 (BLCK)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) 777-71'53
BUILDING PERMIT
r- Date: 6/26/07
x__
Application Number: -07=0000-17-90> Owner:
Property Address: 81832 RUSTIC CANYON DR. SHEA LA QUINTA
APN: 764-280-999-76 -300237- C/O JEFF MCQUEEN
Application description: WALL/FENCE 8800 N GAINEY CENTER
Property Zoning;
MEDIUM A&NSITY, RFS GrnTT�nAr,> n2 g�26R
IrFINANcp
Application valuation: 2125
j
Contractor: 0 2007Applicant: Architect or Engineer: SHEA HOMES, INC.
60800 TRILOGYPARKWAYLA QUINTA
LA QUINTA, CA 92253 DEPT.
(760)777-6005
Lic. No.: 672285
LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION
I hereWofivision
y 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:
Sectioof the Busin s avid Prof s ' 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
Licens enseNo.: 672285 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
tissued.
ate: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 workeis' 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 a 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 me su t to the rkers' compensation provisions of Section
License Law (Chapter Si (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 700 of the L b Cod , I s fort it th 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 155001.: ate: plica
(_ 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 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 ($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.l. '
(_ 1 1, 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.l.
1 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: _
LQPERA11T
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 LaQuinta, 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 ve read this aDPlication.and state t above'i mation is rect. I agree to comply with all
city and ounty ordinancesand state laws relati to 'di
con ru i abauthorize representatives
o t enter upon he above -mention pro ert ns ecti urpos
te: gnature (Applicant or
LQPERMIT
Application Number 07-00001790
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . 54.00
Plan Check
Fee
.00
Issue Date _
Valuation
2125
Expiration Date 12/17/07
Qty Unit Charge Per
Extension
BASE FEE
45.00
1.00. 9.0000 THOU RTT)G 2; 001
-?5, 000
• 9.00
----------------
Special Notes and Comments
------------
------
---------------
85 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.
LQPERMIT