09-0590 (BLCK)P.O. BOX 1504 4
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 09-00000596` Owner:
Property Address: 81280 CAMBRIA CT SHEA LA QUINTA
APN: 764-280-999-23 -300236- C/O JEFF MCQUEEN
Application description: WALL/FENCE 8800 N GAINEY CENTER 350
Property Zoning: MEDIUM HIGH DENSITY RES SCOTTSDALE, AZ 85258
Application valuation: 2375
Contractor:
Applicant: Architect or Engineer: SHEA HOMES, INC.
60800 TRILOGY PARKWAY
LA QUINTA, CA 92253
{� (760)77
rN Lic. No..:: 672 672285
---------------------------------------------------------7---------------------------------------
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
1 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 7 001 f Division 3 of the in ss and Profes 'onal 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
License CI ss: B Li nse No.: 672285 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
ate:ontractor: 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, atter, 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 kandree that, if Ishould beco a subject to the workers' c mpens tion provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or f the Labor Qe, I sh fort ith comply wi h those ovi o s.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by/lam_any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 155001.: 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 rDOLLARS($100,000).
NG: FO SECURE W ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, CT 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 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 N 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 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.).
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/04/09
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 c unty�ordinances and state laws relating to building constru ,Sion, and hereby thwreprev�ddptatrves
of t}a t t ecnA upon the above-mentioned property forspec n p osese
11atete: yY Si ture (Applicant or Agent):
Application Number . . . . . 09-00000590
Permit . .
. WALL/FENCE PERMIT
Additional desc .
.
Permit Fee . . .
. 54.00 Plan Check Fee
.00
Issue Date . . .
. Valuation . . .
. 2375
Expiration Date .
. 12/01/09
Qty Unit Charge Per
Extension
BASE FEE
45.00
1.00 9.0000 THOU BLDG 2,001-25,000
9.00
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Special Notes and
Comments
95`L.F. 6' GARDEN
WALL, ORCO SYSTEM.
2007 CODES
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary
Charged Paid Credited
------------------------------
Due
-----------------
Permit Fee Total
----------
54.00 .00 .00
54.00
Plan Check Total
.00 .00 .00
.00
Other Fee Total
1.00 .00 .00
1.00
Grand Total
55.00 .00 .00
55.00
LQPERMIT
Bin #
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # n
(n"10
i
Project Address: Q' Irl ��
Udo` e(LnNb��-.(AC
Owner's Name: Shea Homes
A. P. Number:
Address: 60-800 Trilogy Parkway
Legal Description: Trilogy @ La Quinta
City, ST, zip: La Quinta, CA 92253
Contractor: Shea Homes
Telephone: 760-77.7-6032
Address: 60-800 Trilogy Parkway
Project Description: Lot
City, ST, zip: La Quinta, CA 92253
Orc - x 6' & 3'
Telephone: 760-777-6032
Oreo Garden Wall -?S If x 6'
State Lic. #: 640934
City Lic. #:
Or f x 3'
Arch., Engr., Designer:
Orcu 7�Gc Wail — —'�^"+'
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Gabbie Nieto
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 760-777-6032
Estimated Value of Project:
APPUCANT:10 NOT118171E 11MIN THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction -
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
"d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
5