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04-7976 (BLCK)BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 ' INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number 04-Q0_07EO Date 12/30/04 Property Address . .. . . . v4`D APN: 764-270-999-153 -300233- Application description . . . WALL/FENCE Property .Zoning . . . . . . MEDIUM HIGH DENSITY RES Application valuation . . . . 4255 Owner Contractor SHEA LA QUINTA SHEA HOMES, INC. C/O JEFF MCQUEEN 81260 AVENUE 62 880Q N GAINEY CENTER 350 LA QUINTA, CA 92253 SCOTTSDALE, AZ 85258 (760)777-6005 WCC: NTL UNION.INS WC: 6436568 08/01/05 CSLB: 672285 06/30/05 CCC B ---------------------------------------------------------------------------- f N 13 2�p5 UI JA CITY OF LA QUINTA P.O. BOX 1504 " VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4 4 a INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 04— %q 7(D Date: 1'13.05 Applicant: Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATIONl I hereby affirm under p, of perjury that I am licensed under Provisio of Chap r 9 ¢o enc' th S�ecylon 7000) of Division 3 of the Business and Professionals de, and my License I force and effect. / c License C�ss Licnlse No04. �lslc%J A -A I — OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 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 dbllars ($500).): U 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 Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reason WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ I have and will maint a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for wh' this permit is issued. Alls ave a d will mai n workers' compn in nc �Q red by S ctioq,3700 of the Labor Code, for the performance of the work for which this permit is My wo rs' compensation ranee carr rgirjlicv�rrarriolicy Number "{ lJll��J1J _ I certify that, in the performs a of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomi , and gree tha if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro 'si s tl Date pplicant WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 /y Lender's Address ik 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 Ouinta, 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 i 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 inf rmation is correct. gree to comply with all city and county ordinances and state laws relating to building ;ate nstru ion, and ereby authori representatives of this county to r pon the v -m operty for inspection purposes. �� Signature (Applicant or Agent): --------------------------------------------------------.-------------- "" Application Number . . . . . 04-00007976 --- ---- o---------------------------------------------=------------------------------ Permit . . . . . . WALL/FENCE PERMIT Additional desc Permit Fee . . . . 72.00 Plan Check Fee .00 Issue Date . . Valuation . . 4255 Qty Unit Charge Per Extension BASE FEE 45.00 3.00 9.0000 THOU BLDG 2,001-25,000 27.00 --------------------------------------------------------------=------------- Special Notes and Comments 135 L.F. 6' GARDEN WALL, 55 L.F. 3' RETAINING WALL, ORCO SYSTEM Fee summary Charged ----------------- Paid Credited Due -------------------- Permit Fee Total 72.00 ---------- .00 ---------- .00 72.00 Plan Check'Total .00 .00 .00 .00. Grand Total 72.00 .00 .00 72.00