06-1397 (BLCK)P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO (� }o FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT �` / INSPECTIONS (760) 777-7153
BUILDING PERMIT
_ Date: 4/06/06
Application Number: C06-00001397 Owner:
Property Address: - 61220 PORTULACA DR SHEA LA QUINTA
APN: 764-280-999-151 -300235- C/O JEFF MCQUEEN
Application description:. WALL/FENCE 8800 N GAINEY CENTER 350
Property Zoning:" MEDIUM HIGH DENSITY RES SCOTTSDALE, AZ 85258
Application valuation: 1625 D 4
Contractor:
Applicant: Architect or Enginee . ASHEA HOMES, INC.
81260 AVENUE 62
eil [S! LA QUINTA, CA 92253.
® (760)777-6005
N FIb�NCyj� Lic. No.: 672285
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LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION _
hereby affirm under penalty of periu that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
4icce'
7000) o ivision 3 of th ess and Prof sionals 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
I ss: ' License No.: 672285 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
✓ ;issued.
Contractor: p,�f have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
T� 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 I 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 �subjectkers' 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 (�^d agree that, if I s ocompensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or ('$j7f',�
of theLabor C Is Ise 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).: te: ApI, 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 ProfessionsCode: The WARNING: FAILUTO 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.EMPLOYERTO 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.).
(_ 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
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 ce ation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above infor ion ' ect. to comply with all
4tyd'o my or nances and state laws relating to n constr i nd hereby authorize representatives
ntronthabove-mentioned pr fo ecti purposes.
U5' ature (Applicant or Age
r
LQPERMIT
Application Number . . . . . 06-00001397
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 39.00
Plan Check Fee
.00.
Issue Date . . . .
Valuation . . .
. 1625
Expiration Date 10/03/06
Qty Unit Charge Per
Extension
BASE FEE.
15.00
12.00 2.0000 HIND BLDG 501-2,000
24.00
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Special Notes and Comments . .
-----------------------------
65 L.F. 6- GARDEN WALL, ORCO SYSTEM
Fee summary Charged Paid
Credited
Due
---------
Permit Fee Total 39.00
---------- ----------,
.00 .00
39.00
Plan Check Total .00
.00 .00
.00
Grand Total 39.00
.00 .00•
39.00
r
LQPERMIT