08-0211 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
4 4Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer: (/
cid, F� �6'
I r ��ti ?ooh
---------------_ -------- - ------------- ----------
LICENSED CONTRACTOR'S DECLARATION -
I here*s:
of per y hat I am li a sed under provisions of Chapter 9 (commencing with
Sef the B in ss and Pr f ionals Code, and my License is in full force and effect.
Li nsI License No.: 672285
ctor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or sheds 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 ($5001.:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is hot 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 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.).
(_ I 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:
LQPERA AIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor:
SHEA HOMES, INC.
60800 TRILOGY PARKWAY
LA QUINTA, CA 92253
(760)777-6005
DLic. No.: 672285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/30/08
/-----.----------W-ORKER---
'S CO---MPENSA--TION --DEC-LA-RAT—ION --------------
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain 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 which this permit is
issued.
11l' 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
insurance carrier and policy number are:
Carrier AMERICAN HOME Policy Number CA 1593364
I ertify [hat, in the performance of the work for
hick this permit is issued, I shall not employ any
person in any ma4WERS'
s to become subjec o the workers' compensation laws of California,
gree that, ibeco ubject to a orkers' compensation provisions of Section
of the L I sha or it h cowith those provisions.
e: pplicant:
WARNING: FAILURE TO SECURCOMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRPENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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 c ssation of work for 180 days will subject
ermit to cancellation.
I certif that have read this' application and state that the above inform on is correct. 1 agree to comply with all
c' an ouri ordinances and state laws relating uil ing c nstructi ,and hereby authorize representatives
o f y enter upon the above-mentioned rop ny f r p purposes.
� u
D e: Si ture (Applicant or A, 1
C_ —
Application Number:
08-00000211
Property Address:
61354�SAPPHIRE LN
APN:
764-280-999-88 -300236-
Application description:
WALL/FENCE
Property Zoning:
Application valuation:
MEDIUM HIGH DENSITY RES
3080
Applicant: Architect or Engineer: (/
cid, F� �6'
I r ��ti ?ooh
---------------_ -------- - ------------- ----------
LICENSED CONTRACTOR'S DECLARATION -
I here*s:
of per y hat I am li a sed under provisions of Chapter 9 (commencing with
Sef the B in ss and Pr f ionals Code, and my License is in full force and effect.
Li nsI License No.: 672285
ctor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or sheds 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 ($5001.:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is hot 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 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.).
(_ I 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:
LQPERA AIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor:
SHEA HOMES, INC.
60800 TRILOGY PARKWAY
LA QUINTA, CA 92253
(760)777-6005
DLic. No.: 672285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/30/08
/-----.----------W-ORKER---
'S CO---MPENSA--TION --DEC-LA-RAT—ION --------------
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain 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 which this permit is
issued.
11l' 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
insurance carrier and policy number are:
Carrier AMERICAN HOME Policy Number CA 1593364
I ertify [hat, in the performance of the work for
hick this permit is issued, I shall not employ any
person in any ma4WERS'
s to become subjec o the workers' compensation laws of California,
gree that, ibeco ubject to a orkers' compensation provisions of Section
of the L I sha or it h cowith those provisions.
e: pplicant:
WARNING: FAILURE TO SECURCOMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRPENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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 c ssation of work for 180 days will subject
ermit to cancellation.
I certif that have read this' application and state that the above inform on is correct. 1 agree to comply with all
c' an ouri ordinances and state laws relating uil ing c nstructi ,and hereby authorize representatives
o f y enter upon the above-mentioned rop ny f r p purposes.
� u
D e: Si ture (Applicant or A, 1
LQPERDIIT
Application Number 08-00000211
Permit . . . WALL/FENCE PERMIT
Additional.desc .
Permit Fee63.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
3080
Expiration Date 7/28/08
Qty Unit Charge Per
Extension
J BASE FEE
45.00
2.00 9.0000.THOU BLDG 2,001-25,000
18.00
----------------------------------------------------------------------------
Special Notes and Comments
88 L.F. 6- GARDEN WALL, 55 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
LQPERDIIT