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08-1330 (RER)f. -. i, A P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 (---! - _y Application Number: C08 0000133.0` Property Address: 81373 JACARANDA CT APN: 764-280-999-154 -300236- Application description: REMODEL - RESIDENTIAL Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 16141 Tit!t44Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER 350 SCOTTSDALE, AZ 85258 VOICE (760) 777-7012 - FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/06/08 Contractor: Applicant: Architect or Engineer: SHEA HOMES, INC. 60800 TRILOGY PARKWAY ) LA QUINTA, CA 92253 A!' (760)777-6005 AUS 1 2 200p 1 I A LiC. No.: 672285 i 1•—] CITY OF LA QUINTA FINANCE DEPT LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I 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 00 0) f Division 3 of the Bus ass and Pr fessionaI 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 Lice t S. License No.: 672285 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ate: ntractor: 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: tate License Law for the Carrier NTL U I hereby affirm under penalty of perjury that I am exempt from the Contractor's SNION 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, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to bec a 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 �&andgree that, if I should becomes bject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or of the La Code, I shall f w h comply with 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 (5500).: Date.plicant: (_) 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 WKERS' 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 CRIMI AL 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 I, 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 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 cessation of work for 180 days will subject permit to cancellation. I certif t that I fpve read this application and state that the above information is correct. I agree to comply with all city a unt ord' ances d state laws relating to building constr coon, and hereby authorize representatives o c ty o er n the above-mentioned pr pert for ins tion purposes. Da Signature (Applicant or Agent Application Number. . . . 08-00001330 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . .. 180.00 Plan Check Fee 117.00, Issue Date . . Valuation 16141 Expiration Date . 2/02/09 . Qty Unit Charge Per Extension BASE FEE 45.00 15.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 135.00 Permit . . . SOLAR PERMIT Additional desc . Permit Fee . . . . 22.50 Plan Check Fee 5.63 Issue Date . . . . . . Valuation . . 16141 Expiration Date . . 2/02/09 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 4.5000 EA SOLAR COLLECTOR < 1000 4.50 1.00 3.0000 EA SOLAR EQUIP MISCELLANEOUS 3.00 ---------------------------------------------------------------------------- Special Notes and Comments REVISION WHILE UNDER CONSTRUCTION - INSTALL PHOTOVOLTAIC SYSTEM 1.4C - 5KW. PLAN 4520C. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 11.70 Fee summary Charged --------------------------- ---------- Paid Credited -------------------- Due Permit Fee Total 202.50 .00 .00 202.50 Plan Check Total 122.63 .00 .00 122.63 Other Fee Total 11.70 .00 .00 11.70 Grand Total 336.83 .00 .00 336.83 LQPERMIT