08-1331 (RER)-.r
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:�08-00001331
Property Address: 81387 JACARANDA CT
APN: 764.-280-999-155 -300236-
Application description: REMODEL - RESIDENTIAL
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 16141
Tjiit °F 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor:
Applicant: Architect"or Engineer: SHEA HOMES, INC.
60800 TRILOGY PARKWAY
LA QUINTA, CA 92253
.(760)777-6005
Lic. No.: 67272
285
LICENSED CONTRACTOR'S DECLARATION
I hereby, affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 000) f Division 3 of the BusRTss and Professionals Code, and my License is in full force and effect.
Licela : B L'cense No.: 672285
Date: ontractor: I
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 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 ($500).:
(_) 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 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.).
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.).
(_ 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: ti I Pi
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/06/08
Dd
2 2003
WORKER'S COMPENSATIOCLARAT , E D V�NTA i
I hereby affirm under penalty of perjury one of the following declarations. -_ EPT,
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as rovided-
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
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 NTL LTNION INS Policy Number' WC1894819
_ I certify that, in the performance 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 California,
nd agree that, if 1 should become subj to the workers' compensation provisions of Section
Q0 of the Labor Code, I shall �tcoly with those provisions.
ate: UUA scant:
WARNING: FAIL ETO CURE WOR ' 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.
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 1 read this application and state that the above information is sect. I agree to comply with all
city and c(ty o finances and state laws relating to building co t ;..tion, an h reby authorize representatives
of thi n y to
of upon t above-mentioned property for ' s c n pu s s.
te: 14�i ature (Applicant or Agent):
Application Number .
. . . . 08-00001331
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
------------------------------------=--------------------------------7------
THOU BLDG
2,001-25,000
135.00
r
• 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 1.10C
- 5KW.
` PLAN 6420C.
------------------------------------------------------------------=---------
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