08-1027 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
SLA QUINTA, CALIFORNIA 92253
Application Number:
L08�-00001027'
Property Address:
81401` JACARANDA CT .
APN:
764-280-999-156 -300236-
Application description:
WALL/FENCE
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
3875
Applicant: Architect or Engineer:
I
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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LICENSED CONTRACTOR'S DECLARATION
I herebyffirm nder penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with
Section 001 f Division 3 of the B e and Prof io als Code, and my License is in full force and effect.
L'',en/sg) L' ense No.: 672285
i� ractor.
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 1$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:
LQPERMIT
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: 6/16/08
Contractor:
SHEA HOMES, INC. OF,
N 1 J60800 TRILOGY PARKWAY
LA QUINTA, CA 92253
(760)777-6005 U1n2u008Lic. No.: 672285Uri
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WORKER'S COMPENSATION DECLARATION
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.
1 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 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,
Ond agree that, if I should bec a subject to the workers' compensation provisions of Section
0 of the bor ode, I sh II forthwith comply with those provisions.
at • pplicant: v\
WARNING: FAILURE TO SECURE RKERS' 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 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 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 th I hav read this application and state that the above information is correct. I agree to comply with all
city an co' ty or nances and state laws relating to building const ction, and hereby authorize representatives
of cou a _,up n the above-mentioned po
ry f r i n purposes.
Date: ig ure (Applicant or Agent):
c.
Application Number . . . . . 08=00001027
Permit . .
. WALL/FENCE PERMIT
Additional desc .
Permit Fee .
. 63.00
Plan Check
Fee
.00
Issue Date . . .
.
Valuation
. . .
. 3875
Expiration Date
12/13/08
Qty Unit Charge
Per
Extension
BASE FEE
45.00 .
2.00 9.0000
THOU BLDG 2,001-25,000
18.00
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Special Notes and
Comments
155 L.F. 6' GARDEN
WALL; ORCO SYSTEM
Fee summary
Charged Paid.
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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
LQPERMIT
Bin #
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
1
Project Address: 81401 Jacaranda Court
owner's Name: Shea Homes
A. P. Number:
Address: 60946 Desert Rose Drive
Legal Description: Trilogy @ La Quinta
City, ST, Zip: La Quinta, CA 92253
Contractor: Shea Homes
Telephone: 760-777-6032
Address: 60946 Desert Rose Drive
Project Description: Lot 156
City, ST, Zip: La Quinta, CA 92253
Structural Calcs.
Telephone: 760-777-6032
Orco Garden Wall -1551f x 6'
State Lie. #: 640934
City Lie. #:
Arch., Engr., Designer:
Truss Calcs.
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lie. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Gabble Nieto
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 760-777-6032
Estimated Value of Project:
APPLICANT: 00 NOT WHITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°d Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3rd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
3