07-1148 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
01 00-0114-8
e6T564'TULARE
Property Address:
LN
APN:
764-280-999-116 -300237-
Application description:
WALL/FENCE
Property Zoning:.
MEDIUM HIGH DENSITY RES
Application valuation:
2125
Tiht 4 4 Q-"
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) 7.77-7153
Date: 4/18/07
Contractor:
Applicant: Architect or Engineer: SHEA HOMES, INC- APR 3 0 2007
60800 TRILOGY PARKWAY t'
LA QUINTA, CA 92253 f.
(760) 777-6005 CITY OF LA QUINTA
Lic. No.: 672285 FINMCEDEPT
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Se ion 7 0) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
Li a : B License No.: 672285
Date:ntractor
OWNER -BUILDER DECLARATION
hereby affirm under. penalty of. perjury that I'am'exempt from the Contractor's,State License Law for the
following reason (Sec. -7031 .5,1Business ,and Professions Code: Any city oi. county that requires a permit to .
construct, alter, improve, demolish, orrepair any.sfructureJ 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 therefrm oandthebasis 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).:
(_ 1 1, 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 improvementis 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 1, as owner of the property, ani exclusively contracting with licensed contractors to construct the project ISec.
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: In
Lender's Address:
LQPERMIT
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.107 '
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 1247619
I certify that, -.in the performance -of the work for which this permit is issued,'I shall not employ any ,
peison 6 any manner so as toybecome subject to the workers' compensation laws of California,
' and agree that, if should become subject to'• woikers' compensation provisions of Section
3.7600 of the La I shal6foor*,with c with those provisions.
at : a— • plican . , J
WARNING: FAILURE TO SECURE WORKERS' 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 I have read this application and state t t the above information is cor ct. I agree to comply with all
city and ounty rdinances and state laws relating to g co truc 'on, and iie y authorize representatives
of �surtly,•tprypr upon the above-mentioned e r ins ctio purpos
ate:^ `DELL11 gnature (Applicant or Age '
7
Application Number . . . ... 07-00001148
Permit . .
. WALL/FENCE
PERMIT
Additional desc .
Permit Fee . . .
. 54.00
Plan Check
Fee
.00
Issue Date
Valuation
. . .
. 2125
Expiration Date
10/15/07
Qty Unit Charge Per
Extension
BASE
FEE
45.00
1.00 9.0000 THOU BLDG
2,001-25,000
9.00
7 -----------------------------------------------------------------------
Special Notes and
Comments
85 L.F. 6- GARDEN
WALL, ORCO' SYSTEM
Fee summary.
--------=--------
Charged
--------------------
Paid
Credited
----------
----------
Due
Permit Fee Total
54.00
.00
.00
54.00
Plan -Check Total
.00
.00
.00
.00
Grand Total
54.00
.00
.00
54.00
LQPERMIT