Loading...
07-1150 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant' 0.7-0'0"0 0"1=1.SA -92 TTUL=ARSE LN 764-280-999-114 -300237- WALL/FENCE MEDIUM HIGH DENSITY RES 2125 Architect or Engineer: �F 1�4�rw BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER 350 SCOTTSDALE, AZ' -85258 Contractor: SHEA HOMES, INC. -r VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-1153 Date: 4/18/07 60800 'TRILOGY 'PARKWAY LA-QUINTA, CA 92253 (760)777-6005 APR 30 PIP Lic. No..: 672285AA 1' 1001 �IAI�yCE 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: . Secb n,7000) f Division 3 of the B eV and Professionals Code, and my'License is in full f6rce'and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensabon as provided ce a •\License No.:. 672285 for by, Section 3700 of the Labor Code, for the performance of the work for which this;permn'is issued,... 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: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Lawfor'the� Carrier AMERICAN'_HOME ••Policy Number, z1247619 following'reason (Sec: 7031.5, Business and Professions Code: Ariy city or" county that requires permit to I certify that, in the performance of the -work -for which"this permitis issued, I shall not employ any construct, alter, improve demolish, or repair'any structure, prior to its issuance, also. requires the'apphcannforthe - _ person in any manner so as to become: subject to thefworkers' •compensation laws of California, 11 .permit to file a signed statement that he ocsfie islicensed pursuanrto,the provisions of the Contractor's State. - • and agree that rf Iahould'become subject Io th orkers. compensation provisions of Section. License Law (Chapter &kommencing with Section 7000) of Division 3 of the Business and Professions Code) or - 11 - 700 of the Labor ` 1 shalkldoiiklojil i ;corn - t e. provisions. �'`�":• ••that'he or she is exempt: therefromand the basis for the alleged exemption. Any violation of Section 7031..5 by any applicant for a•permi£subjects the applicant to'a civil penalty ofnormore than five hundred tlollars.155' I.: e as owner of+the property; or my.employee`s with wagesas their, sole'compensation will -do the,work,.and' the structure isnot intended or offered for'sale (Sec:.7044; Business and'Professio' 'Code:: The WARNING:' FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does,not,a ply to en owner tif property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who doesahe work himself or herself through his or her own employees, provided:that the DOLLARS (5100;000). IN ADDITION TO THE COST OF'_COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended,or offered for sale. If,however, 'Fie'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.): 'APPLICANT. ACKNOWLEDGEMENT (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of.Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to.an owner of conditions:and. restrictions set forth on this application: •i' -•�.' property who build's or improves thereon, and who contracts. for the projects with a contractor(s) licensed 1 . -Each person upon whose behalf this�application•is made, each person at whose.request,and for pursuant to the Contractors' State License Law.). whose benefit work is -performed underor pursuant to any permit issued as a result of this application, (_ 1 I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees.to, and shall defend, indemnify and hold harmless the City 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 of to Quinta, its officers, agents and employees for aqy 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 that the above informat n is correct. I agree to comply with all city an .co`u ty ordinances and state laws.relati to uildin co structio hereby authorize representatives t n ter upon he above -menti ed rop y f in coon s . " /fes ���� .' oDate: ignature (Applicant or ntl: Application Number . . . . 07-00001150 Permit . . . . . WALL/FENCE PERMIT Additional des.c . 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 ---------------------------------------------------------------------------- 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