07-1154 (BLCK)r .. .yam. .. _ • • ..
Jr
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:d 0'7=0_(001154
Property Address:. I X6.1.648—TUt E�'LN
APN: 764-280-999.-110 -300237-
Application description: WALL/FENCE
Property Zoning: MEDIUM,HIGH DENSITY RES ;
Application valuation: 2125
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
�9�
rm•under.;penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Division.. of the Busin ss and Prof ssionals Code, and my License is in full force and effect.
.- License No.: 672285'? ntractor:
ps''• • - "r` - OWNER=BUICDERDECLARATION:�' - -
I herebyaffirm under penalty. of perjury that ban exempt from -the Contractor's State license Law for the, - -
- following, reason.(Sec. 7031-.5, Business and• Profession§ Code:: Any crty'or county -that requires a.peri rh to
construct,',alter ,improve,- y
demolish, or repair ar 'structure,.prior'to:its issuance, also requires the applicant for. the
permit'to file a signed .statement. that he or she is Iicedsed.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.7631 .5 by
.-any applicant for a permit subjects.the applicant to a civil penalty of not morethan five hundred dollars ($500).:
( I I; as owner of the property, or my employeeswith wagesas their sole compensation; will do the work, and
- the structure*is not iritended'oroffered for sale (Skc 7044 Business and Professions Code: The
Contractors' State License Law does not apply to 4;n', of property whotiuilds or improves thereon,
' ;and who does the work himself or,herself through his orlher own employees, provided that the
improvements are not intendedio offered for sale; '.If, however rthe buddmg:dr_improvement issoldwithin
' one year of completion, the owner -builder will have the burderi.of�proving that�6 or she'did not: build or
improve for the purpose of sale.).; .. yy - • r
( L I, has owner of the property, am exclusively contracting with'licensed contractors to construct the project (Sec.
-7044, Businessand Professions Code: The Contractors: State.Lice`nse Law; does not apply to an,ownerof
property.who builds or improves thereon, and who contracts for, the'project's with a contractors) 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
1 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:
LQPERMrT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTT SDALE, AZ 85258
Contractor:
SHEA HOMES, INC.
60800 TRILOGY PARKWAY,-
LA
ARKWAY;LA QUINTA, CA 92253'
(760)777-6005
Lic. No..: 672285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/18/07
APR 3 01007
OF J CD— t'
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=insiiie'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. .^, . v. - ` c - ,
k: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. Myworkers' compensation'- •`r
' insuiance,carrier and.policy numberare -r - -
> r'
Carrier'AMERICAN'„HOME • ' PoliNumber 1247619cy • •
_ I certify 'th'at,'in'the performance of the work for which'this'permit is'issued,-I shall not'employ any
.person in any manner so A to become subject to the workers' compensation laws of California,
andagree that, if should become subject -to a workers' compensation provisions of Section
3700 of the LaI shat-f�owith co ly with those provisions.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,•AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES'AND-CIV,IL'FINES,UP To ONE HUNDRED THOUSAND '
DOLLARS.0100,0.00)..,IN:,ADDITI6N TO THECOST•OF'COMPENSATION, DAMAGES AS PROVIDED FOR IN -.
SECTION 3706 OF THE',LABOR CODE;,INTEREST, AND ATTORNEY'S FEES'
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application'is hereby,rmade to the'Director.of Budding''and Safetyfor a permit subject to the'
. conditions and restrictions,. set -forth on this application. "•
I.. Each.personuponwhose behalf this application is made, each person at whose request and for -
whose. enefiY 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
oi'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 ofissuance 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 .the above information is correct. I agree tocomply with all
4�n c unty ordinances and state -laws relating't "ding construction, hereby authorize representatives
oy y�nter u n the above-mentioned pr for s tion p as.
u Signature (Applicant or A
AV
Application Number
. . . . . 07-00001154
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
-----------------------------------
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
LQPERAM