07-1155 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:_
0.7.^000O1T55
616'62 TUL'ARE LN
7 6' 280-999-109 -300237-
WALL/FENCE
MEDIUM HIGH DENSITY RES -
2125
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) 777-7153
Date: 4/18/07.
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;M
Contractor:
Applicant:. Architect or Engineer:
SHEA; HOMES, 'INC.
60800'TR_ILOGY PARKWAY r
LA QUINTA, CA 92253-
2253(760)777-6005
(760)777-6005
lLic.
No.: 672285
PR 3 0
:
.;
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LICENSED CONTRACTOR'S DECLARATION
I hereby: affirm under penalty ,of'perlury;that I am licensed under. provisions of Chapter.9 (commencing with
WORKER'S COMPENSATION DECLARATION C��F �p� ••F
I hereby affirm under penalty of perjury one of the following declarations:
Se tion 7 001 of Division 3 of theBus'ness�and Pr "essionals Code, and my License is'in full force and effect.
C :- B �`- "` License No.: 672285 ' i
_ I have and will maintain a certificate of consent tit self -insure for workers' compeAsation; a ided .
for, by Section 3700 of the'Labor Code; for the performance of the work;for which this'peimit
-
' issued. , �.
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at ontractor. +',f ` h'I
have and,'will main{ain,workers'ycompensation insurance as required by Section 3700 of•the. Labor - —
' _ . ` • -
Code; for the performance of the work:farwhich this permit_is .issued. 'My Workers=compensation
OWNER -BUILDER DECLARATION _
1 hereby affirm under penalty of penury that I am ez�empt from the Contractor's State. License Law for the
- insurance carrier and policy number are,•.;, -
.' Carner: AMERICAN :HOME Policy Number 124761: r
- following reason (Sec. 7031-.5t Business and Professions Code: Any cityar county. tfiat'iequires.a permitto
- : I'certrfy ;than m'the.performance of, -the woik-for which this permit is.issued 'I;shall notemploy any
construct, alter, improve,,demohsh"or_repav-any structure„prior to its issuance also.reouires the applicant'for�the
c person intany manner saws'to become subject.to the workers. compensation laws'of California_; '. ..
_
permrt�to file a signed iiatemenvthat he,or sne is licensed pursuant t6 the'provisions of the''Contractor.'s State -
License Law (Chaptei,9 (commencing with`Section 70001 of Oivisiom3 of the�Busmess_anii ProfessionsCode) or
�+j4,a9d,pgree that,:if l should becomesubjec t the workers compensation.provisionsbf_Section r
= 3700. of the. La - -II rthwith c ply with those.provisons
�.
tharhe, orsheisexempt therefrom and the basis for the alleged exemption, . Any violatwnbf Section 7031^:5 by .
'�
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__
any applicantpfora_ permit subjects the applicant to a civil penalty of. not.more.thantive hundred dollars-
:;
plica
...i
as owner of theproperty, or my employees with wages as�thei, sole compensation, will Bothe work,'and+
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the'structure'is not intended or offered -for. sale: (Se&7644„Business and Professions Code: The
ContractorsStateLicense.Law does notapply to•an.owner of.property who builds or improves4hereon,
and wtio'does the work himself or herself: through his or her own employees, -provided that the'
improvements are not.intended,or offered forssale :If, however, the building orimpiovement is sold within
one year of completion;,the•owner bmlderwil6_a the'burden of;proying that;he or she'did. not build or'
improve for the purpose of sale.).
1 _ 1 1, as owner of'the property; am exclusively contracting with licensed contractors to construct the project ISec.'
7044, Business andProfessions Code: The Contractors: State License Law does not apply town owner of
property who builds or improves thereon; and,who contracts for the projects with a contractor(s) licensed ,
pursuant to the Contractors' State UcenseLaw'Lr �} -
(_) I am exempt under Sec. , B.&P.C.:for'thisreason'
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
.WARNING: FAILURE TO'SECURE WORKERS"COMPENSATION COVERAGE IS UNLAWFUL,' AND SHALL-
SUBJECT
HALL
SUBJECT AN EMPLOYER TO CRIMINALPENALTIES AND CIVIL FINES WTO ONE HUNDRED THOUSAND
_DOLLARS ($100,000): IN ADDITION TO THE CIDST-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 Budding:ahi)-Safety for a permit subject to the ,
conditions and restrictions set forthon:this application. -
1 . Each peison upon whose.behalf this application is made, e'ach-"erson at whose request and for -
whose benefif'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 anM): 've information. is correct. I agree to comply with all
city a d`cou ty ordinances and state laws c nstru i and hereby authorize•representatives
ft _ nt to enter u n the above-meniect a rposes.ate: "` signature:(Applicanto
Application Number . . . . .. 07-00001155
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
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Special Notes and
Comments
1
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