07-1156 (BLCK)--dollill"
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: <LO'77W7o�Oi003156„
SHEA .HOMES, „INC.
60800.TRILOGY -PAR KWA
Property Address:
61676�TULARE LN
APN:
764-280-999-108 -300237-
Application description:
WALL/FENCE
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
2125
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor: .
VOICE (760) 777-7012
. FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/18/0.7
Applicant: Architect or Engineer:
Y c p e o, a
SHEA .HOMES, „INC.
60800.TRILOGY -PAR KWA
D
6 • : ', ..
LA QUINTA, CA 92253
'
(760) 777- 60 05
pppp
R :J o 2007
/
Lic. No.:
67722285
Hf
CITY OF LA WINTA
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• LICENSED CONTRACTOR'S DECLARATION
FINANCE DEPT
----------------
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:
S tion 00) of Division 3 of the,Business and Professionals Code, and my License is in full force and effect.
_ I have and will maintain a certificate of consent to self insure for workers' compensation, as provided
ss: B, .. �� .. License No.:` 672285.
�{; r.•. •. _
for by Section 3700 of the Labor CodC;for,theperformance of.the work for which this'permitis
issued. -
C ractori s - -
i have and will maintain workers' compensation; insurance, as required by Sectiom3700 of the Labor
.
- :' � • '
Y'' '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 l am exempt from the Contractor's State License Law for the
Carriers -AMERICAN HOME -.'Policy: Number 1247619_
following. reason,(Sec; 7031:5;: Business and'Professions, Code: Any city orcounty tnaigiequiresra: permit to
4Y`.-• I certify:that,.m the;perfor'mance of .the work for which this permit is issued;'I shall, not'employ,any
construct, alter;improve,'demolish, orrepair anystrua"u're pnor to. its issuance also .re[juires the applicant for the
_
person in any mannerrso astob"ecomesubject to the workers"compensation lawsof California, -
,permit•to files signed statement that he or she is licensed pursuantaothe provisions of'the ContTactor'sState
andagreethat if; lr.should become subject �t, he workers' compensation provisions of Section
License Law IChapter9;lcommencing with Secuon 7000) of Division 3 of the Business grid Professions Code) or
3700 of the Labor`C hall-�,o',{;�,`with c with those provisions:
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 permitsutijects the applicant to a civil penalty of;not'more than five hundred doilars (5500).:
ate:
`
scant /. 1•,
(_ )• 1, as.owner.of the property, for my employees. with wages;as.theq sole compensation,,will-do the.work, and
- � ' • - - -
`rthe structure is not intended or offered for•.sale ISec:�7044-, Business and' Professions Code:=The
...WARNING: FAILURE TO SECURE WORKERS' COMPENSATION, COVERAGE. IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply.to an owner of.property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO:ONE HUNDRED THOUSAND
and who does the 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, the building or improvement is sold within
have
one ear of om I ti o the owner -builder will h theb rd n f r 'n that h r h ddn t b ld r
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
'
u e o p ov g a e o s e i o uo
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 nof*apply town owner of
property who builds or improves thereon,. and who contracts for theprojectswith 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.I.
Lender's Name:
Lender's Address:
LQPERMIT
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 that the above inform a�,,sd correct. I agree to comply with all
y an county ordinances and state laws relatin building nstructio hereby authorize representatives
iuenwty to enter upbn the above-riientioerty ((��r� etiorrses:
` - ` gnature (Applicant o 0:
Application Number . . . . . 07-00001156
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
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