07-1158 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO..
LA QUINTA, CALIFORNIA 92253
Applicant:
Architect or Engineer:
BUILbING,&SAVETY DEPARTMENT,
BUILDING PERMIT
Owner:
SHEA LA QUINTA
'C/O JEFF MCQUEEN
".8800 N GAINEY CENTER 350
',,SCOTTSDALE, AZ 85258
-Contractor:
SHEA HOMES, INC.'
,.._ .6080l TRILOGY PARKWAY,
:LA QUINTA, CA 92253
(760)777-6005
Lic.-No.: --672-285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/18/07
Application Number:0
7 - 0-0 (5-0 1-1 518
Property Address:
6=170 -4— T UL -AR t -L N
APN:
764-280-999-106 -300237-
Application description:
WALL/FENCE
Property Zoning:
MEDIUM HIGH. DENSITY RES
Application valuation.:
2125
Applicant:
Architect or Engineer:
BUILbING,&SAVETY DEPARTMENT,
BUILDING PERMIT
Owner:
SHEA LA QUINTA
'C/O JEFF MCQUEEN
".8800 N GAINEY CENTER 350
',,SCOTTSDALE, AZ 85258
-Contractor:
SHEA HOMES, INC.'
,.._ .6080l TRILOGY PARKWAY,
:LA QUINTA, CA 92253
(760)777-6005
Lic.-No.: --672-285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/18/07
LQPERMIT
M
— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —
LICENSED CONTRACTOR'S -DECLARATION
— ---
— — — — — — — — — — — — — — — — — — — — — — — --- — — — — — — 7
WORKER!S COMPENSATION DECLARATION
I hereby ffi,rn under penaltylicensed under pro�isionsbi Chapter 9 (commencing with
of perjury, that I am I
I hereby, affirm under penalty orid-6f the foil6wing declarations:
Se i, go of Divisionand Professionals Code; and'my License is in full force and effect.
3 of the Business
I have*,and will niaiiiiairi'a 6eiti ica of consent to self.insure for workers' compensaticin_as�l
t6
Li - License No . .: 672285
for �y of'i6;l Code, for the performance of the w&lk for -which this.permit is
t7isUed.Sectioir"7b"_
��on�,,Sct;
I have ';compensation insurance, lhe�*Labor
.
,and'Wili'maiijtaihTworkers as required .by;Sec.tion,37'0O of
Code;.for the pe ri8f�imce of the Work idrwhich this permit isissued My''
Pworkers-compensation
OWNER -BUILDER DECLARATION
I In ntrictc�r's State Li�en�e.Law for
hereby affirm,undei penalty of, perjury that I am exempt from the C the
insurance carrier and policy number
619
Carrier AMERICAN'HbM Policy Number .1 247.619
following r�ascin:i§eb.��,7,6�1.
-tt,�6siness in� Professions Code: Any,city or countq-that requir6s,a:pel -
I cerfify'rthat, in the performa Whch.this permit is•l shall noi�employ any
;�e of the worl
- i�' ".any. s ruc ure,.p 'j;�Il f6r.,ihe
construct,,�alrei, ir" " i ,t l it� iss6a�c�,ialso r6�
Val gWireis,tihe'a
g�dis'on'lin"a,n"y.-m-a,nn,e—r..soaLs�to 66colriie sul the workers' compeniation*Iaws of. California,
- 0,
MeAi*,tfiat: he, or�sl d pursuant to the
permit to file:a signed�si4te 'I se provisions 9. the ontract r s tatb
License Law'(Chapter'§'(6ohirilieri6ing with Section 70001 -of Division'3 of.the*Bi3gil Professions Code) or
' I - " — - -
d�ll subjebt
gr6e,tl io.thANorkers comp niati6hprovisions of Section
'r
of 0 those provisions,
La
00, L5 I -;ha cl N
exemption'.,lAQ'�io
I d the basis for the alleged'Iaiiol Section 7031.5 l
that he or she is exemptzilter6fiom an
an applicant for a pirmt:sybiects thea licaht6a.civil halty'oflnot,m6re tl hundred dollars ($500)
p
j'i,'a's.ownei:of,thii'property, 'or my employees with as their solec&npensation'will do the,wqrk; and,
—7
"` Business`' '
ru �'re is:�otintended or offered -for ;�I7044andFi�fessions CodiYnW1
-!
wA NING. FAILU ECUREWORKERS',COMPENSATION COVERAG9IS,�jAWFUL, AND SHALLContractors'
"
State License Law does not apply e10ner of property who builds or improves thereon,
!,
_�SUBJECT AN EMPLOYER TO CRIMINAL ANDCIvil -U0R6oNE'HUNDRED THOUSAND
I . . I FINES' - o
and'who doe's"the work himself or lhers6lf tfiio66l r, her..own employees, provided that the
DOLLARS 1$100;000). xIN ADDITIONJO THE COST OF.,C6MPENSATION_DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. It hiwever,'the building or improvement is sold within
SECTION 3701l LAB6k.CbbE: INTEREST, AND ATTORNEY'S' FEES.
one year of'c6mpletion, the owner -builder Will hdvd the burden' -6f proving that'he sl did not build or
improve for the purpose of sale.).APPLICANT
ACKNOWLEDGEMENT
1, as 6Wr`e_r�`6f th6� property, am exclusively 'contracting .wfth licensed contractors to construct the project (Sec.
'The
IMPORTANT Application is hereby madeto tfie Director of B - uilcl and Safety for a permit subject to the
' "'
7044, Businiisstand Professions Code: Contractors' State License Law does not apply to n owner
a
i
t forth Iiiiation.
conditions and restrictions set h
?,
builds or improves tand,-. .
il who contracts. for the projects with a contractol licensed
_ .-
1 EacWpei;c��Vipdn wh'os6-behalf-tfiWapplication is made, each person.at whose request and for
pursuantto the Contractors' State License
whose benefit worpe ormed ul _r oe'pursuant.to any permit issued4s-asult�ofthis application,
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
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.
Date: Owner:
2. Any permit issued asa result of this application becomes null.and void if work is not commenced
within 180 days.from date of issuance of such permit, or cessatioh.,of,work for 180, days will subject
CONSTRUCTION LENDING AGENCY
permit to cancellatio6.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that I l read this application and state th. the above information iAorrect. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.).
count ordinances and state relating co uc 'on, ' Preby authorize representatives
g to
Ato�l
upon the above-mentioned pe I ins ct, rp
0�
t4per
01
lApplicant or Ad
Lender's'Address:
/2teq:���ture
LQPERMIT
M
Application Number . . . . . 07-00001158
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
LQPERMIT