06-2689 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tiilt 4 4a Qum&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor:
Applicant: Architect or Engineer: SHEA HOMES, INC.
81260 AVENUE 62
��. LA QUINTA, CA 92253
(760)777-6005
Lic. No.: 672285
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION -
I.hereby a_ irm rider penalty of per' at I am licen d under provisions of Chapter 9 (commencing with '
Section 0), Division 3 of the us ss and Pr a 'onals Code, and my License is in full force and effect.
Licen I s: License No.: 672285
ta: ontracto
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Coritractor'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 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of,not more than five hundred dollars ($500).:
(_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
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.).
•(_ 1 1, 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 not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
( ) 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.).
Lender's Name:
Lender's Address: I,
LQPERA1IT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/17/06
D Q 0 0
JUL 2 2006
CITY OF LA QUINTA
FINANCE DEPT.
----------------------------------------------—
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 -insure 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.
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
insurance carrier and policy number are:
Carrier AMERICAN HOME A Policy Number 12476,19
_ 1 certify that, in the perfor nce the work for which this p r it is issued, I shall not employ any
person in any manner so to ecome ubject to the wor s' compensation laws of California,
and agree that, if I s co a sub t to the the m ensation provisions of Section
700 of the La or ode I s II orth co Iy ith t ovisions.
r -
ne: plicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,000). IN ADDITION TO THE COST 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 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 oft is permit.
2. Any permit issued as a result of thisol
n becomes null and vo' if work is not commenced
within 180 days from date of issuarmit, or cessatio f work for 180 days will subject
permit to cancellation.
I y that have read this application and slate i o anon is o rect. I agree to comply with all
it cou ty ordinances and state laws relatinons tion, rid eby authorize representatives
f t c t to enter upon a above-mentionenspe ion p, p
D Si ature (Applicant or Age
Application Number:
06-00002689
Property Address:
61172 TOPAZ DR
APN:
764-280-999-161 -300237-
Application description:
WALL/FENCE-
ALL/FENCEProperty
PropertyZoning:
MEDIUM HIGH DENSITY RES
Application valuation:
3495
Tiilt 4 4a Qum&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor:
Applicant: Architect or Engineer: SHEA HOMES, INC.
81260 AVENUE 62
��. LA QUINTA, CA 92253
(760)777-6005
Lic. No.: 672285
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION -
I.hereby a_ irm rider penalty of per' at I am licen d under provisions of Chapter 9 (commencing with '
Section 0), Division 3 of the us ss and Pr a 'onals Code, and my License is in full force and effect.
Licen I s: License No.: 672285
ta: ontracto
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Coritractor'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 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of,not more than five hundred dollars ($500).:
(_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
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.).
•(_ 1 1, 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 not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
( ) 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.).
Lender's Name:
Lender's Address: I,
LQPERA1IT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/17/06
D Q 0 0
JUL 2 2006
CITY OF LA QUINTA
FINANCE DEPT.
----------------------------------------------—
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 -insure 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.
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
insurance carrier and policy number are:
Carrier AMERICAN HOME A Policy Number 12476,19
_ 1 certify that, in the perfor nce the work for which this p r it is issued, I shall not employ any
person in any manner so to ecome ubject to the wor s' compensation laws of California,
and agree that, if I s co a sub t to the the m ensation provisions of Section
700 of the La or ode I s II orth co Iy ith t ovisions.
r -
ne: plicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,000). IN ADDITION TO THE COST 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 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 oft is permit.
2. Any permit issued as a result of thisol
n becomes null and vo' if work is not commenced
within 180 days from date of issuarmit, or cessatio f work for 180 days will subject
permit to cancellation.
I y that have read this application and slate i o anon is o rect. I agree to comply with all
it cou ty ordinances and state laws relatinons tion, rid eby authorize representatives
f t c t to enter upon a above-mentionenspe ion p, p
D Si ature (Applicant or Age
e
LQPERAIIT
Application Number 06-00002689
Permit WALL/FENCE
PERMIT
Additional desc .
Permit Fee 63.00
Plan Check
Fee
.00
Issue Date
Valuation
3495
Expiration Date 1/13/07
Qty Unit'Charge Per
Extension
BASE
FEE
45.00
2.00 9.0000 THOU BLDG
2,001-25,000
18.00
-----------------------
. Special Notes and Comments
------------------------
95 L.F. 6' GARDEN WALL & 70 L.F.4'
KNEE
WALL, ALL ORCO SYSTEM
Fee summary Charged
Paid Credited,
Due
----- ----
Permit Fee Total 63.00
-
.00
----------
.00
63.00
Plan Check Total .00
.00
.00
.00
Grand Total 63.00
.00
.00
63.00
e
LQPERAIIT
Wt