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06-2692 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO . LA QUINTA, CALIFORNIA 92253 Application Number: 06-00002692 Property Address: 61238 TOPAZ DR APN: 764-280-999-158 -300237- Application description: WALL/FENCE Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 3165 Applicant: Architect or Engineer: P (Ar . BUILDING & SAFETY DEPARTMENT BUILDING PERMIT ICENSED CONTRACTOR'S DECLARATION 1 here affirm nder penalty of perju th I am licensed n r provisions of Chapter 9 (commencing with do 70001 'sion 3 of the B in and Professio als Code, and my License is in full force and effect. L s la i e se No.: 672285 �t : ntractor: 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 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 7031.5 by any applicant fora permit subjects the applicant to a_civil penalty of not more than five hundred dollars ($500).:' (_ 1 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.). (_) 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 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.). (_ 1 I am exempt under Sec. , BAP.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:�� LQPERA11T VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 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. 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 Policy Number 124.7619 _ I certify that, in the performance of the work for which this permit is issued, -I shall not employ any person in any manner so as to become subject to the rkers' compensation laws of California, an gree that, if I shot d b me s�ubjct the wor s' compensation provisions of Section 370 h Labor h I fortth ply w' h p ovisions. te: ant: WARNING: FAILURE TO SECUR ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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 of this permit. 2. Any permit issued as a result ofR ion becomes null and void if work is not commenced within 180 days from date of ch permit, or cessation of work for 180 days will subject permit to cancellation. - I certify th t 1 have read this application andab a info atio is torr ct. I agree to comply with all city c my or antes and state laws rdi onstru on, a d by authorize representatives of th c ti�to en eou on the above-menty f inspect pur e: lL� S/v,( ture (Applicant or Date: 7/17/06 Owner: SHEA LA QUINTA- C/O JEFF MCQUEEN 8800 N GAINEY CENTER 350 SCOTTSDALE, AZ 85258 Contractor: SHEA HOMES, INC.81260 AVENUE 62 LA QUINTA, CA 92253JUL 20 kl_ 2006 .(760)777-6005Lica. No.: 672285 TY OF LA QUINTA 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. 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 Policy Number 124.7619 _ I certify that, in the performance of the work for which this permit is issued, -I shall not employ any person in any manner so as to become subject to the rkers' compensation laws of California, an gree that, if I shot d b me s�ubjct the wor s' compensation provisions of Section 370 h Labor h I fortth ply w' h p ovisions. te: ant: WARNING: FAILURE TO SECUR ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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 of this permit. 2. Any permit issued as a result ofR ion becomes null and void if work is not commenced within 180 days from date of ch permit, or cessation of work for 180 days will subject permit to cancellation. - I certify th t 1 have read this application andab a info atio is torr ct. I agree to comply with all city c my or antes and state laws rdi onstru on, a d by authorize representatives of th c ti�to en eou on the above-menty f inspect pur e: lL� S/v,( ture (Applicant or Application Number . . . . 06-00002692 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 63.00 Plan Check Fee .00 Issue Date . . . . Valuation 3165 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 85 L.F. 6' GARDEN WALL & 65 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 LQPERMIT