06-2688 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPII O
LA QUINTA, CALIFORNIA 92253
Application Number: 06-00002688
Property Address: 61285 TOPAZ DR
APN: 764-280-999-7 -300237-
Application description: WALL/FENCE
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 4405
Applicant:
T -4,6t 4 4 Q"
Architect or Engineer:
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LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
hereby bffirm rider penalty of per' t at I am licens dkrovisions of Chapter 9 (commencing with
Sect n 000) f Division 3 of the usi s and Profes ie, and my License is in full force and effect.
L'ns: e No.: 672285
ate: t / 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 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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001.:
(_) 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 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 _ 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.).
Lender's Name:
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
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 n n
LA QUINTA, CA 92253
(760)777-6005
Lic. No.: 672285 ' IU JUL 2 0 2006
Lin OF LATA
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WORKER'S COMPENSATION DECLARATIO
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.
Y—LI 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 an policy number are:
Carrier AMERICAN HOME Policy NumbA 1247619
I certify that, in the pe rmance of the work fo hich this permit is issued, I shall not employ any
person in any manne so to ecome subje t to the workers' compensation laws of California,
and agree that, if I sh uld ec a subj workers' compensation provisions of,Section
3700 of tf� Lab sha I forthwith with those provisions.
WARNING: FAILURE TO SEC16RE WORKERS' 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 forany act or omission related to the work being
performed under or following issuance of t ,is permit.
2. Any permit issued as a result of this applic ion becomes null and void if work is not commenced
within 180 days from date of issuance of uch permit, or cessation Ifork for 180 days will subject
permit to cancellation.1 ce f thatAA have read this application and state that t above i-rmation iCI agree to comply with all
cit�oordinances and state laws relating to bui 'ng ns ction,andhauthorize representatives
of to enter upon above-mentioned p inspe ion pyrpose
v /
(Applicant or Age 1:
LQPERMIT
Application Number . . . . . 06-00002-688"
Permit WALL/FENCE PERMIT
Additional desc
Permit,Fee72.6-0
Plan Check
Fee
.00
Issue.Date . . . .
Valuation
4405.
Expiration Date 1/13/07
Qty Unit Charge Per
Extension
BASE
FEE
45.00
3.00 9.0000 THOU BLDG
2,001-25,000
27.00
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Special Notes and Comments
125 L.F. 61 GARDEN WALL & 80 L.F.41
KNEE WALL, ALL ORCO SYSTEM
Fee summary Charged
-----------
Paid Credited
Due
----------------- ----------
Permit Fee Total .72.00.
----------
.00
--------
.00
-
72.00
Plan Check Total .00
.00.
00
.00
Grand Total -'72.00'
.00
.00
72.00