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06-3984 (BLCK)P.O.-BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 'Application Number: Property Address: APN: , Application description: -Property Zoning: Application valuation: 06-00003984 , 61524 TOPAZ DR 764-2'80-999-145 -300237 WALL/FENCE MEDIUM HIGH DENSITY RES 2835 - 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: , SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER 350 SCOTTSDALE, AZ 85258 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 0 Date: 11/14/06 r''#JV eo.10 Contractor: Applicant: Architect or Engin er: rC/ OD SHEA-HOMES , INC. 81260 AVENUE 62 LA QUINTA, CA 92253 (760)777-600S Lic. No..:" 672285 ----------------------------------------! -- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION , 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: Section 7000) 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 . License ass: License No.: 672285 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. '� ,` L ate: �nuactor: Rte_ 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 OWNER -BUILDER DECLARATION - insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt"from the Contractor's State License Law for the Carrier AMERICAN HOME Policy Number 1247619 following reason (Sec. 7031.5. Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repairanystructure, prior to its issuance, also requires the applicant for the person in -any man so a to bebrthh ubject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State _ and agree that, if I u conctto the rkers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or ' 3700 of the Lab , I hall f comply - it 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 permit subjects the applicant to a civil penalty of not more than five hundred dollars IS5001.: e: " pplicant. - ( 1 1, 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 Coder 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 ($100,000). 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 SECTION 3706 OF THE LABOR CODE; INTEREST, AND ATTORNEY'S FEES. 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.). , APPLICANT ACKNOWLEDGEMENT ( 1 I, as owner of the. property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044; Business and"Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for ' pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, ( ) I am exempt Cinder 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 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 CONSTRUCTION LENDING AGENCY. - permit to cancellation. -I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the " I certify that I have read this application and state that t bo a info ion i correct. agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). city and co my o inances and state laws relating tot g c pec i n, an hereb thorize representatives of this o n y to` r upon the above-mentioned prop rty or i pecti purp ss. Lender's Name. - D nature (Applicant or Agent l: Lender's Address: LQPERMIT ' • Application Number . . . . 06-000.03984 Permit . . . . . . WALL/FENCE PERMIT - - - Additional desc Permit Fee 54.00 Plan Check .Fee .00 Issue Date . . . Valuation 2835 Expiration Date 5/13/07 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 -75 L.F. 6- GARDEN WALL &'60 L-. F. 4' KNEE WALL-, BOTH 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 - .