06-3978 (BLCK)P.O. BOX 1504 VOICE (760) 777-7012
i 78.495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY- DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 11/14/06
Application Number: 06-00003978 Owner:
Property Address: 61571 TOPAZ DR SHEA LA QUINTA
APN: 764-280-999-19 -300237- C/O JEFF MCQUEEN
Application description: WALL/FENCE D 8800 N GAINEY CENTER 350
Property Zoning: MEDIUM HIGH DENSITY RES SCOTTSDALE, AZ 85258
Application valuation: 3130 NOV 20 2
006
Contractor:
` Applicant: Architect or En ineer: -CITY OFSHEA HOMES, 'INC.
FINANCE DEP�NT A _
81260 AVENUE 62
..11. I•A QUINTA, CA 92253
(760)777-6005 .
Lic. No..: 672285
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LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION *DECLARATION
I 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 Bu ' nd 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
Licens lass: B Licens No.: 672285 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
ate: ontrac 1- 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 pe ormance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any mann - so as to becom subject 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 thLabor�Cnft-4ANI
ome su i t to -the wor rs' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 700 of the l f hwit comply wi h e 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 ($500).: ate pplica
(_ 1 I, as owner of the property, or my employees with wages as their sale compensation, will do the work, and -
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: 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 1, 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
7644, 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,
_ 1 _) 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
r , 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 o uch 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 in rmation iJhb
gree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). - city and -ounty rdinVicesandsa laws relating to co st tion, nhorize representatives
of this my to a ve-mentioned p pert for pe wn pu
Lender's Name:
Oki e: licant or Age
Lender's Address:
LQPER111IT -
Application'Number 06-00003978
Permit. . WALL/FENCE PERMIT
Additional desc
Permit Fee . . . . 63*.00
Plan Check
Fee
.00
Issue Date
Valuation
. . .
3130
Expiration Date 5/13/07
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
90 L.F. 6f GARDEN WALL & 55 L.F. 4'
KNEE•WALL, BOTH 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
LQPERA11T