06-4339 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06-0000433,9
Property Address: 61634 TOPAZ DR
APN: 764-280-999-140 -300237-
Application description: WALL/FENCE
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 3005
Applicant: 'Architect or Engineer:
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 922
.(760)777-6005
Lic. No.: 672285
VOICE (760) 777-7012
FAX (760) 777-701.1
INSPECTIONS (760)777-7153
D °
JAN 051007
Date: 12/21/06
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:
Se t' 7000) of Division 3 o u iness and Profe�sionlsode,and my License is in full force and effect.
Licene1� nse No.: 672285 -
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 '
11`\7
ate:° �2 ntracto .
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
- OWNER -BUILDER DECLARATION -
insurance carrier and policy number are:
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 pert once 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 man a beco ubject to th 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
License law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
and agree that, ' shou c e u, je to theme w rs' compensation provisions of Section -
f the bor Cad I sh fo hwith ompl a 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 155001:
D lic t:
1' 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
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 1$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
.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,
(_ 1 I am exempt under Sec. , 8.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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: — PW
LQPERDtIT
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 issuedasa 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
permit to cancellation.
I certify that I have read this application and state that a abo Informati is correct. 1 gree -to comply with all
citM�A
nances and state laws relating ui con tr ion; a hereby a rize representatives
of eupon the above-mentioned ropert for i e n purp as.
ature (Applicant or Age v
Application Number' . . . . . 06-00004339
Permit WALL/FENCE PERMIT
Additional desc .
Permit -Fee 63.00 Plan Check- Fee
.00
Issue Date Valuation
30.05
Expiration Date ; 6/19/07
�. -.
• 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. 61GARDEN -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
.0"0
Grand Total 63.00 .00 .00
63..00
- LQPERAIIT , \