06-4340 (BLCK)P.O. BOX 1504 VOICE -760 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT " -
Date: 12/21/06
Application Number: 06-00004340 Owner:
Property Address: 61656 TOPAZ DR SHEA LA QUINTA
APN: 764-280-999-139 -300237-.-• " C/O JEFF MCQUEEN
Application description: WALL/FENCE 8800 N GAINEY CENTER 350 .
Property Zoning: MEDIUM .HIGH DENSITY RES SCOTTSDALE, AZ 85258
Application valuation: 2505 ,
Contractor:
Applicant:. Architect or Engineer: SHEA HOMES, INC-
- 81260 AVENUE 62
LA QUINTA, CA 92253 D
(760)777-6005
Lic. No.: 672285 JAN 05 2007
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: N
. Lender's Address:
I,QPE"I IT
performed under or following issuance of this permit.
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, of cessation of work for 180 days will subject
permit to cancellation.
certify that I have read this application and stale tha a bove i form n is correct. I agree to comply with all
city nd ount ordinances and state laws relatin b 'I con uction, nd hereby thorize representatives
of thi un a upon t e above-mentione grope y f insp tion pu poses. - - - i -
ate: g ature (Applicant or Ag
i
OF LA QUINTA
--------------------------=------------------------------------------
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• - LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSAT IIt oE�oClmI€rTrY
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:
Sectio 700 ) of Division 3 of [he B i and Prof ssi oats 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
Lice s Cla B 'cense No.: 672285
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
-
te. V racto
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 workerscompensation
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 performance 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 become 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
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or,
d agree that ul beco a ject tot
�1�3700%of the abo I shat forth ith-co
workers' compensation provisions of Section
wig 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 (5500).:
nt: --
(=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 (5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED, FOR IN
- improvements are not intended or offered for sale. however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
ilf,
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 _ I 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
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: N
. Lender's Address:
I,QPE"I IT
performed under or following issuance of this permit.
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, of cessation of work for 180 days will subject
permit to cancellation.
certify that I have read this application and stale tha a bove i form n is correct. I agree to comply with all
city nd ount ordinances and state laws relatin b 'I con uction, nd hereby thorize representatives
of thi un a upon t e above-mentione grope y f insp tion pu poses. - - - i -
ate: g ature (Applicant or Ag
i
Application Number . . . . . 06-00004340
Permit . . . WALL/FENCE
PERMIT
Additional desc .
Permit Fee 54.00
Plan Check
Fee
.00
Issue Date
Valuation
2505
Expiration Date 6/19/07
Qty Unit Charge Per
Extension
BASE
FEE
45.00
1.00. 9.0000.THOU BLDG
2;001-25,.000
9.00.,
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Special Notes and Comments
65.L.F'. 61GARDEN WALL & 55 L.F.
4KNEE
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
.0"0
00
54.00
" I.QPMNIIT
_
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