06-4337 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Applicant:•
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800rN GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor:'
SHEA HOMES; INC.
812.60 AVENUE 62
LA QUINTP; CA 92253
(760)777-6005
Lic. No.': 672285
VOICE (760) 777-7012
FAX (760) 777-7011.
INSPECTIONS (760) 777-7153
Date: 12/21/06
JAN .0 5 2007
CITY OF LA QUINTA
FINANCE DEPT..
LICENSED, CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION'
I hereby affirm under penalty ofeLjur, 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 he B si ss and Profe io als 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
Licen ss i se No.: 672285 - for by Section 3700 of the Labor Code, for the performance of,the work for which this permit is
issued.
ontractor. - 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: - - -
Iherebyaffirm 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 ISec. 703.1.5, Business and Professions Code: Any city or county that requires a permit to _ 1 certify that, in the per ormance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any str6cture, prior to its issuance, also requires the applicant for the person in any m as to beco subject to ft 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 - nd agree tha if I sh ul eco e s bj t to the rkers'. compensation provisions of Section
License law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or th abor C e, I hall rthwit com h ose 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 permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: _ a-
'(_) - 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 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
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 contractorls) 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 under Sec. , BAP.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 at I have read this application and state th r above inf rm tioJ
agree to comply, with all
work for which this permit is issued (Sec. 3097, Civ. C.). - - city a ounty Qrdinances and state laws relatit con uctio , thorize representatives;ate:
thin p ni�(o`e t on.th above-mentic d prop rty ins tion uLender's Name:J
n ture (Applicant or
Lender's Address: • !�f - .
LQPERAIIT - ,
t
Application Number:
06-00004337' .
Property'Address:
61667 TOPAZ DR
APN:'
764-280-999-23 -300237-
Application description:
WALL/FENCE
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
3005
Applicant:•
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800rN GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor:'
SHEA HOMES; INC.
812.60 AVENUE 62
LA QUINTP; CA 92253
(760)777-6005
Lic. No.': 672285
VOICE (760) 777-7012
FAX (760) 777-7011.
INSPECTIONS (760) 777-7153
Date: 12/21/06
JAN .0 5 2007
CITY OF LA QUINTA
FINANCE DEPT..
LICENSED, CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION'
I hereby affirm under penalty ofeLjur, 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 he B si ss and Profe io als 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
Licen ss i se No.: 672285 - for by Section 3700 of the Labor Code, for the performance of,the work for which this permit is
issued.
ontractor. - 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: - - -
Iherebyaffirm 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 ISec. 703.1.5, Business and Professions Code: Any city or county that requires a permit to _ 1 certify that, in the per ormance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any str6cture, prior to its issuance, also requires the applicant for the person in any m as to beco subject to ft 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 - nd agree tha if I sh ul eco e s bj t to the rkers'. compensation provisions of Section
License law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or th abor C e, I hall rthwit com h ose 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 permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: _ a-
'(_) - 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 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
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 contractorls) 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 under Sec. , BAP.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 at I have read this application and state th r above inf rm tioJ
agree to comply, with all
work for which this permit is issued (Sec. 3097, Civ. C.). - - city a ounty Qrdinances and state laws relatit con uctio , thorize representatives;ate:
thin p ni�(o`e t on.th above-mentic d prop rty ins tion uLender's Name:J
n ture (Applicant or
Lender's Address: • !�f - .
LQPERAIIT - ,
Application Number . . . . . 06-00004337
Permit . . . WALL/FENCE
PERMIT
Additional desc .
Permit Fee . . . . 63.00
Plan Check
Fee
.00
Issue Date
Valuation
3005
Expiration Date 6/19/07
Qty Unit Charge Per
Extension
BASE
FEE
45.00
" 2.0,O %5.10000 THOU. BLDG_2,001-25,000
18.0.0
------- --------
r 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
.00
Grand Total 63.•00
.00
.00
63.00'
LQPER\IIT • . ..
-