06-4347 (BLCK)T4,4 P.O. BOX 1504 VOICE (760).777--7012'
78-495 CALLE TAMPICO - FAX (760) 777-7011
LAQUINTA; CALIFORNIA 92253.. BUILDING & SAFETY DEPARTMENT' INSPECTIONS (760) 777-7153 '
BUILDING PERMIT
Date: 12/21/06
• Application Number: '-06-00004347- 1 Owner:
' Property Address- ` 61.739 -TOPAZ DR'' a SHEA LA QUINTA
APN:- 764-280-999-26 -300237-. C/O JEFF MCQUEEN
'Application description: WALL/FENCE 8800 N GAINEY CENTER 350
Property Zoning- MEDIUM .HIGH' DENSITY RES a SCOTTSDALE,,- AZ 85258 + .
+ Application valuation: 3165 M
Contractor:
Applicant: - Architect or Engineer: SHEA HOMES, INC. JAN O 2007 '
81260 AVENUE62='
- - f LA QUINTA, CA 92 3
(760)777-6005 CITY OF LA QUINTA f
Lic. No.:.672285 FINANCE DEPT.
• LICENSED CONTRACTOR'S DECLARATION - - - WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty ofperjury 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 Class: - License No.: 672285 for by Section 3700•6f the Labor Code, for the performance of the work for which this permit is r
lA1 ''I}'1C^ Imo- issued.
Sate:actor _1. \ u � • . 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 repair any structure, prior to its issuance, also requires the applicant for the - person in any manner 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 and agree that, if uld com s 'act to the orkers' 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 L or Co eJ s II rthwi cow ly ith those provisions. ••
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by .1
_ any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: 1 plica J .� iL
• (_ 1 'I, as owner of the property, or my employees with wages astheirsole 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 heorshe did not build or -
improve for the purpose of sale.). - APPLICANT ACKNOWLEDGEMENT
(_ 1 I, as owner oftheproperty, am exclusively contracting with licensed contractorstoconstruct 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 performedunder 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
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. 1 .
1 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 [he abo i ormation 's orr t. I ag to
comply with all
work for which this permit is issued (Sec. 3097, Civ: C.). - - - city and unt ordinances and state laws relating to bu' mg c r coon, a hereb ayth i representatives
• of thi t.uity enter upon the above-mentioned-pro rty for i spe 'on pur ses.-
Lender's Name: — . _ -- - _ - - = - `J / j
ate: r nature (Applicant or Agent):
Lender's Address:
LQPERIt11T - - ,
Application Number . . . . 06-00004347
Permit . . . WALL/FENCE
PERMIT
Additional desc :. .
Permit Fee 63.00
Plan Check
Fee
."00'
Issue Date
Valuation
3165
Expiration Date.-- 6/19/07
"
• Qty Unit Charge Per
-Extension
BASE
FEE
45.00 '
2.00 9.0.000 THOU BLDG
2,001-25,000
18.00
--------- - --------------------------------------------------
Special Notes and Comments.
85 L.F. 61GARDEN WALL & 65 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
•
t
- LQPERA4I1-