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06-4348 (BLCK)"` I 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 __, � - }•'•4 . � ' . Date: 12/21/06• - Application Number: 06-00004348 Owner: , Property. Address: 61763 TOPAZ DR SHEA LA QUINTA APN: 764-280-9.99-27 -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:. 6040 Contractor: Applicant: Architect or Engineer: SHEA HOMES, INC- A 81260 AVENUE 62' D LA .QUINTA, CA 92253 7 - ' (� T. (760)777-600.5 �5 ��01- ` LiC . No.: 672285 JAN CITY OF LA QUINTA FINANCE DEPT. J 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 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 lass: B. - License No.: 672285 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued: t oat/e:� y ontractor. �y ' .J "' _)CI 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 became 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 ome subject to the workers' compensation provisions of Section - License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or I I of the boall �rlh ithco ly with those provisions.that he or sheis exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 byany applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: 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 oroffered 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 ofproperty 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 THECOSTOF COMPENSATION, DAMAGES AS PROVIDED FORIN 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 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 benefitworkis performed under or pursuant to any permit issued as a result of this application, , 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 Ouinta, its officers, agents and employees for any actoromission 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 ofwork for 180 days will subject CONSTRUCTIONLENDINGAGENCY- 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 e above information is correct. I agree to comply with all work for which this permit.is issued (Sec. 3097; Civ. C.). -_ city and county ordinances an state laws relating ��cnstructi ��nlotivesoft c�uyty t)o en r up the above-mentioned nspe ion Lender's Name: ate:. nature (Applicant or Agen ' Lender's Address: �� .LQPERMIT - Application Number 06-00004348 Permit . . . WALL/FENCE PERMIT Additional desc - Permit•Fee 90.00. Plan Check Fee .00 - Issue Date Valuation, 6040 Expiration Date 6/19/07 Qty Unit Charge Per Extension BASE FEE 45.00 5.00 9.00.00 THOU, BLDG 2,001-25,000 '45:00 --•--------------------------- Special Notes and Comments -------------------------- 45 L.F. COMBO WALL, 6' GARDEN, 3' RETAINING, 15.5 L.F. 61GARDEN WALL & 65 L.F.'4' KNEE ;WALL, ALL.ORCO SYSTEM Fee summary Chargees Paid Credited Due i. ----------------- ---------- _ ---------- ---------- =--------- Permit Fee Total 90.00 .00 ."00 90..00 Plan Check Total .00 .00 .00 .00 Grand Total, 90.00 .00 .00 90.:00 LQPEILNIT .. -