07-0852 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO,
LA QUINTA; CALIFORNIA 92253
Application Number:�_0.7�-00000852 ` �r
Property Address: �6T567- TORO -CANYON WY
APN: 764-280-999-119 -300237-.
Application description: WALL/FENCE
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 2500
Applicant:
Architect or Engineer:
.I0 1 "
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.
60800 TRILOGY PARKWAY,
LA QUINTA, CA 92253
(760)777.-6005
Lic. No.: 672285
LICENSED CONTRACTOR'S DECLARATION -
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Sectio 7000) of ivision 3 of the Business and Professictrials Code, and my License is in full force and effect.
s ss: B Li nse No.: 672285
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions'Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
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 `
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 ($500).:
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 -
• Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the' work himself or herself through his or her own employees, provided that the
' improvements are not intended or offered for sale. If, however, the building or improvement is sold within
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.). -
• 1._ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractors) licensed
. pursuant to the Contractors' State License Law.).
I—) I am exempt •under Sec. , B.&P.C. for this reason
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: IA -
Lender's Address: r9
LQPERMIT,
VOICE (760) 777-7012
FAX (760) 777-7011.
INSPECTIONS (760) 777-7153
Date: 3/22/07
a
MAR 301001 D
.. 1110E D .
' WORKER'S COMPENSATION DECLARATION,
-,,hereby affirm under penalty of perjury one of the following declarations:
_ 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
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
insurance carrier and policy number are: _
Carrier AMERICAN HOME Policy Number 1247619
_ I -certify that, in the performance of the work for which this permit is issued, 1 shall not employ any
person in any manneras to become subject to the workers' compensation laws of California, .
and agree that, if I sho d become subject.to the workA' compensation provisions of Section
V 7 f the Labor II fortnh ply se provisions.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUN DRED.THOUSANE)
DOLLARS ($100,000).,IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
• APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
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.
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
permit to cancellation. -
I certify that I have read this application and state that th above information is correct. I agree to comply with all
city and county ordinances and state laws relating to b cons ruction, and Aby authorize representatives
of the ty toe ter upon the above-mentioned p pert insp do urpos
ate: JS gnature (Applicant or Agent .
e
Application Number •07-00000852
Permit WALL/FENCE PERMIT
Additional, desc-
Permit Fee 54.00 Plan.Check Fee
.00
Issue Date Valuation
250Q --
Expiration Date,:'. 9/18/07
Qty Unit Charge, Per
Extension
BASE FEE
45.00
1.00 9.0000 THOU BLDG 2,001-25,000
9.00 -
Special Notes and Comments
100 L.F. 6!' GARDEN WALL, ORCO SYSTEM
Fee summary Charged Paid Credited
Due
•Permit Fee Total 54.00 .00 .00
54.00
Plan Check Total j .00 .00 .00
.00
Grand Total 5.4.00 .00 .00
54.00
LQPERMIT -