07-0840 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: t„�_ 07'00000840
Property Address: 61633 TORO CANYON WY
APN: 764-280-999-122 -300237-
Application description: WALL/FENCE
Property. Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 2250
• 4.Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE,•.AZ 85258
VOICE (760) 777-7012
FAX (760) 777-7011.
INSPECTIONS (760) 777-7153
Date: 3/22/07
Contractor: U d
Applicant: Architect or Engineer: SHEA HOMES,. INC.
60800 TRILOGY'PARKWAY
LA QUINTA, CA 92253 Ala3 g ?ppl
. (760) 777-6005
Lic. No.: 672285 7 A
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licens d under provisions of Chapter 9 (commencing with I hereby affirm under penalty of.perjury one of the following declarations:
Section 00) of Division 3 of th �y ' sand Profess nal C.
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
Lic ass: B I nseNo.: '672285 E - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
. Da on factor. �Othave 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 sous 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 I sho become subject to the orke ' 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 Labor Code II fort ith mply w 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 a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001.: ate: ✓ licant:Il
1 _ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure isnot 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 burdemof proving that he or she did not build or
improve for the purpose of sale.).
(_ 1 .I, asownerof 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
( ) 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:
Lender's Address: '
rAW
LQPERMIT
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
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 certifyyyyyythat I have read this application and state that t above information is correct. I agree to comply with all
ciu ty ordina es and state laws relating to buil ' constr ctio and hereby horize representatives
oft n enter on the above-mentioned e o insp ion p poses.
Date: ' at, (Applicant or Age
Application Number .07-00Q00840
Permit WALL/FENCE PERMIT
'Additional_- desc
a 'Permit 54.`00 r
_
Plan Check
`Fee
.00
_Fee
Issue Date
Valuation
2250
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
Fee summary Charged.
- . ------z---- ----------
Paid Credited
----------
-
Due
---- - - - --
---------:7---'---
Permit Fee Total 54 O
.00
.00
.54.00_
Plan Check Total .00
.00.
.00
.00;
-Grand Total 54.00
.00
.00
..54.00
LQPERMIT