07-0850 (BLCK)P.O. BOX 1504 ^' VOICE (760) 777-7012
78-495 CALLS, TAMPICO FAX (760) 777-7011
LA QUINTA; CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
• - - BUILDING PERMIT
Date: 3%22/07
Application Number: `„407-00000850 Owner:
Property Address: 61655 TORO CANYON WY SHEA LA QUINTA
APN: 764-280-999-123 -300237- C/O JEFF MCQUEEN
Application description: WALL/FENCE. 8800 N GAINEY CENTER 3 D d
Property Zoning: MEDIUM'HIGH DENSITY' RES SCOTTSDALE, AZ 85258.
r Application valuation: 2125
-Contractor: MAR 30 ?OU7
Applicant: Architect or Engineer: SHEA HOMES, INC.
60800 TRILOGY PARKWAY Cn1'OFLAQUI�TA
r _ LA QUINTA, CA 92253 CE 1)
.11/ry (760)777-6005 .
Lic. No:: 672285
Coll .
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION -
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 Pivision 3 of the B 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
( L e I>lS�: License No": 672285 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
r/J issued.
ate: C ntractor: , _y"ave 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 _ 1 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, prioi to its issuance, also requires the applicant for the person in any manner so as to become subject to the wor rs' 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 ee that, if, Ishou ome subj ct t the.workers ompensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or �$0� fit Labor Co h II forth h co ply with th provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by a, 1
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Date: pplicant:
(_ 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 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 1$100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, thebuilding or improvement is sold within SECTION 370,6 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 benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ I 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 da s 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 1 certify that I have read this application and state that the abov i ormation is [eby
t. I agree co ply with all
work for which this permit is issued (Sec. 3097, Civ. C.). - - cAte:-t
my ordi antes and state laws relating to buildin r coon, and uthoriz re r entatives
- oent r upon the above-mentioned propert ar nspe 'on purpos
Lender's Name:
nature (Applicanor Agent):
Lender's Address: -
LQPERMIT
Application Number . . . . .. 07-00000850
Permit WALL/FENCE PERMIT'
=. Additional desc
Permit Fee 54.00 Plan Check
Fee
.00
Issue Date -Valuation
2125
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
85 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 .00,•. .00
.00
.00
Grand Total -54.:00 .00
00
54,. 00
- LQPERMIT -