07-0847 (BLCK)P.O. BOX 1504 , VOICE 760 777-7012
"::;i
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING &' SAFETY- DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT = =
' Date: 3/22/07
Application Number:'07-00000847 Owner:
Property Address:. 61721 TORO CANYON WY SHEA .LA QUINTA
APN: 764-280-999-126 -300237- C/O JEFF MCQUEEN
Application description: WALL/FENCE8800 N GAINEY .CENTER 350 "
.Property Zoning: MEDIUM HIGH DENSITY RES SCOTTSDALE, AZ 85258
Application valuation: 1875 D
a
Contractor:
Applicant: Architect or Engineer: SHEA HOMES, INC. Qf
' 60800 TRILOGY PARKWAY
' LA QUINTA, CA. 92253 c3
• (760)7.77-6005
�(� •. Lic. No.: 672285*
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 000) of Nvision 3 of the Business nd Professionals Cod , 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
e c - Lic nse o.: 672285 for by Section 3700 of the Labor Code, for the performance of the'work for -which this permit is
issued.
a - ctor: - 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 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 a ee that, if I u ecome subject t t orkers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or f the Lab C I hall fo hwi h com ith those 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 (5500).: icant: .
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 ($100,000). IN ADDITION.TO,THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN , -
" improvements arenot 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
't' (_) 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,
(_ 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 Ouinta, 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. '
hereby affirm under penalty of perjury that there is a construction lending agency for theperformance of the I certify t at I have read this application and state that information is correct. I gr a to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). cit c unty or i nces and state laws relating t 'Id g c uctio ,and he by au or a representatives
0 o toe a upon the above-mentioned opert for in' tion urposes. -
Lender's Name: '
e (Applicant or Agent . '
Lender's Address: - - -
LQPERMIT -
_ Application Number .. . . . 07-00000847
Permit WALL/FENCE,.PERMIT
_ Additional desc .
Permit Fee 43.00 Plan Check Fee
.00
Issue Date. Valuation• . .
. 1875•
Expiration Date 9/18/07 ,
Qty Unit Charge Per
Extension
BASE FEE
15.00"
14.00 2.0000 HND BLDG '501-2, 000
28.00,-
- - - -- -- - -- -- - --
Special Notes and Comments"
- - - - - - - -
75 L.F. 6.' GARDEN WALL, ORCO SYSTEM
" Fee summary Charged Paid Credited
----------
Due
Permit-Fee Total 43.00 00 .00
43.00
Plan Check Total .00 ."00 .00
.00•
Grand Total 43.00 00 .00
43.00 i
- LQPERMIT