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07-0632 (BLCK)P.O. BOX 1504' VOICE (760) 777-7012. T4ht 4 78-495 CALLS TAMPICO FAX (760) 777-7011 -LA- Q.UINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT ` • Date: 2/27/07 Application Number: k�,07-00000632 , Owner:- Property•Address: 61765 TORO CANYON WY SHEA LA QUINTA " APN: -764=280-999-128:-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: `2000 Contractor: - Applicant: Architect or Engineer: SHEA HOMES , - INC. 60800 TRILOGY PARKWAY ga�� 12 LA QUINTA,,CA 92253 j� 2007 (760)777-6005' • -. _ LiC. No.: 672285 CF FI.A��l1f1iT'� _ /A ��� � LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penaltyofperjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: t n 7 00) of Division 3 of the Busine s and P_ rofessif nalicode, 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 as � 1 Ltrera N 22 85 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is. x/11 issued. Date�VJP: ontractor: 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 • _ 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 t 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 should become subject to th orkers' 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 LabC-7311. oy'�'�e I s all f rthwi o with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by C� V I 1 1. \, any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500): - - • - e: pplicant: V - 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 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 - .. (_) 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 s pursuant to the Contractors' State License Law.). a _ 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 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: r 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. - 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 the above information is correct I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.1. _ ' city and ounty rdinances and st a laws relal ri :)ding c str tion, and hereb authorize representatives , of i tc enter upon above -mention p y fPr•i ec n Lender's Name: " - , - - • D • ignature (Applicant orAgentl:' • Lender's Address: - - - - -LQPERMIT; - ; •' - Application Number 07-00000632 Permit WALL/FENCE PERMIT �Additional,desc.. - - - - — - Permit Fee 45.00 Plan Check. Fee .00. Issue .Date Valuation 2000. ' ExpirationDate 8/26/07 Qty' Unit Charge Per Extension , BASE FEE 15.00.. 15.00 2.0000 HND BLDG 501-2,000 - 30.00 Special Notes and Comments 80 L. F. COMBO WALL, RETAINING, 6' -(3' GARDEN), ORCO SYSTEM' -Fee -summaryCharged Paid Credited. Due Permit Fee Total 45.00 .00' :'00 45.0.0. • Plan •Check Total 00. ..00 .00 .-00 Grand Total 45.00 .00' .00 - 45.00 LQPERMIT