07-0630 (BLCK)P.O. BOX 1504 *VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX' (760) 777-7011
LA QUINTA, CALIFORNIA 92,253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
31 Date: 2/27/07
Application Number: X07-09000-0630 ._ Owner:
Property Address: 61787 TORO CANYON WY SHEA LA QUINTA
APN: 764-280-999-129 -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: - 4250 - D
Contractor: v d
Applicant: Architect or Engineer: -.SHEA -HOMES, INC. -
60800 TRILOGY_ PARKWAY- �(JAp ��o�
LA QUINTA, CA 92253 ,`11111
(760)777-6005 Qli
®�
Lic. No.. 672285 �t�TA_
C/,
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 1700q) of Division 3 of the B iness and Profe sionals 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
' LicMe
'c rise No.: 6722 B 5 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. '
` tA• 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 permitisissued. 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 ISec. 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 per on in any manner so as to become subject to th�'ioh rke '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 anQl�agree that, if I should me subj ct t the wos'.c mpensation provisions of Section - -
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or �/��=•y�00pf3fie Labo:Cod II forth co Igyniov' ions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by IVVv l
any applicant for a permit subjects the applicant to a civil penalty of not more than -five hundred dollars (5500): e. scant:
(_ 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 Professi6ns 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 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
t 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
• • - - - withir- 180 days from date of issuance of such permit,, of 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 Pat Iha a read this application .and •state that the above information is correct. - gree to comply with all
- • work for which this permit'is issued ISec. 3097, Civ. C.L. - . c' d o ty rdtLiORces and. state laws relating- ilding c str tion andh ,ereby �u horize representatives
n r on the above-m:ntione for in acts p se
Lender's Name: �hqQ #.
ate: gnature (Applicant or Agent):
Lender's Address:
LQPERMIT
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Application Number 67-,60000630
-Permit' WALL/.FENCE_ PERMIT
-
�,
Additional_.desc
Permit Fee 72.00
Plan Check
Fee
-.00
..Issue Date. 1. ... "."-V
' 4250
Expiration.bate. 8/26/07 v<.
Qty Unit Charge PerExtension.
BASE .. FEE '
45.00-
-3-.00. 9.0000 -THOU 'BLDG 2;.001-25;000
27.00 ,
------------------ --------------------- Special Notes and Comments"
-------------
.170 L.F. 6' GARDEN WALL,ORCO SYSTEM
Fee summary Charged' " Paid
Credited
Due:
-
Permit Fee: Total 72:00
00"
---
00
- .-- --.--
72.00
Plan Check Total ' _00,
00
.00 "
00" "
-
Grand Tota -1 .72.:00 .'
:.00•.. -.00
72.00
LQPERMTT