04-4931 (BLCK)raT_Q.
BUILDING & SAFETY DEPARTMENT
_P..O.. Box 1504. .
(.760),777-7012-
-495
77-70128 495 CALLS TAMPIC.O FAX (760) 777-7011
y' LUA'�QUINTA, CALIFORNIA 92253 INSPECTION'REQUESTS (760).777--7153 .
BUILDING PERMIT
Application Number -04-00004931 Date 6/16/04•
Property Address .... . . . . 81.290 STONE CROP LN'
APN: 764 -270. -999. -81 -300233 -
Application description WALL/FENCE
Property Zoning MEDIUM HIGH DENSITY RES
Application. valuation 5110
-Owner Contractor
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7`7_ a -
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SHEA :LA QUINTASHEA' HOMES, INC.' :
C/O..JEFF MCQUEEN 81260 AVENUE 6.2
880'0 N.- GAINEY . CENTER 350'.,LA .QUINTA CA 92253
SCOTTSDALE AZ 85258 (.760) 771-6005
WCC: NTL -UNION -.INS
WC:. 7.165833 08/01/04
' CSLB•` 672285 OG/3.0/05
CCC: B
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Permit. WALL/FENCE PERMIT
.Additional' desc
Permit Fee 81.00 Plan Check Fee .00
Issue Date Valuation 5110
Qty Unit Charge:.Per Extension
BASE FEE 4-5.00
4.00. 9.0000 .THOU BLDG 2;:00'1'.-25,000 "` 4'' 36.00
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Special Notes and Comments
150 LF '6'GARDEN WALL ORCO STND ,.
85 LF 3 ' RETAINING WALL ORCO. STND
Fee summary .-Charged .Paid Credited Due..
Permit Fee Total 81..00 00 .00 81.00
Plan'Check Total .00 00 :00, ..00
Grand Total 81.00 .00' 00 81.00
•
P.O. Box 1504- TA
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 922.53
Application Number:
Applicant:
Applicant's Mailing Address:
BUILDING & SAFETY DEPARTMENT
VOICE {.760) 777-7012.
. FAX (760) 777-7011
INSPECTIONS (760)'777-7153
Date: 60 " vZ�'�
Architect or Engineer:'
A VA
Architect or Engineer's Ad
Lic. No.
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm u er anally of perjury that l am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
'Code, and my LI n in full force and effect.^�
License Class License N
U I
Date ` I- Contractor 51%Nft0—C-*_
OWNER -BUILDER DECLARATION
I hereby affirn under penalty of perjury that I am exempt from the Contractors` State License Law for the.following.reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant for the permit to file a signed .
statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or.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.):
U 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 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 or through his or her own employees, provided that fhe'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 burden of proving that he or she did not build or Improve for the purpose of sale.).
U 1, as owner of the property, am exclusively contracting with licensed contractors to constrict 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 contractors) licensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec. BA P.C. for this reason
Date Owner
WORKERS' COMPENSATION. DECLARATION
hereby affirm under penalty of perjury one of the following declarations:.
_ I have and will ma1ntain a certificate of consent to self4nsure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work for which this Rermit is issued.
I have an III maintain w rs' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which.this permit is
ed y orkers' co nsation insurance caniem�mIoofloFrximbar e;-�
Carrier Policy Number {. �Q�
_ I certify tha in the performance of the work for whirh this permit is Issued, I shall not employ.any person in any manner so as to. become subject to the workers'
compensation laws of California, and agree t I should become subject to the workers' compensation provisions of Section 3700'of the Labor Code, I shall
forthwith comply with those p
Dateu Applicant 11�+�
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 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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
Lenders Address
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, indemnity 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 certify that I have read this application and state that the above information Is correct Joagree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county to n the ab ve{nehtioned property for Inspection purposes.
Date w ✓cX_Lt4k Signature (Applicant or Agent):