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04-3508 (BLCK)BUILDING &SAFETY DEPARTMENT I 50Y (760) 777-7012 OFPQT8-495 WALL T PICO FAX (760) 777-7011 L �QuaN�T , CALIFORN.IA 92253. -INSPECTION REQUESTS (760).777 -7153 BUILDING PERMIT Application Number . . . 04-OQ003508` Date 4/16/0I Property Address 81730 SUN CACTUS LN APN: 764-270-999-59 -300231- Application description WALL/FENCE Property Zoning MEDIUM HIGH DENSITY RES Application valuation 108 Owner Contractor ------------------ ---=----%-:--.------------- SHEA LA QUINTA CALIFORNIA POOLS'&.SPAS. C/O`JEFF MCQUEEN P.O. BOX'1280 8.8.0:0.N GAINEY CENTER 350 COACHELLA: CA. 92236 :SCOTTSDALE AZ 85258- (760) 39:8-9222 WCC : STATE FUND Aja;.; :ti:-_ _ WC. - %.0460.0061T:68 01/01/05 CSLB: 6561'28 10/31/04 CCC r. C8• -C27' -C29-053- Permit WALL/FENCE PERMIT Additional desc Permit Fee.-... 15.00 Plan Check Fee D0 Issue Date Valuation . . . . 1J8 ..Qty Unit. Charge Per ExtensiDn BASE FEE 15.00 Special. Notes and .Comments. 5,LF 5.',BLOCK WALL .CITY STND. Fee summary Charged Paid Credited Due Permit Fee Total:...: 15;:00 .00 ..00 15.0.0 'Plan 'Check Total. 00 00, 00 ::00 Grand Total 15.00 .00 '00 15.00 P.O. BOX 1504����/:. �/ VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 440INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Applicant: t ' Architect or Engineer. Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code. and my, Liceruy is iyft{II force and effect !� p License Gass / C, ) s se No. (� / 6 Date 2( Contractor OWNER -BUILDER DECLARATION hereby am under penalty of perjury that I am taffirmI h or county that apt from the Contractors' State License Law for the following reason (Sea 7031.5. Business and Professions Code: Any statement that he orequ r she is licensed to censtrucL alter, �pve. demolish. or repair any structure, prior to its issuance, also requires the applicant for the permit to fie a signed 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 ($500).): 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 (Sea 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 the improvements are not intended or offered for sale. If, however, the budding 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 construct 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 contractor(s) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , B.3 P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificate of consent to set4nsure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the perfomhanee of the work for which this permit is issued. _ 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 5MMY knsation iensur rand pol��hyr2b r �. ��/�� Cartier �hiP _ icy 7" I certify that, in the performance of the work for which 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 that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, l shall forthwith comply with Lase provisi / Date_' Applicant V 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 ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY 1 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 pernit subject to the conditions and restrictions set forth on this application. I. 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, 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 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 ' ect. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to ataertftZheabave-menfioned property for inspection purposes. Date `- ?e"4 Signature (Applicant or Agent):