09-1000 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 09-00001000
Property Address: 81295 JASMINE CT
APN: `764-280-999-34 -300236-
Application description: WALL/F„ENCE
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 1040
Tit!t 4 4a Q"
Applicant: Architect or Engineer:
�l,4
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby -form u der penalty of perjury th t I am license u der provisions of Chapter 9 (commencing with
Secti 7 00) o Division 3 of the s s and Professi na Code, and my License is in full force and effect.
Li C e e 855368
Date: C tracto . J
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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).:
(_) 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 through his or her own employees, provided that the
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.).
(_) I, 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 contractors) licensed
pursuant to the Contractors' State License Law.).
(_) I am exempt under Sec. , B.&P.C. for this reason
- Date:
Owner:
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:
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/16/09
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN n_ Q
8800 N GAINEY CEN 350 1
SCOTTSDALE, AZ 85 8
SCEP 2'3 Z9 -i99
Contractor: CITY OF LAr^i4IN;A
SHEA HOMES LIMITE PARTNUR;MI'I f',}F}'`d
60800 TRILOGY PKWY
LA QUINTA, CA 92253
(760)777-6032
Lic. No.: 855368
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance 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 issued. My workers' compensation
insurance carrier and policy number are:
Carrier NTL UNION INS Policy Number WC6987825
_ I certif that, in the performance of the work for which this permit is iss , I shall not employ any
pe i n in any manner so as to bec me subject to the workers' comp anon laws of California,
an gree that, if I should come ubj t to the workers' compens i n visions of Section
Of the Labor Code, h f hw h comply with hos ro s.
ate:- I pplicant:
WARNING: FAILURE TO SECURE WORKEA-LTIES
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL P AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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, 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.
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 t • t I ha a read this application and state that the above information is correct. I agree comply with all
city c unty dinances and state laws relating to�,tyngi con uction, and here authoriz presentatives
of this niy nter upon eabove-mentioned prf in coon urposes.
te: 'J�r Si ature (Applicant or Agent):
Application Number . . . . . 09-00001000
Permit . . . WALL/FENCE
PERMIT
Additional desc . .
Permit Fee 27.00
Plan Check Fee
.00
Issue Date . . . .
Valuation.
1040
Expiration Date 3/15/10
Qty Unit Charge Per
Extension
BASE
FEE
15.00
6.00 2.0000 HND BLDG
501-2,000
12.00
----------------------------------------------------------------------------
Special Notes and Comments
65 L.F. 3' RETAINING WALL, ORCO
SYSTEM.
2007 CODES.
-
Fee summary Charged
--------------------
Paid Credited
--------------------
Due .
-----------------
Permit Fee Total 27.00
.00 .00
27.00
Plan Check Total .00
.00 _.00
.00
Grand Total 27.00
.00 .00
27.00
1
LQPERMIT
Bin #
Permit # City of La Quinta
,, Building & Safety Division
P.O. Box 1504,78-495 Calle Tampico
' t a�� La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: Cf Owner's Name: Shea Homes
A. P. Number:
Legal Description: Trilogy @ La Quinta
Contractor: Shea Homes
Address: 60-800 Trilogy Parkway
City, ST, zip: La Quinta, CA 92253
Telephone: 760-777-6032
R
- M Ira
State Lic. #: 640934 City Lic. #:
Arch., Engr., Designer
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Address: 60-800 Trilogy Parkway
City, ST, zip: La Quinta, CA 92253
Telephone: 760-777-6032
Project Description: Lot 3 Li
Orco Combo Wall - if x 6' & 3'
Orco Garden Wall - if x 6'
Orco Retaining Wall -65 if x 3'
Orco Knee Wall - If x 4'
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Gabbie Nieto Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: 760-777-6032 Estimated Value of Project:
APPLICANT: 00 NOT WE 1ELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2n° Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
7° Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 09-00001000
Property Address: 81295 JASMINE CT
APN: 764-280-999-34 -300236-
Application description: WALL/FENCE
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 1040
Applicant:
Ta�v 4t G�st,1w
VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
Architect or Engineer:
BUILDING PERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER
SCOTTSDALE, A _8'_258
Contractor:
SHEA HOMES,IN
Date: 10/08/09
2 n' 'J
�s1,��
60800 TRILOGY Axt n sax ._. - --
LA QUINTA, CA 2253 („jy�:*9e41.iL'F't�l�
(760)777-6005
r Lic. No.: 672285
/ ------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I herebyffirm un er penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 0i
10 of ivsion 3 of the us nes and Profes on Is Code, and my License is in full force and effect.
Li se laB, license No.: 672285
Dat tractor:
I OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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).:
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
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 through his or her own employees, provided that the
_ 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.).
(_) I, as owner oftheproperty, 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.).
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
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:
Lender's Address:
LQPERMIT
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance 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 issued. My workers' compensation
insurance carrier and policy number are:
Carrier NTL UNION INS Policy Number WC6987825 .
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,
anfagree that, if I shout become subject to the workers' compensation provisions of Section
00 of the Labor Co sha I fort nth comply with those provisions.
Uat WApplicant:
WARNING: FAILURE TO SECURE WOR RS' 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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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, 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 is correct. I agree to comply with all
cit and ounty o dinances avid state laws relating to building construction, and hereby authorize representatives
Of
is c un / Hier upon the above-mentioned propert for inspect purposes.
�a eY r nature (Applicant or Agent):
t - '
� -- z
.6!7
Application Number . . . . . 09-00001000
Permit .. . . .. WALL/FENCE PERMIT
Additional desc . .
Permit Fee 27.00 Plan Check Fee
.00
Issue Date . . . . 9/28/09 Valuation . . .
. 1040
Expiration Date 3/27/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
6.00 2.0000 HND BLDG 501-2,000
12.00
---------------------------------------------------------------------------=
Special Notes and Comments
65 L.F. 3' RETAINING WALL, ORCO SYSTEM.
2007 CODES.
CHANGE OF CONTRACTOR FEE ASSESSED TO
INSERT SHEA HOMES INC. AS NEW CONTRACTOR
OF RECORD.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . CHANGE OF CONTRACTOR
4.50
Fee summary Charged Paid Credited
----------------------------------------------------------
Due
Permit Fee Total 27.00 27.00 .00
.00
Plan Check Total .00 .00 .00
.00
Other Fee Total 4.50 .00 .00
4.50
Grand Total 31.50 27.00 .00
4.50
LQPERMIT
I