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09-0999 (BLCK)f P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: V�I09_ =00000999 1 Property Address: 81307 JASMINE CT APN: 764-280-999-35 -300236- Application description: WALL/FENCE Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 2000 Applicant: Architect or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION • 4vQ" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby ffirm u der penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Secti 7 001 o Division 3 of the u in ss and Pro es ienals Code, and my License is in full force and effect. Lic s a B r License No.: 855368 5ate:tivA ontractor: 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 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.). (_ 1 1 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 ------------------ 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 V issued. L 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 issu , I shall not employ any person in any manner so as to become subject to the workerscomp s ion laws of California, a agree that, if I should becom suLctct.o.the wo kers com ns io pr visions of Section of th Labor Cod I shall rthply w th a 'ovi l, / Applicant: WARNING: FAILURE TO SECURE W RKER ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN P ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION T 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 permi to cancellation. I c i t t I hav read this application and state that the ab ve information is correct. I agr to comply with all cit unty inances and state laws relat to b "din con ruction, and her y auth r' a representatives of thi y t nter upon above-mentio e o rty f e, on pu te: nature (Applicant or Agent . � CPaie: U/16/0 Owner: I�! (nj SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER 350 SCOTTSDALE, AZ 85258 CffX `:F�y::zuie��'r� Ica rrZ}' Contractor: SHEA HOMES LIMITED PARTNERSHIP 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 V issued. L 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 issu , I shall not employ any person in any manner so as to become subject to the workerscomp s ion laws of California, a agree that, if I should becom suLctct.o.the wo kers com ns io pr visions of Section of th Labor Cod I shall rthply w th a 'ovi l, / Applicant: WARNING: FAILURE TO SECURE W RKER ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN P ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION T 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 permi to cancellation. I c i t t I hav read this application and state that the ab ve information is correct. I agr to comply with all cit unty inances and state laws relat to b "din con ruction, and her y auth r' a representatives of thi y t nter upon above-mentio e o rty f e, on pu te: nature (Applicant or Agent . LQPERAIIT Application Number . . . . . 09-00000999 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee 45.00 Plan Check Fee .00 Issue Date Valuation . . . 2000 Expiration Date 3/15/10 Qty Unit Charge Per Extension BASE FEE 15.00 15.00 2.0000 HND BLDG 501-2,000 30.00 ---------------------------------------------------------------------------- Special Notes and Comments 125 L.F. 3' RETAINING WALL, ORCO SYSTEM. 2007 CODES. ---------------------------------------------------------------------------- Other Fees BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited -------------------- Due --------------------------- Permit Fee Total ---------- 45.00 .00 .00 45.00 Plan Check Total .00 .00 .00 .00, - Other Fee Total 1.00 .00 .00 1.00. Grand Total 46.00 .00 .00 46.00 R Bit, # Submittal City of La Quinta Building & Safety Division P.O. Box 1504,78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: I `3Q� Jt� (Pub- Owner's Name: Shea Homes A. P. Number: Address: 60-800 Trilogy Parkway Legal Description: Trilogy @ La Quinta City, ST, zip: La Quinta, CA 92253 Contractor: Shea Homes Amount Telephone: 760-77.7-6032 Structural Calcs. Address: 60-800 Trilogy Parkway Project Description: Lot 5 City, ST, zip: La Quinta, CA 92253 Oreo Combo Wall - if x 6'& 3' Telephone: 760-777-6032nt - F1_N -_ Im Orco Garden Wall - if x 6' State Lic. #: 640934 Called Contact Person City Lic. #: Orco Retaining Wall -125f x 3' Arch., Engr., Designer: Orco Knee Wall - if x 4' Address: Plans picked up City, ST, Zip: Construction Telephone: State Lic. #: Flood plain plan r ', Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Gabbie Nieto Sq. Ft.: T#stories: # Units: Telephone # of Contact Person: 760-777-6032 Estimated Value of Project: APPLICANT: 00 NOT WRITE BELOW 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 2nd 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:- "d 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 78495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 09-000009"99� Property Address:81307 JASMINCT APN: 764-280-999-35 -300236- _ Application description: WALL/FENCE Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 2000 Applicant: c&t!t440" Architect or Engineer: ►lI P, ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Ahereby m*undepenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with 03 of the Busine and Professio aIs Code, and my License is in full force and effect. License No.: 672285 tractor: 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 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.). (_ I 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: 10/08/69 Owner: SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER 350 SCOTTSDALE, AZ 85258 1, Contractor. SHEA HOMES, .INC. v 60800 TRILOGY PARKW C, LA QUINTA, CA 92253 ��iJSr1P� (760)777-6005 Lic. No.. 672285 ------------------ 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, a d agree that, if I should become subject to the workers' compensation provisions of Section 0 othe Labor Code, I shall fo [with comply with those provisions. icant: WARNI G: FAI�10111f0p"SECUREWtE ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CALTIES 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 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 that I have read this application and state that the above information is correct. I agree to comply with all city an. WSi d state laws relating to building construction, and hereby authorize representatives of is he bove-mentioned p party for inspection purposes. D 'te (Applicant or Age LQPERMIT i Application Number . . . . . 09-00000999 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee 45.00 Plan Check Fee .00 ` Issue Date 9/28/09 Valuation . . . . 2000 Expiration Date 3/27/10 Qty Unit Charge Per Extension BASE FEE 15.00 15.'00 2.0000 HND BLDG 501-2,000 30.00 ---------------------------------------------------------------------------- ' Special Notes and Comments 125 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 . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 CHANGE OF CONTRACTOR 4.50 ' Fee summary Charged Paid Credited ------------------------------ Due --------------------------- Permit Fee Total 45.00 45.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 5.50 1.00 .00 4.50 Grand Total 50.50 46.00 .00 4.50 LQPERMIT i