08-0525 (BLCK)P.O. BOX 1.504
78-495 CALLE.TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: ( 08-00000525 1
Property Address: t 81379 JOSHUA TREE CT .
APN: 764-280-999-136 -300236-
Application description: WALL/FENCE
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 1625
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER
SCOTTSDALE, AZ 85258
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/28/08
Contractor:
SHEA HOMES, INC.
60800 TRILOGY PARKWAY
LA QUINTA, CA 92253
(760)777-6005
Lic. No.': 672285
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LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I h r' by affi under penalty of perjur that I am li en ed under provisions of Chapter 9 (commencing with
I hereby affirm under,penalty of perjury one of the following declarations:
,Se ti n 7000 Div ion 3 of th ess and P fe ionals 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
Lic i License No.: 672285
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
a ntracto LL -
issued. _
I have and will maintain workers' cumpeosatiun insurance, as required by Sectiun 3700 of the Labur
Code, for the performance of the work for which this permit is issued. 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 CA 1593364
following reason (Sec. 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
p rson in any manner so as to become ubject to the workers' 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
- agree that, if I should become subi t to the workers' compensation provisions of Section
• License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code). or
0 of the Labor de, I shat orth ' y'with those provisions.
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).:
te: pplicant:
(_ 1 1, 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
WARNING: FAILURE TO SECURE W KERS' 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 oroffered 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.).
(_) 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 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:
LQPER.MIT
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 r
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 o cancellation.
I certi'y at 1 have ea this application and state that the above informat n i correct. I agree to comply with all
ty d ounty n and state laws relating to building construction an hereby authorize representatives
'f thi rc I
t he above-mentioned prope for inspection es=�
te: nature (Applicant or Agent):
Application Number " . . . . 08-00000525
Permit . . . . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 39.00 Plan Check Fee
.00
- Issue Date . . . . Valuation . .
1625
Expiration Date 9/24/08
Qty Unit Charge Per
Extension
BASE FEE
15.00
12.00 2.0000 HND BLDG.50i-2,000
24.00
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Special Notes and Comments
.65 L.F. 6- GARDEN WALL, ORCO.SYSTEM
Fee summary Charged Paid Credited
---------------------------
Due
------------------------------
Permit Fee Total 39.00 .00 _ .00
39.00
Plan Check Total .00 .00 .00
.00
Grand Total 39.00 .00 .00
3.9.00
J
LQPERMIT