04-4457 (BLCK)BUILDING & SAFETY DEPARTMENT
K 1504 (760).777-7012
:ALLE TAMPICO FAX (760) 777-7011
TA, CALIFORNIA 92253 INSPECTION' REQUESTS (760) 777-7153
BUILDING PERMIT
r . . . 04-00004457
Property Address . . . . . 60607 LACE LEAF CT
APN: 764-270-999-115 -300231-
Application description . . . WALL/FENCE
Property Zoning . . ... . . . MEDIUM HIGH DENSITY RES
Application valuation �_ 2300
Date 5/21/04
Owner !Contractor t
------------------------ - '
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SHEA LA QUINTA SHEA HOMES, INC.
C/O JEFF MCQUEEN 81260 AVENUE 62
8800 N GAINEY CENTER 350 LA QUINTA CA 92253
SCOTTSDALE AZ 85258 (760) 777-6005
WCC: NTL UNION INS
WC: 7165833 08/01/04
CSLB: 672285 06/30/05
CCC: B
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Permit . . . . . . WALL/FENCE PERMIT
Additional..desc .
Permit Fee . . . . 54.00 Plan Check Fee .00
Issue Date . . . Valuation . . . . 2300
Qty Unit Charge Per. Extension
BASE FEE i4.`.,-f•�1.. �; ' _ �.-£ 45.00
1.00 9.0000 THOU BLDG 2,00.1-25,000 9.00
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Special Notes and•Comments ,
92 L.F. 6' GARDEN WALL, ORCO SYSTEM
Fee summary
------------------
Permit Fee Total
Plan Check Total
Grand Total
Charged Paid
54.00 .00
.00 .00
54.00 .00
Credited Due.
.00 54.00
..00 .00
.00 54.00
P.O. BOX 1504 a/,����
78.495 CALLE TAMPICO II VOICE (760) 777-701:
LA QUINTA, CALIFORNIA 92253 4VFAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
Application Number: 445 7
AM I' t I Date:
V Ica" .
Applicant's Mailing Address: lehlu
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm u enalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professio
Code, and my Li full force and effect. t,. nals
License Class License No. 3
I hereby affirm under penaltyof OWNER -BUILDER DECLARATION
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 ($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 (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 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.).
U 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.).
U I am exempt under Sec. , BA 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 self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance
the work for which this permit is issued.
_ I have a� tyilllmaintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
er j1As. ue VLy% \o;ks' compgn, ation insure mer and policy number are:
f! , Number
_ I certify that, in the performance of the work for whic is 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, ' 1 hould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I sll
' /� forthwith comply with those pro ' i he
�. Date �Y Applicant
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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I herebyaffirm under CONSTRUCTION LENDING AGENCY
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
IMPORTANT APPLICANT ACKNOWLEDGEMENT
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 issued as a result of this application, the owner, and the applicant, each ag es to, and shall. defend, whose
nity and hold � t work is pertoplication
under or Pursuant
Ou nta any permit
officers, agents and employees for any act or omission related to the wo in
2. Any permit issued as a result of this application becomes null and void if rk is not Comert endr�Inll 0 tlayu�rted this
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 info tion is oo I agree to comply with all city and county ordinances and state Isws relating to building
constructio and reby authorize representatives of this county t upon ve-mentioned property Percy for inspection purposes.
Date
Signature (Applicant or Agent):