04-4454 (BLCK)�. °
� s
BUILDING & SAFETY DEPARTMENT
�v4 P.O. BOX 1504 (760).777-7012
c?�M= 78-495
CALLS TAMPICO
oF'Tt �i, FAX (760) 777-701 1
rIt
� LA'QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760.) 777-7153
JUN Q � Z00� BUILDING PERMIT
CITY OF U• CNUr :Tf.
App-hcato =Number . . . . x__0.4=0_004454 Date 5/21/04
Property Address . . . . . . 60590 LACE LEAF CT
APN: 764-270-999-118 -300231-
Application description . . . WALL/FENCE
Property Zoning . . . . . . . MEDIUM HIGH DENSITY RES
Application -valuation 2250
Owner Contractor
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 . . . . 2250
Qty Unit Charge Per Extension
BASE - FEE - 45.00
1.00 9.0000 THOU' BLDG'2,,001-25,000 9.00
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Special Notes and Comments
90 L.F. 6- GARDEN WALL, ORCO
SYSTEM
Fee'summary ..Charged Paid
Permit Fee Total 54.00 .00
Plan Check Total 00 ..00
Grand Total 54.00 .00
z
t j
Credited Due
..00 54.00
.00 .00
.00 54.00
P.O. BOX 1504
78-495 CALLE TAMPICO `fl) � VOICE (760) 777.7012
Tar44�G�a�'
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
Application Number: 0 Z/ Date:
Applicant: Architect or Engineer: .
Applicant's Mailing Address: Architect or Engineer's Address:
N
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm un y of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Code, and ss Lice�ll force and effect. ��
cense Class ' e No. _
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of 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 thepermit 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 contractors) licensed pursuant to
the Contractors' State, License Law.).
U I am exempt under Sec. , B.8 P.C. for this reason
Date Owner
WORKERS' 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
1 1 issNgQ._M�workers nsabon i nce ra otic
Aa L VLI\'� ysu2 permit is
Came " . /Policy Number
_ I certify that in the performance of the worts for whi his permit is issu , I s II not employ an
compensation laws of California, and agree thio if should become sub ea to the workers' �rperson in any manner so as to become subject to the workers'
T" -' comply with those provisiorp. t pensation provisions of Section 3700 of the Labor Code, I shell
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
I hereby affirm under penalty of perjury that there isa construction lending agency ONthe perforLENDING
anceAGENCY
Lenders Name e work for which this
permit is issued (Sec. 3097, Civ. C.).
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 a
1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuaica nt to an
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 s nt toa, its
pent
officers, agents and employees for any act or omission related to the work in
g performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if, 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.
Ice" that I have read this applicatiori and state that the above i ornation is co 1 agree to comply with all city and county ordinances and state laws relating to building
constructi n, d hereby authorize representatives of this county enter upon the ve-rnerttioned ro
%► property for inspection purposes.
Dat V Signature (Applicant or Agen