04-4452 (BLCK)BUILDING & SAFETY DEPARTMENT
)X 1504 (760).777-7012
CALLE TAMPICO FAX (760) 777-7011
NTA, CALIFORNIA 92253 INSPECTION REQUESTS (760).777-7153
BUILDING PERMIT
tipplicazion aescription
Property Zoning . . . .
04-00004452/
60546 LACE LEAF CT
764-270-999-120-300231-
WALL/FENCE
MEDIUM HIGH DENSITY RES
Application valuation , ,-- 5690
Date 5/21/04
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
--------------------------------=-------------------------------------------
Permit . . . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee 81.00 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 5690
Qty ' Unit.Charge Per. Extension
_ BASE FEE. �.:_ # . f _ 4 5 . 0 0 .
4.00 9. 0000 THOU'a YBLDG� 2; 0.01-25, 000 ' • . 36.00
------------------------------------------------------------=--
Special Notes and -Comments
170 L.F. 6' GARDEN WALL, 90 L.F. 3!
RETAINING WALL, BOTH ORCO SYSTEM
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Grand Total
Charged
81.00
.00
81.00
Paid Credited Due
---------- ---------- ----------
.00 ..00 81.00
:00 .00 .00
.00 .00 81.00
C&f 4
P.O. BOX 1504
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
Architect or Engineer:
VOICE (760) 777-7012
FAX (760) 777-701 1
INSPECTIONS (760) 777-7153
Date:
rvunneci or tnglneer's Address:
Lic. No
BUILDING PERMIT DECLARATIONS
I hereby affirm u nalt of LICENSED CONTRACTOR'S DECLARATION
y perjury that I am licensed u r provisio s of Chapter 9 ( g with Section 7000) of Division 3 of the Business and Professionals
Code, and my L' full force and effect.
License Ctass 1 License No. C�
Date (O ontractor
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 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 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 he 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.).
(--) I am exempt under Sec. , BA P.C. for this reason
Date Owner
I herebyaffirm under WORKERS' COMPENSATION DECLARATION
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.
1 -have and will maintain w ers' compensati n insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
ssue�. Hl�ws ers' co e s 'o rence� a oli rem
artier Policv Hurn r 113
_ I certify that, in the performance of the work for hich this
permit is issued, I shall not employ any person in any manner so as to become subject to fhe workers'
1�Ahcompensation laws of California, and agree ha , if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
with comply with those provisions.
Date Applica
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.
CONSTRUCTION LENDING AGENCYI hereby affirm under penalty ofperjury 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
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 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 , and shall, defend, indemnity and hold harmless the City of La Ouinta, its
officers, agents and employees for any act or omission related to the work beim
2. Any permit issued as a result of this application becomes null and void if work n I comemenceedunder�1n11180 dayiufrom datef issuance of this ance of such perrIA or
cessation of work for 180 days will subject permit to cancellation.
I certify that I havr-b
ead this application d state that the above information is correct. I to comply with all city and county ordinances and state laws relating to building
construction ndreb
y authorize resentatives of this county to n the a ntio
Property for inspection Purposes.
ate Signature (Applicant or Agent):