04-4451 (BLCK)BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
)78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
;Apple tion Number 04 000-04451 Date 5/21/04
Property Address . . . . . 60502 LACE LEAF CT
APN: 764-270-999-121 -300231-
Application description . . . WALL/FENCE
Property Zoning . . . . . MEDIUM HIGH DENSITY RES
Application valuation . . 6620
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 90.00 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 6620
Qty Unit Charge Per Extension
BASE EEE ;,t 45. 0 0 .
5.00 9.0000 THOU BL66-2,`001-25,000 45._00
--------------- ------------------------------------------------------------
Special Notes and Comments
220 L.F. 6' GARDEN WALL, 70 L.F. 3'
RETAINING WALL, BOTH ORCO SYSTEM -" u ,'
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ------------ ----------
Permit Fee Total 90.00 .00 ..00 90.00
Plan Check Total .00 .00 .00 .00
Grand Total 90.00 .00 .00 90.00
. � t
P.O. BOX 1504 ,G`��
78-495 CALLE TAMPICO � VOICE (760) 777-701:
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-701 1
INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: _ 0 y �t� 15 Date:
Applicant: Architect or Engineer:
Applicant's Mailing Address: Architect or Engineer's Address:
Lic. No.
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm un" nalty of perjury that I am lice=icense
ions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Code, and ss LicBps�is in full force and effect.
License Class 3�
d —
Date l� V nt16. ractor
I herebyaffirm under OWNER43UILDER DECLARATION
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 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) o 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. , B.8 P.C. for this reason
Date Owner
I hereby affirm under penaltyof WORKERS' COMPENSATION DECLARATION
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 and will maintain ers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
n do rcaraar,�y�
mss ers �j 1yQ(IL anee l 1 j
Cam • "N� aeriry Number
_ I certify that, in the performance of the work fo rch this permit is issued. I shall not employ an
y person in any manner so me subject to the workers'
compensation laws of California, and ogre th t if I should become subject to the workers' compensation provisions o Saections to e37�00 f the Labor ode I shall
to hwith Comply with those provi 'ons.
Date mZ�
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.
I hereby affirm under penalty of perjury that there isa construction lending RUCTION LENDING AGENCY
con
9 agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name
Lender's Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a
med
1. Each Person upon whose behalf this application is made, each person at wehosresrequest and for hto the rose benefitions and t snpeA s set forth under on this a Pursuant to an
issued as a result of this application, the owner, and the. applicant, each agrees to, and shall, defend, indemnity and hold harmless the City of La Ouinta, any permit
officers, agents and employees for any act or omission related to the wb in
2. Any permit issued as a result of this application becomes null and void if i sno formed under
rwifollowing� ssuance ethis
a issuance of such pem7iL or
cessation of work for 160 days will subject permit to cancellation.
I certify that I have read this application and state that the above i rhation is co agree to comply with all city and county ordinances and state laws relating to building
construction, an hereby authorize representatives of this county nter n toned Property
C_A� p party for inspection purposes.
Date Signature (Applicant or Age : J
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