04-4450 (BLCK)rid -
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��1 t�\! BUILDING & SAFETY DEPARTMENT
a-Zi-� w P,.0 'Box 1504 (760).777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
J11sa 1012�81A QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number
Property Address . . .
APN:
Application description
Property Zoning . . . .
A licatinn valuation
. . . 04-00004450 r Date
. . . 60480.LACE LEAF CT
764-270-999-122-300231-
WALL/FENCE
. . . MEDIUM HIGH DENSITY RES
pp .. 4965
J
Owner
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE AZ 85258
5/21/04
Contractor
SHEA HOMES, INC.
81260 AVENUE 62
LA QUINTA CA 92253
(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 . . . . 72.00 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 4965
Qty Unit Charge Per Extension
BASE, FEE 4 5. 0 0 .
3.00 9.0000 THOU BLDG 2,001-25,000 27.00
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Special Notes and Comments s
157 L.F. 6' GARDEN WALL, 65 L.F., 3.'
RETAINING WALL, BOTH ORCO SYSTEM'
Fee summary Charged Paid
Permit Fee Total 72.00 .00
Plan Check Total .00 .00
Grand Total 72.00 .00
Credited Due
..00 72.00
.00 .00
.00 72.00
P.O. BOX 1504
78-495 CALLE TAMPIl.O
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Address:
Architect or Engineer:
VOICE (760) 777-7012
FAX (760) 777-701 1
INSPECTIONS (760) 777-7153
Date:
tArcnneci; or tnglneer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
I herebyaffi LICENSED CONTRACTOR'S DECLARATION
enalty of perjury that I am licensed undo rasions of Chapter 9 (common g with Section 7000) of Division 3 of the Business and Professionals
C e, and my i in full force and effect. � ` A
�nse Clas License No. c
�- Date ontractor tjo=,��
I herebyaffirm under OWNER43UILDER DECLARATION
penalty of perjury that I am exempt from the Contractors' State License Law fort 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' Stale 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 fort 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 r improve for the purpose of sale
o .
(, I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and
State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects w : The Contractors'
ith Professions
contractor(s)
ions oCode:
licensed pursuant to
t 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 t performance
Of the work for which this permit is issued.
I have and will maintain orkers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
�l's� {Id�MY•q�rkers' pensatio rance c�rtll�n
arae 'l•� �+1 Policy Number ` `
_ I certify that, in the performance of the work for ' h this permitis issued, I haalll ot �eemmpplo-y an
compensation laws of California, and agree at, f I should become subject to the workers' compensation provisions of Srson in any manner so aection 3700f t s to become subject
Code, to ft workers,
shall
forthwith comply with those provis' ns.
/ate pli
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.).
Lendees 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 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 pursuant to an
permit
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 Cluinto its
officers, agents and employees for any act or omission related to the work b
ming
2. Any permit issued as a result of this application becomes null and void if is npo rfcormrmonced rwiiMor following
inl t p ay* from date of issuuance of this ance of much
cessation of work for 180 days will subject permit to cancellation. Ooh or
I certify that I have read this application and state that the above i rmation is
constructio , a d hereby, representatives of this county t nt Pon the a agree tocomply
property with all city and county ordinances and stale laws rotating to building
for inspection purposes.
e ignature (Applicant or Agent(): i