04-5196 (BLCK)I
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BUILDING & SAFETY DEPARTMENT
)x 1504 (760).777-7012
CALLE TAMPICO FAX (760) 777-7011
NTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
APN:
Application description . . .
Property Zoning . . . . . . .
Application valuation . . . .
Owner
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE AZ 85258
V0 40.00.0.51-9 6- Date 6/29/04
60430 DESERT ROSE DR
764-270-999-8 -300233-
WALL/FENCE
MEDIUM HIGH DENSITY RES
1625
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
----------------------------- =---------------- 7 -7 ---------------------------
Permit . . . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee 39.00 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 1625
Qty Unit Charge Per Extension
BASE FEE 15.00
12.00 2.0000 HND BLDG 501•-2,000 24.00
----------------------------------------------------------------------------
Special Notes and Comments
65 L.F. 6' GARDEN WALL, ORCO
SYSTEM
Fee summary Charged Paid Credited Due
---------- ---------- ----------
Permit Fee Total 39.00 .00 .00 39.00.
Plan Check Total .00 .00 .00 .00.
Grand Total 39.00 .00 .00 39.00
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P.O. BOX 1504 '�� VOICE (760) 777-7012
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78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: / 9 65:1 I Date: % - �2 -Gy
Applicant:
Applicant's Mailing Address:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby aff penalty of perjury that I am licensed under provis6nsf �gmmencinga with Section 7000) of Division 3 of the Business and Professionals
Code, and y U in full force and effect. cense Class censel
Data
L
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 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 fora 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
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.
have a will maintain ers' compensation insurance requi y U.' n, 3700 of the Labor Code, for the performance of the work for which this permit is
sued M workers' pensation in3urarice ca oli �e:L
Carrier __,::Policy Number i
_ I certify that, in the lgrfoTmance of the work for which thlis permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws 2those
'and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply wit
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 AGENCY
I hereby affirm under 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
Lender's Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT 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 to, and shall, defend, indemnify and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit.
2. Any permit issued as a result of this application. becomes null and void if work 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.
I certify that 1 have read this application and state that the above ir4agnIkon is correct. "Moned
all city and county ordinances and state laws relating to building
construction, end h reby authorize representatives of this Cc6un!nter pon afor inspection purposes.
/bate Si ture (Applicant or Agen
COMPRESSION STRENGTH TEST RESULTS
Client: Shea La Quinta, LLC Date: 11/14/04
Project: Trilogy @ La Quinta - Shea Homes Project No: 02-1109
81-260 Avenue 62
La Quinta, CA 92274
Set ID Structure Age of Test Compression Strength
JCM ID Location Date Cast Cylinder ID (days) (psi)
Set A Phase 7B - Lot # 3008 Slab on Grade 9-23-04 Concrete
2734W Entry Required psi: 4000
7741 7 2850
CC) q30 1-0s6 PIC I'JLc 7742 28 4240
7743 28 4300
Page 1.of a
CERTIFIED:
JW Inspections supplies Me service
of compression strength test results only.
Per ASTMC39
JCM Inspections
39725 Garand Lane Suite F
Palm Desert, CA 92211
INSPECTIONS
Phone: 760-345-5554 - Fax: 760-772-3895
INSPECTIONS
COMPRESSION STRENGTH TEST RESULTS
Client: Shea La Quinta, LLC Date: 11/14/04
Project: Trilogy @ La Quinta - Shea Homes Project No: 02-1109
81-260 Avenue 62
La Quinta, CA 92274
Set ID Structure Age of Test Compression Strength
JCM ID Location Date Cast Cylinder ID (days) (psi)
Set A Phase 7B - Lot # 3008 Slab on Grade 9-23-04 Concrete
2734W Entry Required psi: 4000
7741 7 2850
CC) q30 1-0s6 PIC I'JLc 7742 28 4240
7743 28 4300
Page 1.of a
CERTIFIED:
JW Inspections supplies Me service
of compression strength test results only.
Per ASTMC39