04-4940 (BLCK)BUILDING & SAFETY DEPARTMENT
1504. (760),777-7012
\LLE TAMPICO FAX (760) 777-7011
A., CALIFORNIA 92253 INSPECTION REQUESTS (760).777-7153 .
BUILDING PERMIT
Appl:c=at on Number . . . . .
04-0000.4940- Date. 6/16/04
�Add--r-e°ss
Brope.rty
60605 DESERT ROSEDR
.
APN:
764 -270 -.999 -77 -300233 -
Application description
WALL/FENCE
Property Zoning : . . . . .:
MEDIUM HIGH DENSITY.RES.
Application valuation
6500
Owner :
Contractor
SHEA LA QUINTA
SHEA HOMES, INC.
C/O JEFF MCQUEEN
81260 AVENUE 62
8800 N GAINEY. CENTER 350
ISA QULNTA
CA -92253
SCOTTSDALE. . AZ.8.5258..
(7.60) 77.7-600.5
WCC: NTL.UNION
INS
WC: 7165833
08/01/.04
CS1;13:. 6:72.2.85<
06/3.0/05
CCC: B
Permit. WALL/FENCE-PERMIT
`
Additional desc
Permit Fee . . . . 90.00
Plan Check Fee .
..00
Issue Date
Valuation ...
6500
Qty Unit Charge.. Per
Extension
BASE FEE`:
45:00
5.00. 9..000'0 THOU BLDG..2 '0 0 1-25,'O 0. 0
45.00
-:.----------=-----------°----.--------------
special Notes and Comments
---- ----------- --------
�.
--- --- ---------
260 LF 61GARDEN.WALL ORCO STND
Fee summary Charged
Paid Credited
Due
Permit Fee Total 90.00
00 '00
910.00
Plan Check Total 00
.00 .00
.00
Grand Total 90.00
00 00
90.00
P.O. Box 1504 W.
VOICE (.760) 777-7012.
78-495 CALLS TAMPtCo C&t FAX (760) 777-7011
LA QUINTA, CALIFORNIA 922.53 94. INSPECTIONS (76.0)'.777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 04/ 44[ '�'D Date: 16 - 0 �.
Applicant:
Applicant's Mailing Address:
Architect or Engineer:*
Architect or Engineer's d re
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm and�LA�nalty of perjury that l am licensed under provisi ns of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
'Code, and my Lice full force and effect. �� O`er C
License Class _ License No. 6
DateIvZ
Contractor
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 for a permit subjects
theapplicant to a civil penalty of not more than five hundred dollars ($500).):
( j 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
pate 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 selfinsure 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 ve a d will maintain wo rscompensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which.this permit Is
ue� Y/�"�oitc c nsation Insurance ca '
I certify that, in the performance of the work for which this permit Is Issued, I shall not employ.any person in any manner so as to, become subject to the workers'
compensation laws of California, and agree the f I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date �6 Applicant(</ V
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 3700 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 wo 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 I have read this application and state that the above information is corre agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county t upon the e -mentioned property for inspection purposes.
DateSignature (Applicant or Agent):