09-0948 (SPIN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
09-00000948
Property Address:
61002 DESERT ROSE DR
APN:
764-270-999-124 -300231-
Application description:
SPECIAL INSPECTION
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
100
T4ht 4 4 Q�&&
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby aff' m unde penalty of pe rjthat I am licensed unde provisions of Chapter 9 (commencing with
Sectio 7 q0 ) ' f 'i si 3 of the Bur e and Profession als ode, and my license is in full force and effect.
Licens CI Lic ns No.: 672285
te: U ont ctor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
construct, after, 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 Contractor's 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).:
(_ 1 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 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.).
(_ I 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.). -
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
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:
LQPERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUE
8800 N GAINEY
SCOTTSDALE, AZ
Contractor:
SHEA HOMES., INC.
60800 TRILOGY PARK
LA QUINTA, CA 9225
(760)777-6005
Lic. No.: 672285
r'� 1
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
O�Date: 10/08/09
i
Id
1�9
------------------
WORKER'S 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.
y i I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
T Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier NTL UNION INS Policy Number
_ 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,
an agree that, if 1 should become subje� to the workers' compensation provisions of Section
7 0 of the Lab6r CrI shall to ft c pF( with those provisions.
4te" cant:
. FAILURE TO SECURE WORK ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
AN EMPLOYER TO CRIMINAL FIENALTIES 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.
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 th I have read this application and state that the above information is correct. 1 agree to comply with all
;ty and co my ordinances and state laws relating to but ing constructio reby authorize representatives
histhe above-mentioned prop r forinspecti urposes.
e: ture (Applicant or Agent):
Application Number . . . 09-00000948
Permit : .
. SPECIAL INSPECTION
Additional desc .
Permit Fee . ..
. 100.00 Plan Check Fee
.00
Issue Date
9/14/09 Valuation . . .
. 100
Expiration Date
4/04/10
Qty Unit Charge
Per
Extension
BASE FEE
100.00
----------------------------------------------------------------------------
Special Notes and
Comments
SPECIAL INSPECTION TO FINAL SFD UNDER
RIVERSIDE COUNTY
PERMIT #BRS023470.
CHANGE OF CONTRACTOR
FEE ASSESSED TO
INSERT SHEA HOMES
INC. AS NEW CONTRACTOR
OF RECORD.
----------------------------------------------------------------------------
Other Fees . .
. . . CHANGE OF CONTRACTOR
4.50
Fee summary
Charged Paid Credited.
Due-
-----------------
Permit Fee Total
---------- ---------- ---------- ----------
100.00 100.00 .00
.00
Plan Check Total
.00 .00 .00
.00
Other Fee Total
4.50 .00 .00
4.50
Grand Total
104.50 100.00 .00
4.50
LQPERMIT
`filq� 4
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/03/09
Application Number: 09-00000948 Owner:
Property Address: 61002 DESERT ROSE DR SHEA LA QUINTA
APN: 764-270-999-124 -300231- C/O JEFF MCQUEEN
Application description: SPECIAL INSPECTION 8800 N GAINEY CENTER 35 D d
Property Zoning: MEDIUM HIGH DENSITY RES SCOTTSDALE, AZ 85258
Application valuation: 100 SEP 14
2009
Contractor:
Applicant: Architect or Engineer: SHEA HOMES LIMITED PAR NERS pF�QUINTq
60800 TRILOGY PKWY FINANCE�EPL
LA QUINTA, CA 92253
(760)777-6032
Lic. No.: 855368
------------------------------=---------------------7--------------------------------------------
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereb affirm under penalty of perjury t at 1 am lice sed nder provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
S n 7000) Division 3 of the u ' sand Prof ssio als Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
c e s B License No.: 855368 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
ate: ontracto I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier NTL UNION INS Policy Number
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to *WARNING:
hat, in the performance of the work for ich this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the in any manner so as t bec me sub'eyllwoerLe,or
thwkers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's Stateree that, if I s I be om subject o co pensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) orof the Labor C I s rthf4ith oprovisions.
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 155001.: A cant:
(_) 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 TO SECURE WO RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
(_ 1 1, 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.).
1 _ I I am exempt under Sec. , 8.&P.C. for this reason
Date:
Owner:
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: K
LQPERMIT
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
klave
to cancellation.
I certi thread this application and state that the above inf rmation is correct. I agr to c mply with all
c' onances and state laws relating to build' cons ctio , and hereby auth ize r resentatives
o ter uponth bove-mentioned prope f ins ti urposes.at ISig ure (Applicant or Agent):
Application Number
09-00000948
Permit . .
. SPECIAL INSPECTION .
Additional desc .
Permit Fee . . .
. 100.00 Plan Check
Fee
.00
Issue Date
Valuation
. . .
. 100
Expiration Date
3/02/10
Qty Unit Charge Per
Extension
BASE FEE
100.00
-------------------------------------------------------------
Special Notes and
Comments
----------------
SPECIAL INSPECTION
TO FINAL SFD UNDER
RIVERSIDE COUNTY PERMIT #BRS023470.
Fee summary
Charged Paid Credited
Due
Permit Fee Total
100.00 .00
.00
100.00
Plan Check Total
.00 .00
.00
.00
Grand Total
100.00 .00
.00
100.00
LQPERMIT