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09-0950 (SPIN)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 09-00000950 Property Address: 61030 DESERT ROSE DR APN: 764-270.-999-126 -300231- Application description: SPECIAL INSPECTION Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 100 T4`yl °F xi�Qum& BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER 350 SCOTTSDALE,. AZ 85258 Contractor: Applicant: Architect or Engineer: SHEA .HOMES, INC. 60800 TRILOGY PARKWAY :J LA QUINTA, CA 92253 (760)777-6005 lrI Lic. No.: 672285 -------------------------------------------------------------------------------- LICEJry� S�ED CONTRACTOR'S DECLARATION I hereby irm u der penalty of perjury t t 1�T' licensed under•pr0 isions of Chapter 9 (commencing with Section 7 0 1 o Division 3 of the Busin n{I Professionals C ,fnd my License is in full force and effect. Licems C k ����\\ II Lice s, n: 672285 1 v 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, 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 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).: (_) 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.). (_ 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.). (_) I am exempt under Sec. , B.&P.C..for this reason Date: Owner: CONSTRUCTION LENDING AGENCY 1 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.I. Lender's Name: Lender's Address: LQPERMIT �r 00-, VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/08/09 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. 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 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 pe on in any manner o as to become subject to the workers' compensation laws of California, n agree that, if I ou became ubject o he workers' compensation provisions of Section 0 f the Labor ode„ hall f with comply with those provisions. Det$/ icant: WARNIN FAIL E TO SECURE WOR S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINA ENALTIES 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 Quihta, 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 t0 cancellation. I certify t at I have read this application antl to that the above information is correct. I agree to comply with all Ah ordinances and state laws lati gt building construction, and hereby authorize representatives t o enter upon the above -me tioned p ty for inspection purposes. Sig ure (Applicant ar Age Application Number . . . 09-00000950 Permit . . . . . SPECIAL INSPECTION Additional desc . Permit Fee . . . . 100.00 Plan Check Fee .00 Issue Date . . . . 9/14/09 Valuation . . . . 100 Expiration Date 3/13/10 Qty Unit Charge Per Extension BASE FEE 100.00 ---------------------------------------------------------------------------- Special Notes and Comments SPECIAL INSPECTION TO FINAL SFD UNDER RIVERSIDE COUNTY PERMIT #BRS023472. ` CHANGE OF CONTRACTOR FEE ASSESSED TO INSERT SHEA HOMES INC. AS NEW CONTRACTOR OF RECORD. ------------ ---------------------------------------------------------------- Other Fees . . . . . . .. . 1. 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 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T-v4t 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/03/09 Application Number: 09-00000950 Owner: (f Ql Property Address: 61030 DESERT ROSE DR SHEA LA QUINTA I APN: 764-270-999-126 -300231- C/O JEFF MCQU Application description: SPECIAL INSPECTION 8800 N GAINEY E ERS Property Zoning: MEDIUM HIGH DENSITY RES SCOTTSDALE, Z 58 x'14 ?009 Application valuation: 100 Q Contractor: F �V(`E (/��►Tq Applicant: Architect or Engineer: SHEA HOMES LIMITED PARTN P 60800 TRILOGY PKWY LA QUINTA, CA 92253 N (760)777-6032 LiC. NO.: 855368 ------------------------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereb affirm under penalty of perjury that I am license under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Sectio 7000) f Division 3 of the a and Prof - s nals 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 Li n ss • A 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: C ractor:, 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 _ I certify that, in the performance of the work for which 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 .person in any manner so as to become subject to the work ' com ensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should o e subject to the orke en ation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or f_3 00 of the Labo od , I al forthwt\'th co ply - itIt o pr ' ions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by U't any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 1$5001.: ate pplicant: 1 _ I 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 WARN NG: FAILURE TO SECURE KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJ T 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.). - APPLICANT ACKNOWLEDGEMENT ` (_ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractors) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_ 1 I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City 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.I. Lender's Name: Lender's Address: .p LQPERMIT of La Ouinta, 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 t t I ha a read this application and state tWaboinformation is co, ect. I a r eto comply with all city a c ynty inances and state laws relating tn, an her by i e representatives of t rtL t6 n up the above-mentioned p pur es.te: gnature (Applicant or Agent) Application Number . . . . . 09-00000950 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 #BRS023472. 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 " 0 LQPERMIT