06-2884 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 0.6-00002884
Property Address: 81780 EAGLE CLAW DR
APN: 764=280-999-40 -30023:5-
Application description: WALL/FENCE
Property Zoning: -MEDIUM HIGH .DENSITY RES
Application valuation: 2500
T4&t 4.4 Qulk&
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereb Nirm_ nder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with'
Se 000) Division 3 of the Bus' ss and Pr ionels Code, and my License is in full force and effect.
s:: Ucense No:: 672285
Date: nMtract
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt froiti the Contractor's StatwLicense Lew for the
following reason, (Sec. 7031.5, Business and Professions. Code: Any city or county that requires•a permit to
construct, alter, improve, demolish, orrepair 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 arta Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Anyviolation of Section 7031.5 by
any applicant for a permit subjects the applicant,to a civil penalty of not more than five hundred dollars (8500).:
(_,)' I, as owner of the property, of my employees with wages as theirsole compensation, will do the work, and
ttwstructureis 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— 1 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,appiy 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 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: A Lender's Address: A
LQPERMPL'
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor: D
SHEA HOMES, INC,.
81260 AVENUE 62
LA QUINTA, CA 92253
(760)777-600.5"
Lic. No.: 672285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7.153
Date: 8/Q9/06
AUG 14 2006
-------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirmunder penalty of perjury oneof 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:L.abor Code, forr the performance of the work for which this permit is
issued.
it, 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 riumber:are:
Carrier AMERICAN HOME Policy Number 124.7619
_ I certify that, In the performance of the work for which this permit is issued,] shall not employ any
person in any manner so as to become subject to theorkers' compensation. laws of California,,
I a4d agree that, if I sNId. mom, subject to the W. ce s' compensation provisions of Section
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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to theMireetor of Building and Safety for a permit subject to the
conditions and restrictions,sat 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, aril the applicant, each agrees to, and shall defend, indemnify. and hold harmless the City
of La Quinta, its officers, agents and employees -for anyact 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,issuanoe,of such permit, or cessation of workJ,ao.,s will:subject
permit to cancellation.
I certify t ctrl have d thisapplication and state that -t bovei ormat is correct. ply with all
city and c my ordi nces:and state laws relating to' Ai uction, erebyesentatives
oft c t toVntova-mentioned pr rty f r.in tion pu
6.plicant or Agent .
Application Number . . . . . 06-00002884
Permit . .
. WALL/FENCE PERMIT
Additional desc .
Permit Fee . . .
. 54.00
Plan Check.
Fee
.00
Issue Date . . .
.
Valuation
. . .
. 2500
Expiration Date
1/30/07
Qty Unit Charge Per
Extension
BASE
FEE
45.00
1.00 .9.0000 THOU BLDG
2,001-25,000
9.00
---------------------------------------
Special Notes and
Comments
-------------------------------
LOT 40 - 100 L.F.
6' GARDEN WALL,
ORCO
SYSTEM
Fee summary
Charged
Paid
Credited
Due
Permit Fee Total
-------- ----------
54_.00
----------
.00
---------
.00
54.00
Plan Check Total
.00
.00
.00
.00
Grand Total
54.00
.00
.00
54.00
�1 �s.�llll