06-2885 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:-
06-00002885
Property Address:
81790 EAGLE CLAW DR
APN:
764-280-999-39 -300235-
Application description:
WALL/FENCE
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
2125
Applicant: Architect or Engineer:
LICENSED CONT CTOR'S DECLARATION
1 hereby irm u r penalty of perj I am licensed , nd provisions of Chapter 9 (commencing with
Section:? )Of ivision`3 of the nd Profewio Is ode, and my License is imfull force and effect.
I.J. 'ce - No.: 672285
ate: ra
OWNER -8111 LDER DECLARATI O N
I hereby affirm under penalty of perjury that I,am exemptfrom 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 Settlor 70001 of;Dlvision 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:applicam to a civil penalty of not more than five hundred dollars (8500).:
1 _ 1 I, as owner of the property; or my employees with wages as their sole compensation, will do the work, and
the structure isnot intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to en.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 ProfessionsCode: The Contractors' State License Law does not apply to an owner of
property, who.builds or improves thereon, and who contracts forthe projects _with a contractor(s) licensed
pursuant to the ContrectoW State License Law.).
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
CONSTRUCTION LENDING AGENCY
I hereby affirm underponalty 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:
i:,Q oulm
Owner:
SHEA LA QUINTA.
C/O JEFF MCQUEEN
88'00 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/09/06
Contractor: ItAUG
SHEA HOMES, INC.
812_60 AVENUE 62
LA QUINTA, CA 92253 14 2006
(760)777-600.5
LiC. No.: 672285
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.
II 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 AMERICAN HOME Policy Number 1247619
I certify that, in.the perfo ante of the work for whichAN rmit is issued,_ shall not employ any
on
:m any manner as tom subject to the w 'compensation laws of California,
an agreeahat; H Ls_houl co esu to worker ' c pensatlon,provisions of'Section
3 t Labor all girth h comp with a provisi , .
nt:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL; AND SHALL
DR
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNED THOUSAND
DOLLARS (9100,000). 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 fora 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 resultof this applicetlon,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of Le Quints, 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.lf'work is not commenced
within 180 days from date of issuance of ch permit, or cessation of work for. 180 days will subject.
rmit to cancellation.
pe
Lcertrfy hat I ve read this application andstate th abo Info anon is_corr agree to comply with all
ci nt rdinances and state laws relating buil co stru n, her y a horize representatives
of is t er upon the above-mentioned operty or' pact: purp
e ure (Applicant •orAge
Application. Number . . . . 06-00002885'
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 54.00 Plan Check Fee .00
Issue Date . . . Valuation . . . . 2125
Expiration Date 1/30/07
Qty Unit Charge Per Extension
BASE FEE 45.00
1.00 9.0000 THOU BLDG 2,00.1-25,000 9.00
-------------------- -------------------------------------------------
Special
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Special Notes and Comments
LOT 39 - 220 L.F. 6' GARDEN WALL, ORCO
SYSTEM
Fee summary. Charged Paid Credited Due
------- •---------------------------- - ------ ----------
Permit Fee Total 54:.0.0 .00 .00 54.00
Plan Check Total. .00 .00 .00 .00
Grand Total 54.00 .00 .00 54..00
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