06-2886 (BLCK)o `7[
P.O. BOX 1504
78-495 CALLE TAMPICO
LA. QUINTA, CALIFORNIA 92253
Application Number:
06-00002886
Property_ Address:
81800 EAGLE CLAW DR
APN:
764-280-999-38 -.300235-
Application description:
WALL/FENCE
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
2,125
T4'!t 4 4 QuAI&
Applicant: Architect -or Engineer:
a/A
BUILDING & SAFETY DEPARTMENT
BUILDING .PERMIT
------------------------------------------------
LICENSED CONTRACTOR'SDECLARATION
I.hereby affirm nder penalty of p u that I am licensed under provisions of Chapter 9 (commencing with
Seco 70001 Oivisiom&of tit and P f ionals Code, and. my License is in full force and effect.
FRI License -No.: 672285
Dat . ontrector:
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.. 7631.5,.Busihess and Professions Code: Anycityor county that requires a permit to
construct, altar; 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 sheds licensed pursuant to the provisiorwof the Contractor's, State
License Law (Chapter 9 (commencing with Section 7000),of Division 3•of the Buainess,and Professions Code) or
that he.or ahe,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 penaltyof not more then five hundred dollars (8500).:
(_) 1,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 ISec. 70", Business and Professions Code: The
Contractors' State, License Law does not apply to an ownerof'property who builds or improves°thereon,
and who does the work himself or herself through hisor 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 sate.).
1—) 1, as owner of the property, am exclusively contracting with licensed contractors to construetthe project (Sec.
7044, Business'and Professions Code: The Contractors' State License Lew does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractors) licensed
pursuant to the Contractors' State. License Law.).
1 _) I�am exempt under Sec. ; B.6P.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 performanceof 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 MCQUEEN
8800 N GAINEY CENTER 3
SCOTTSDALE, AZ 85258
Contractor:
SHEA HOMES; INC.
812,60 AVENUE 62
LA QUINTTA, CA 92253
(760)777-6005
Lic. No.: 672285
VOI.CE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/09/06
50
tDAUG 14 2006
CITY OF LA QUINTA
FINANCE DEPT.
WORKER'S' COMPENSATION, DECLARATION
I herebyaffirm under penalty of perjury one of the,following declarations:
I have and will maintain a certificate of consent to seff-insure for workers' compensation, as provided
for by Section 3706 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 AMERICAN HOME Policy Number 1247619
_ I rtify that, in,the pe rmanceof the work for wh this permit is issued, I shall not employ any
1 rson in any man so, to bbbggqcome subject o orkers"compensation laws of California,
I agree tit it" I I cc s�Dtect to the, rke compensation provisions of Section
(y b of/j he _ _ . C I It rthw ,com ith th provisions.
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 (4100,0601• IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THELABOR CODE; INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Applicatiowis hereby made to the Director GfBuilding 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 requestand for
whose benefit work is performed under or pursuant to any permit issued as a rewlt,of this application,
the owner„and the applicant, each,agrees.to, and shall defend, indemnify and,hold harmless the City
of La Quints, its officers, agents and employees for any act or omissionrelated to the work being
performed under or following issuance of this permit..
2. Any permit'Jssued as.a result of this application becomes, null, and, void if work`is not commenced
within 180 days from date.of issuance of ch permit, or'oessation of w for 180 days will subject
permi to cancellation.
I certify attl hev read this application endstate.th- in f ati- - '-.torr agree to.comply with all
city a my or inances and state laws relating t buil ion, a here a horize representatives
oft ' t er upon above-mentioned p pert n.pur
t
Date: netureiApplicantor Agen_ _
Application Number . . . . . 0.6-00002-886
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
2,001-25,000
9.00
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Special Notes and.Comments
LOT 38 - 85 L.F.
61 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
.60
.00
54.60