06-0706 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06-00000706
Property Address: 81835 EAGLE CLAW DR.
APN: 764-280-999-119 -300215.-
Application description: WALL/FENCE
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 2875
T4t!t 4 XP Q"
.BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/16/06
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258:
Applicant: Architect. or Engineer:U FEB A HOMES, INC..
60 AVENUE 62
Z®Q� QUINTA, CA 92253
60)777-6005
ic. No..: 672285
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LICENSED CONTRACTOR'S DECLARATION
Lhereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section_ 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
Licensetlnass:- LicenseNo.: 672285
rector:
OWNER4 0JILDER DECLARATION
1 hereby affirm under penalty of perjury that l am exempt from the Contractor's State License Lawlor 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 fora permit subjects the.applicant:to a civil penalty of not more than fivwhundred dollars (8500).:
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 Lioense,Law does not apply town 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 improvemenvis soldwithin
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, as owner of the.property, am exclusively contractingwith 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
I. hereby affirm,underpenalty 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:
LQPE &n
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one:of'the following declarations:
_ I have and:will:maiinain a certificate of consent to self -insure for`workers' compensation, as provided
for bySsction 3700 of the Labor Code, forthe performance of the work for which this permit is.
Aissued.
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 plumber 1247619
_ I certify that; in the performance of the won "for which this permit is issued, I shall.not employ any
person in any manner so as to become ect to the workers' compensation laws of California,
and agree that; if I should become subje o the workers' compensation provisions of Section
37p0 of the Labor calf forth comply'with,those:provisions.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION' COVERAGEIS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (s100;0001. 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's result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnifyand hold harmless the City
of La Quanta, hs officers, agents and employees forany actor omission relatedto 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 daysfrom date of issuance of such permit, or cessation of work fort 80 days will subject
permit to cancellation.
I certify that I have read this application and state that the ebove.information'is c rect. 1 agree to comply with all
city and: ounty dinances and state laws relating to d onstructio reby authorize representatives
of i to mer upon the above mentioned or nspection pur
r% aur
-Si re (Applicant or Age
Application Number . . . . . 06-00000706
Permit . .
. WALL/FENCE
PERMIT
Additional desc .
.
Permit Fee . . .
. 54.00
Plan Check
Fee
.00
Issue .Date . . .
.
Valuation
. . .
. 2875
Expiration Date .
. 8/15/06
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
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115 L.F. 6" GARDEN
WALL, ORCO SYSTEM
Fee summary
Charged
Paid,
Credited
Due
Pe-rmit Fee Total
54.00
.00
.00
54.0.0
Plan Check Total
.00
.00
.00
.00
Grand Total
54.00
.00
.0.0
54.0.0
�v1 •-:l'j .7IY 11