06-2890 (BLCK)"r P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
06-00002890
81840 EAGLE CLAW DR
764-280-9,99-34 -300235-
WALL/FENCE
MEDIUM HIGH DENSITY RES
2000
Tjht 4 4 0"
Architect or Engineer:
PIK
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LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby ffirm u der penalty of perjury hat lam li under provisions: of Chapter 9 (commencing with
Section 0) of ivisi" 3 of the Susi sand Pro onals Code, and my License is in full force and effect.
Lice No.: 672285
Date: ntractor: in
OWNER -BUILDER DECLARATION
I hereby affirm under Penalty of perjury that 1 am:exempt from the -Contractor's State License Law for the.
following^reason Sec. 7031.6, Business and'Professions Code: Any city or county that requires ,a permit to
constructi alter, improve, demolish, or repair any structure, prior to its,issuanoe,.also,requires the applicant for the
permit to filwa signed statement that he or she is licensed pursuant to theprovisions of the Contractor's, State
License.Law (Chapter 9 (commencing whh'Section 7000) of Division 1 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 -(8500)•:
(_) 1, emowner of the property, or my employees with wagesastheir, 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 io 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 notintended 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,forthe purpose of'sals.)•
(_ 1 1; as owner of the property, am exclusively contracting with licensedcontractors to construcuthe project.(Sec.
7044, Business and,Professions Code: The'Contractors' State License Law does not apply to,amowner 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 J.
(_) I 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:
Lender's Address:
I:QPERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER
SCOTTSDALE, AZ 85258 IID
Contractor
SHEA HOMES, INC.
81260 AVENUE 62
LA QUINTA, CA 92253
(760)777-6005
Lia. No.: 672285
VOICE (760) 777-7012
FAX (760) 777-701.1
INSPECTIONS (760) 777-7153
Date: 8/09/06
°D
AUG 14 2006
OF
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WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury ons of the following declarations:
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by SectionW06 of the Labor Code, for the performance of the work:for which this permit . is
issued.
�Lheveand"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 7619
_ I certify that, in the:perfMSCf the work for whic the permit'is issued;) shall not.employ.any
pe on n:any ma esubject tot or rs compensation lawsof Celifornip,
agree at,:i Ishme bje other,�k,`aj�,'mpsationprovisions'of Section
o�of 1 e Le r C1 fo withc �nPIY t t4os9 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 (8100;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 upomwhose behalf this application is made,.each,person at:whose request and for
whose benefit work is performed under orpursuarrt to any permit issued as a,resuh 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 omission related to the work being
performad under or following issuance of this permit.
2. Any permit issued as a result of this.appiica ion' bec - null and void if work is not commenced
within 180 days from date of issuance of ch permit, o cessation of w for 180 days will subject
Perm' to cancellation.
*certtfy he read this -application and state t _ irtf - atio is corre I agree to comply with all
y o inanoes and starts laws relating to uil i of stru ion, a here horize.representatives:
t upon a above-mentioned pr Pe for pact spur s
nature (Applicant or Age -
Application Number . . . . . 06-00002890
Permit . . . WALL/FENCE
PERMIT
Additional desc . .
Permit Fee . . . . 45.00
Plan Check Fee .,
.00
Issue Date . . .
Valuation . . .
. 2000
Expiration Date,. . 1/30/07
Qty Unit Charge Per
Extension
BASE
FEE
15.00
15.00 2.0000 FIND BLDG
501-2,000
30.00
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Specia
Special Notes and Comments
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LOT 34 - 80 L.F. 6- GARDEN WALL,
ORCO
SYSTEM
Fee summary Charged
Paid Credited
Due'
-------------- ---- ---- ----------
Permit Fee Total 45.00
---------- ----------
.00 .00
45.00
Plan Check Total .00
.00 .00
.00
Grand Total 45.00
.00 .00
45.00
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