06-2892 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number- 06-00002892.
Property Address: 81850 EAGLE CLAW DR
APN: 764-280-999-33 -300235-
Application description: WALL/FENCE
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 1750
T4'!t 4 4 Qu&M
Applicant: Architect. or Engineer:
DO/
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I here affirm u der penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Se 00),of i ion 3 af.th "nese and. Pr essi nals Code, and my License is in full force and effect.
u Ieense No.:. 672285
Date: Co tracto
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's- State License Law forthe
following reason (Sec. 7031.5, Business and Professions Code: Anycity or county that requires a permit to
construct, alter, improve, demolish, or repaioany 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 sheds exempt therefrom and the basis for the alleged exemption. Any violatien,of Section 7031.5 by
any applicant fora permit -subjects the applicant toe civil penalty of;not more ttien five hundred dollars ($500).:
1—) I, 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 (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.Mrself 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 thepurpose of sale.).
1 _) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec.
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,Ucense Law.).
(_ 1 I am exempt under Sec. • B4P:C: forthis reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
Ifiereby 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'sName•
Lender's Address: 010
LQPERMff
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)777-6,005
LiC. No.: 672285
VOICE (760) 777-7012
FAX (760)177-7011
INSPECTIONS (760) 777-7153
Date: 8/09/06
e D
AUG 14 2006
-------------------
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of theJollowing 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,Jorthe 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
Cade, for the. performance -ofthe work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier AMERICAN HOME Policy Number 1247619
_ I certifythat, in the perfc ante of the work forwhich this perm: r Lssued, I shall not employ any
person in any ma as to beco bject to the workers' pensetion laws of California,
end tee that I shou a su ' ;to the workers' c previsions of Section
3 t or Cod ; I s II rth h co w' those pr ons..
ar
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 R IN
SECTION 3706 OF'THE 'LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is.heriibV 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 asa result 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
performed. under or following. issuance of: this permit.
2. Any permit issued as a result of this applicatio mes null and void if work is no menced
within 180 days from date of issuance of suc r r cessetion of work for 1 ays will; subject
M
o cancellation.
ead this application and'state.that t ;a ve for anon come 1 agr ywith all
n and state laws relating to bu ' onst ion, a ereby her - epr tatives
n above-mentioned operty r ins npurp���.OI�J\na�/tre (Applicant or Agent):
Application Number . . . . . 06-00002892
Permit . . . •WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 41.00 Plan Check Fee .00
Issue Date . . . Valuation 1750
Expiration Date . . 1/30/07
Qty Unit Charge Per Extension
BASE FEE 15.00
13.00 2.0000 HND BLDG 501-2,000 26.00
--------------------------------------------------------------------------.-
Special, Notes and. Comments
LOT 33 - 125 L.F. 6' GARDEN WALL, ORCO
SYSTEM
Fee summary Charged
Permit Fee Total 41.00
Plan Check Total .00
Grand Total 41.00
LQPE UMT
Paid Credited Due
.00 .00 41.00
.00 .00 .00
.00 .00 41.00