06-2893 (BLCK)-�.
BOX 1504
78-495 CALLE TAMPICO
LA. QUINTA, CALIFORNIA 92253
Tjht 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 06-00002893 Owner:
Property Address: 81860 EAGLE CLAW DR SHEA LA QUINTA
APN: 764-280-999-32 -300235- C/O JEFF MCQUEEN
Application description: WALL/FENCE 8800 N GAINEY CENTER 350
Property Zoning: MEDIUM HIGH DENSITY RES SCOTTSDALE, AZ 85258
Application valuation: 2000
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
I hereby aff' m and r penalty of perjury th I am licensed underprovisions of Chapter 9 (commencing with
Section 70 )'of Di ision 3 of the B and.Professio als Code, and my License is ir.full force and effect.
Li B nse No.: 672285
Date:, or:
OWNER -BUILDER DECLARATION
.I1hereby affirm under penalty of perjury that I -am exempt: from the Contracl:Ws,State License Law for the
following reason (Sec. 7031.5,Business and Professions Code: Any city or county that requires a permit to
constrict, alter, improve, demolish, or repair any structure, prior to its issuance; also requires the applicant for the
permit to file a signed statement thet.he or she is licensed. pursuant to the provisions of the Contractor's State
'('C
License Lawhapter 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 for: a. permit;subjects the • applicant. to &civil penalty of not more than five hundred dollars (8500).:
1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and 1100
the structure isnot 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 herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If; however, the building' or improvement.issold within
one year of completion, the owner-builderwill have the burden of proving that he or she did not build or
improve for the purpose of sale.).
1 _ 1 I, as owner of the property, em exclusively contracting with licensed contractors:to:construct the. project (Sec.
7944; Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon,end who contracts for the projects with a, contractor(s) licensed
pursuant to the Contractors' State License Law.).
l _ 1 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.).
Lande0s Name:
Lender's Address:
Contractor:
SHEA HOMES, INC.
81260 AVENUE 62
LA QUINTA, CA 92253
(760)777-6005
Lic. No. 6.7.228.5
VOICE (760) 777-7012
FAX (760) 777-701.1
INSPECTIONS (760) 777-7153
Date: 8/09/06
tA
eUG 141006
CITY OF LA QUINTA
FINANCE DEPT.
-------------
WORKER'S COMPENSATIONOECLARATION
I hereby affirm under penalty of perjury" one of the followirig: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.
Ilia and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for ihe' 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
1 certify that*FAILRE
inthe performance of the work for which this permit is issued, I shall not employany
ny manner so as to become subject to the workers' compensation laws of California,
hat, if I s e suN .to the workers' co nsation provisions of Section.
��pe Labor ode, sh o Th c ly wlth those .visions:
D/ a .WARNECURE 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.IN
SECTION 3705 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 result of this application,
the owner, and the applicant, each.agress to,:and shall defend,,indemnifyand hold harmless the Ctty
of La Quints, its officers„agents and employees for any actor omission related to the work being
performed under or following issuanceof this permit.
2. Any permitissued es a result of this application becomes null'and void if work is not commenced
within 180 days from date of issuance.of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify thfitl have read this; application and state thaAhe,ab a information is: correct. I,agree to comply with all
city my, or 'n c and state laws relating t g onstru ion, and hereby& orize-representatives
pf tIj(srai i to - o the above-mentioned rop rtyf \r nape n pur
Date: 61 ig ture (Applicant or
Application Number . . . 06-00002893
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 HND BLDG
501-2,000
3.0.00
--------------- ----------------------------------------------------------
,Special Notes and Comments
LOT 32 - 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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