06-2894 (BLCK)Amaw
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
0.6-00002894
Property Address:
81870 EAGLE CLAW DR
APN:
764-280-999-31 -300235-
Application description:
WALL/FENCE
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
2125
Applicant: Architect or Engineer:
plot
•4 i�l1YIN�
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
---------------- ---------- --------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby ffirm un er penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with
Section 000) of i `ion 3 of the. and Prof Tiono�ls",Code, and my License is in full force and effect.
U lo.: 6 722 8 5
te: actor:
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. 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. Anyviolation 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 _) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and 10
the.structure.is not intended or offered for sale (Sec. 7044, Business.and Professions Code: The
Contractors' State License Law dees.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 novintended or offered.for sale. If, however, the, building or improvementis 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 sale.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project.(Sec.
1044, 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 wntractor(s),licensed
pursuant to the Contractors' State License Law.)..
(_ 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.).
Lender's Name: 1
Lender's Address: J_
LQPERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor:
SHEA-HOMES, INC..
81,260 .AVENUE 62
LA r)UINTA, CA 92253
(760)777-6005
Lie. No.: 672285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/09/06
tAUG 14 2006
CITY OF LA QUINTA
FINANCE DEPT.
WORKER'S COMPENSATION DECLARATION
1 hereby affirm'under penally of perjury one of the following 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.
I have and will maintain workers' compensation insurance, as requiredby 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 numberare:
Carrier AMERICAN HOME Policy Number 1247619
_ ( certify that, in the performance of the work for which this permit is issued, I is iell'not employany
person; in any m r so m to becor1hme subject t he workers' compensation laws of California,
1nd agree th , ff I become act tot orkers' compensation provisions:of Section
7PQ otth bar C e,, shell t4ith oompl those provisions:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE'JS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 10100,0001. 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 Whoswrequest and for
whose benefit work is performed under or pursuant to any permit issued as a 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 application becomes null and void if work is not commenced
within 180 days -from date of'issuanoe of such permit, or cessation of work for 180 days will subject
permit.to cancellation.
I certify M I ha read thisapplicatian end state that t abov formation is correct, Iagrgp comply with all
city a my o jna and state laws relating t n ructionp� authori esenretives
of po the:above-mentioned ops for? coon Deas.
Date: 'gnature (Applicant or Agent .
Application Number . . . . . 06-00002894
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
-------------------------------------------------------------
Special Notes and
Comments
--------------------
LOT 311 - 85 L..F.
6' 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
.00
.00
54.00
LQPERMT