06-2896 (BLCK)l
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
06-00002896
Property Address:
81880 EAGLE CLAW DR
APN:
764-280-999-30 -3.00235-
Application description:
WALL/FENCE
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
2000
Applicant: Architect or Engineer:
BUILDING &.:SAFETY DEPARTMENT
BUILDING PERMIT
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of'perjury that I am.lioensed under provisions of Chapter 9 (commencing with
Section 000) of ivision 3 of thaBusi and Tof6*onals Code, and my. License isiinfull force,and effect.
Li - B .cense No.: .6,72285
ate: � rector:
OWNER BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 am exempt from the Contractor's State License Lew 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'orshe is lieenved pursuant to the provisions of the Contractor.'s State
License Law (Chapter 9 (commencing with Section 7000) of Division3 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 @.permit subjects the applicant two civil penalty of not more then five hundred dollars (8500).:
(_) I, as owner oUthe property, or my employees with wages,as their sole:componsation, will do the work,,and
the structure isnot intended or offered forrsale (Sec: 7044, Businessland 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 herselfAhrough'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 orshe 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.
7644, Bushess'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.).
(_ 1 I,am exempt Under Sec.. , &&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:
LQPERMrr
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/09/06
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor: D d
SHEA,HOMES, INC..
81260 AVENUE 62
LA QUINTA, CA 92253 AUG 14 2006
(760)777-6005
Lic. No. c 612285 CITYOFLAQUINTA
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WORKER'S COMPENSATION DECLARATION
Lhereby affirm,under penalty of.perjury one;of�ths following declarations:
I have and will maintain a certificate.af'consent to self -insure for workers' compensation,, as, provided
_
for by Section 3700 of the Labor Code, for the performance of the work forwhich this permit is
issued.
_ L,have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of theworkfor which this permit is issued. My workers' compensation
Insurance carrier and policy number are:
Carrier AMERICAN HOME_ Policy Number 1247619
I certify -that; in the performance of the work for which this permit. is-issuedi I shall not employ any
person in anyman eo es o become subjecltot orkers' compensation laws of California,
e agree that, 'rf I u oma bj the coo k rs' compensation provisions of Section
1tNI
the la C s all fo with ply se revisions.
Dat `Alice .
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 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 issuedes a result of this application,
the owner, and the applicant; each agrees to, and shall defend, indemnify and hold harmlew'ihe City
of La Quints, its.officers, agents°and,employess 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 ofthis application becomes null and void if work isnot commenced
within 180 days: from date of•issuence of such permit, or cessation of work for 0 days will'subject
per t to. cancellation.
I certify t at I he�e -read this application and state th a inform tonl �c,orrect. I as o comply with all
city and oldigwnces�and state laws�releti o bui r co ructio0eritl fl�ebyaut-resentatives
oft s n rt Porhthe above -mentions props for ' ion rp ;N,1 J
Date: -tJ 1 1✓ - Y Ugnature (Applicant or
Application Number . . . 06-00002896
Permit . .
. WALL/FENCE
PERMIT
Additional desc .
.
Permit Fee . . .
. 45.00
Plan Check
Fee
.010
Issue Date . .
.
Valuation
. . .
. 2000
Expiration Date .
. 1/30/07
Qty Unit Charge Per
Extension
BASE
FEE15.00
15.00 2.0000
HND BLDG
501-2,000
30.00
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Special Notes and
Comments
LOT 30 - 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
LQr RMff