06-2899 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY .DEPARTMENT
BUILDING PERMIT
Application Number: 06-000_02.899 Owner:
Property Address: 81900 EAGLE CLAW DR SHEA LA QUINTA
APN: 764-280-9'99-28 -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: 20.00
Applicant: Architect or Engineer:
pip
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with
Section 000) Division 3 of fbIness and Prof ssionals Code, and my License is in full force and effect.
Lice11a License
672285
ate: 1 onVactw.
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. 7031:6, Business and Professions Code: Anycity or county that requires'a permit to
construct, alter, improve, demolish, or repe(r anystructure, prior to its issuance, also raquire&the applicant for the
permit to file a signed statement that he or she Is'licensed, pursuant to the provisionsof the Contractor's State
License1aw (Chapter 9 (commencing wtth'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 7031.6 by
any applicant for permit.subjects the applicant to a civil penalty of not more than five hundred dollars (8600).:
(_ 1 I, as owner of theproperty, my employeeswith wages as their sole compensation, will do the work, and
the structure is not inten70
ded or offered for sale (Sec. 41, 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 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 the purpose of sale.).
1 _) I, as owner of the property; am exclusively contracting with licensed contractors to construct the project (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 contractsfor the projects -with a contractor(s) licensed
pursuant to the Contractors' State. License Law.).
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: -
LQPERMIT
Contractor:
SHEA HOMES, INC,
81260 AVENUE 62
LA QUINTA, CP 92253
(760)777-6005
Lia. No.: 672285
V
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/09/06
AUG 14 2006
WORKER'S COMPENSATION DECLARATION
M1
I hereby,affirm under penalty 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 required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My°workem' 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 -issued, I shall not employ any
person in any mann so as to become subject to 1h orkers' compensation laws of California,
n4and agree that, ( oma suto.the w rs' compensation provisions of Section
00 of the La r C e,. 11 hwIt amply t provisions:
1�. I
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 3708' OF THE LABOR CODE;., INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the.Directorof 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 a result of this application,
the owner, and the applicant, each agrees to, and'shall defend, indemnify and hold harmless the City
of La Ouirita, 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 result of this application becomes-null,and void If work'is notcommenced
within 180 days from date of issuance of ch permit, or cessation of, work for 180 days will subject
permit to cancellation.
I certify that I h ve read this application and state that t inform 'on is Corr I agree to comply with -all
city and county rdinanees and state laws relating t ui in ctio her b authorize representatives
of -t' t ter u he above-mentioned ape for ion r
ate gnature (Applicant or. Ag
Application Number . . . 06-0.0002899
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
---------------------------------------------------°
Special Notes and Comments
--------------------
LOT 28 - 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
.0'0
.00
Grand Total 45.00
.00
.00
45.00
rel ..N1-1