06-2897 (BLCK)x
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tdy44Qa&&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 06-00002897 Owner:
Property Address: 81920 EAGLECLAW DR SHEA LA QUINTA
APN: 764-28.0-999-26 -300235- C/O JEFF MCQUEEN
Application description: WALL/FENCE 8800 N GPINEY CENTER 350
Property Zoning: MEDIUM. HIGH DENSITY RES SCOTTSDALE, AZ 85258
Application valuation: 2000
Applicants Architect or Engineer:
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of,perjury that I.am licensed,under provisions of Chapter 9 (commencing with
Section 7 ) of, ivision 3 of th `less and Ptof ssionals Code, and my License is.in full force and effect.
Lice . B License No.i 672285
Date• v ntractor:
OWNER -BUILDER DECLARATION
I herebyaffirm 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.requirss a permit to
construct, alter,; improve, demolish, or repairanyatructure; 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 (Chapter9 (commencing with Section 7000) of'Division 3 of the:Business and Professions Code) or
that he or she is exemputherefrom and.the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects thwapplicant'to a civil,penalty of not more than five hundred dollars (8500).:
(_ 1 I, as owner of the property, or my employees with wages as theivsole compensation, will do the work, and /10
the structure is not intended or offered for sale I 44
Sec. 70, 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.).
(_) 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 contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State. License Lew.).
(_) I am exempt under Sec. , B.&P.C. for, this reason
Data:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm.under penalty of; perjury that.therwis a construction lending agency for the performance of the
work'for which this permit is issued (Sec. 3097, Civ: C.).
Lender's Name: k
Lender's Address:.
LQPERMIT
Contractor-
SHEA HOMES, INC.
81260 AVENUE 62
LA QUINTA, CA 92
(760)777-6005
Lic. No.: 672285
VOICE (760) 777-7012
FAX (760) 777-7014
INSPECTIONS (760) 777-7153
2
AUG 141006
CITY OF LA QUINTA
FINANCE DE
Date: 8/09/06
WORKER'S COMPENSATION DECLARATION
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'.workers' compensation
insurance carrierand policy number are:
Carrier, AMERI CAN HOME Policy Number 1247619
I certify that, in the ormance of the work for which thi rmit is issued, I shall not employ any
person in any so as to becUb)j!ewlt
'tothe wo ers''compensation laws of Californis,
rid agre "rf I Id, mehe worker compensation provisions of Section
Labor e, all fop wit ovisions.
Dale. �
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 (51`00,000). IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN
SECTION:3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APP.UCANT ACKNOWLEDGEMENT
IMPORTANT Applicationis hereby made to the Director of Building and Safety for a permit subject to the
conditions,and restrictions sat 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 ofthis application,
the owner, and the:.applicant, each agrees to, and shall defend;indemnify,and hold .harmless tCity
of La Quints, its officers„agents and employees for any act or omission related to the work be rig
performed under or following issuance, of. this permit.
2. Any permit issued as a result of this application becomes null and vo(d.if'work is not,commenoed
within 180 days from dateofissuance of permit, or cessation of work fo 180 days will subject
permit cancellation.
I certify th I have ad is application and-state,th ta ve , for io is correct.. I as to comply with all
city or, I a and state laws relating t buil rig ru , a hereby - - - ize representatives
Of o e above-mentioned o for i io rp
ate: re (Applicant or Age
Application Number . . . . 06-0000.2897
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 S01-2,000 30.00
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Special Notes and Comments
LOT 26 - 80 L.F. 6' GARDEN WALL, ORCO
SYSTEM
Fee summary Charged
---- ----------- ----------
Permit Fee Total 45.00
Plan Check Total .00
Grand Total 45.00
LQW MIT
Paid. Credited Due
.00 .00 45.00
.00 .0.0 .00
.00 .00 .45.00