06-2902 (BLCK)I..
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06-0000.29.02
Property Address: 81930 EAGLE CLAW DR
APN: 764-280-999-25 -300235-
.Application description: WALL/FENCE
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 1750
Applicant:
T-v4t 4 4 Qu&m
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor:.
Architect or Engineer: SHEA HOMES, INC...
81260 AVENUE 62
LA QUINTA, CA 92253
(760)777-6005
aI Lica. No.: 672285
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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 70061 of Division 3 of the Business and Professionals Code, and my License is in full force_ and effect.
License lass:{ ��J/� License No:: 672285
Date: l �`�'� mractor.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjurythat I am exempt from the Contrector: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
Wcense 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. Any violation of Section 7031.5 by
any applicantforpermit 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
the structure is not 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 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 1, 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 contrictor(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 lendingagency for theperformanceof the
work for which this permitis issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQFERMLT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/09/06
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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 Lebor
Code; for the performance of the work for which this permit is issued. My workers' compensation
insurance carrievand policy number are:
Cartier AMERICAN HOME Policy Number 1247619
I certify that, in the performance of the workfor which this permifis issued, I shall not ,employ any
person in any manner so as to become sub's to the workers' compensation laws of California,
and agree that, if I s Id become,suliject t workers' compensation provisions of Section
13700 of the Labgj shaifortNv4hIcy *Ith those provisions.
WARNING: FAILURE TO SECURE'WORKERS' COMPENSATION.COVERAGE,IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND'CIVIL FINES UP TTH
T.0ONE HUNDRED OUSAND
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 setforth 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 harmlessthe City
of La Quinta, 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 isnot commenced
within 180 days from date of issuance of uch permit, or cessation of work for 180 days will subject
permit to cancellation.
1 certify that I have read this application and state than ab e'in orm me agree to comply with all
city! - coun 'ordinanoss-and state laws relating t - nat cA�pur.
►eb au horize representatives
of tis 'm�{y/1 �a[+ er u n the above-mentioned ope spa 'o
/te 6 ignature (Applicant or. Age ,
A'.
Application Number . . . . 06-00002902
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 41_.00
Plan Check Fee
.00
Issue Date . . . .
Valuation
1750
Expiration Date 1/30/07
Qty Unit Charge Per
Extension
BASE
FEE
15.00
13.00 2.0000 HND BLDG
501-2,000
26.00
------------------------ -----------------°--------------------------------------
Special .Notes and Comments
LOT 25 - 70 L.F. 6' GARDEN WALL,
ORCO
SYSTEM
Fee summary Charged
-------------
Paid Credited
Due
----- ---- ----------
Permit Fee Total 41.00
---------- ----------
.00 .00
41.00
Plan Check Total 0'0
.00 .00
.00
Grand Total 41.00
.00 .00
41.0.0
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