07-2246 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 07-0000224.6
Property Address: 819.30 EAGLE CLAW DR
APN: 764-280-999-25 -300235-
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 500
Applicant:
Architect or Engineer:
91A
UCEdSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I"hereby affirm under, penalty of perjury that Ia licensed under provisions of Chapter 9 (commencing with
section 7600) of Division 3 of the'Business ani Professionals Code,, and my. License is in full force and effect;
LicenseCl s: 98 C2.7 C29- A I "License No.: 656128
Date: Contractor
NER-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 pennivto
construct; alter,' improve, demolish, orrepalvany structure,. prior to its issuance,also-requirestrtie applicant for the .
permit to file a signed statement.that he or she is=llcensedpursuant to the, provisions of the: Contractor's State
Ucense�Law (Chapter 9 (commencing with,Section 7000) of Division 3 of the:Business and Professions'Cods)-or
that he or she is exempt therefrom and the basis for the alleged exemption. AnyNielation of Section 7031.5 by
any applicant for. a permitsubjects-the applicanCto:a civil penalty of not;more than fivehundred dollars ,($500).:
I _) I, as owner of the property, or my employees with wages as their sole compensation, will do.the work„and
the structure is'nat intended or offered for`sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Lew does not apply town owner of property Who,build&orimproves thereon,
and who.does the work Himself or herself through his or her own employees, provided4hat the
improyements,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 provinp:that he or she did not build or
improve'for the purpose of sale.).
(_ 1' I, asrowner.ofthe 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 orimproyes thereon; and,who contracts for the`projects`with a contractor(s) licensed
pursuant:to'the Contractors"State License taw.).
1_) Iam'exemprunderSec. ,.B:BP.C.forthis.reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 hereby:affirm under.penalty of perjury that there is•a construction lending,agency for the performance of the
work forwhich this permit is issued (Sec. 3097 Civ. C;).
Lender's Name: _
Lender's Address:
LQPERMTT
VOICE (760) 777-7012
FAX. (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/06/07
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
880'0 N GAINEY CH
SCOTTSDALE, AZ—S
Contractor:
TESERRA-
P.O. Box 1280
COACHELLA, CA
(760.) 398-.9.222
Lic. No.:, 65612
-------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of. perjury one of the following declarations:
_
1. have and will maintain a car ificate of consent,to self -in sure for workers' compensation,.as provided
for by Section 3700 of the Labor Code, for theperformance of the<work for which this permit is
issued.
I.haveand'will maintain•workeW compensation insurance, as�requiied by 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 number are:
Carrier SEABRIGHT Policy Number BB1070510
I certifythat, in the performance of the work: for which.this,permit'is issued, I shall not employ any
person in any manner so as to be ome subject -to theworkers' compensation laws of California,
and agree that; rf I should,becom aubjecttoahe workars'.compensetion provisions+oYSection
700 of the'Labor C Nal comply with thoswprovisions.
Date:
_J 1700
WARNING: FAILURE TO SECURE WOR R ' COMPENSATION COVERAGE .IS•uNLAWFUL,'AND SHALL
SUBJECT AN EMPLOYER -TO CRIMINAL PENALTIES AND�CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS:(8100,000). 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 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 underor pursuant to any permit Issued as a result of thisiapplication,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of Le Ouinta, Its officers, agenmand.employees.for4rry,act or omission related'to thework'tieing
peffornied 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 such permit, or cessation of work;for 180 days will subject
permit to cancellation,
I certify that I have read this application and state thartlie abov ddormation is correct. I agree to comply with all
city and county grdinances,and state laws relating tobuil ruction,.andhereby authorize representatives
of this coupty t enter upon the -above-mentioned pro action purposes.
Date: Signature (Applicam:or Agei
Application Number . . . . . 07-00002246
Permit BUILDING PERMIT
Additional desc .
Permit Fee . . . 15.00 Plan Check Fee 9.7:5
Issue .Date . . . Valuation . . . . 500
Expiration Date 2/02/08
Qty Unit Charge Per Extension
BASE FEE 15.00
Permit . . PLUMBING
Additional desc .
Permit Fee . . . . 18.0.0 Plan Check Fee 4.50
Issue Date . . . . Valuation . . . . 0
Expiration Date 2/0:2/08
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00
--------------------------------------------------------- -------------------
Special Notes and Comments
FIREPIT PER APPROVED PLAN ONLY.
Fee summary Charged Paid Credited Due
Permit.Fee Total 33.00 .00 .00 33.00
P1an.Check Total 14.25 .00 .00 14.,25
Grand Total 47.25 .00 .00 47.25
Bin #
. , .w '.,t Qty of La Quinta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760),777-7012
Building Permit Application and Tracking Sheet
Perms/
Project Address:,, °^= Q C4Ata C(Z-
Owner's Name:
A. P. Number:
Address: "
Legal.Description:'
Pity, -ST' Zip:
Contractor:
Telephone:
Address:0 Bax
Project Description:
City, ST, Zip: t co�- 2si=.3 & -
\ r o tij
Telephone: ZZZ
State Lic. # : dos 2 CityLica;#:
Arch., Engr., Designer.
.Address:
City, ST, Zip:
Telephone:
State Lie. #:
Construction Type: Occupancy:
Project type (circle :one)(New dd'n Alter Repair Demo
Name of Contact Person:
Sq. FL:
___
#Stories: 7;UMts:
Telephone # of Contact Person:
Estimated Value of Project:' 57QC)
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Ree'd
TRACMG . PERMiT,FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections.
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Encra Cala.
Plans ticked up
Construction
Flood ptain,plan
Plans resubmitted
Mechanical
Grading plan
2e -Review; ready for correctioneissue
Etectrical O
Subcoutactor List
Called Contact.Person
Plumbing. dope
Grant Deed
Plans picked up
SALL
AO -A - Approval
Plans resubmitted
Grading
IN HOUSE:
''" Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
I
Called ContactPerson
A:LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
N
0
.-
ri