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07-1007 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 07-000.01007 Property Address: 81950 EAGLE CLAW DR APN: 764-280-999-23 -300235- Application description: WALL/FENCE Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 2125 TdY440uhA Architect or Engineer: 11- 1A BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER SCOTTSDALE, Az 8525B. Contractor: SHEA HOMES, IN 60800 TRILOGY LA QUINTA, CA. (760)777-6OQ5 Lic., No.: 6722 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/02/07 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I herebva irm and r penalty of per' tat 'amlivens under provisions of Chapter 9 (commencing with I hereby affirm, under penalty of perjury one of the following declarations: Section 7" ) o_ f Di ision 3 of the u§i and Prof si rials Code, and my License is' in full force:and effect. I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided LicenseI H n No.: 672285 _ - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is act r: issued. I have and will maintain workers' compensation insurance; as required by Section 3700 of the Labor <e. Code, for the performance of the work1forwhich this permit. is: issued. My workers'.compensation OWNER -BUILDER DECLARATION insurance carrier and policy number are:eby affi m under penalty of perjury that I em exempt from the Contractor's State.Ucense Law for the Carrier AMERICAN HOME Policy Number 1247619 followingreason (Sec. 7031:5, Business and Professions Code: Any city or county that requires a.permit to I certify that, in- the performance of the work for Which this permitis issued, I shall not employ any construct,alter, improve, demolish; or repair any structure; prior to its•issuance,also requires theapplicant for the permit to files signed statement that Ire.orshe.is licensed pursuant to the provisions of the-Comraaor's,State _ person in any manner so-as,toabecome bject to he rkers' compensation laws of California, and agree th�iflul - ubje to theork mpensation provisions of Seaton License. Law (Chapter 9 (commencing with Semon 7000) of Division 3'of the Business and Professions' Code) or 00 of the1 hall fo with. ply a revisions. that he or she is exempt therefrom and the basis'for the alleged exemption. Any violation'of`Section.7031.5 by any applicant for a permit subjects -the applicant to a civil penalty of not more than five Hundred dollars (¢500)n e: li I I, 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 WARNING: FAILURE TO: SECURE WORKERS' COMPENSATION COVERAGE IS,UNLAWFUL, AND SHALL Contractors' Statelicense Law does not apply to an owner of property who, builds, or improves thereon, SUBJECT AN EMPLOYER, TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees,- provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES,AS PROVIDED •FOR IN improvements,are notintended or offered for.sele. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). APPLICANT ACKNOWLEDGEMENT (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to.the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State_License Caw.)� whose benefit work is performed under or pursuant': to any permit issued as a result of.this application, (_ ) I am exempt under Sec. - ; BAP.C: for this reason the owner, and the applicant, each agrees to; and shall defend, indemnify'and hold harmless thwCity 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 isissued (Sec. 3097, Civ.:C.). Lender's Name: Lender's Address: � .�Z I.QPERNUT of -La Qumta,.nts 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 is not commenced within 180 days from date o_ f issuance of ch permit, or cessation of,work for 180 days will subject permit to cancellation. 2116P/prU reef this a pplicationand.srate that t =a a in do orrea. I ee to comply with all nances and state laws relating to buil Ing co ructi ,end ”. 7eby ize representatives Of f�rupon above-mentioned,, -'n pectic, urpos 'nature (Applicant.. or Age Application Number . . . . . 07-00001007 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 54.00 Plan Check Fee .. .00 Issue Date . . . . Valuation . . . . 2125 Expiration Date . . 9/29/07 Qty Unit Charge Per Extension BASE FEE 45.00 1.100 9.00.00 THOU BLDG 2,001-25,000 9.00 ------------ Special.Notes and - ----------------.-- Comments --------------- 85 L.F. 6' GARDEN WALL, ORCO SYSTEM Fee summary Charged Paid Credited Due Permit Fee Total 54.00 .00 .00 54.00 Plan Check Total .00 .00 .00 .00 Grand Total 54.00 .00 .00 54.00 LQT