07-1009 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINI'A, CALIFORNIA 92253 -
Application Number: 07-00001009
Property Address: 81960 EAGLE CLAW DR
APN: 764-280-999-22 -300235-
Application description: WALL/FENCE
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 1875
Ta�v 4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA.
C/O JEFF MCQUEEN
8,800 N GAINEY CENTER
SCOTTSDALE, AZ 85258
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153'
Date: 4/02/07
Contractor.:
Applicant: Architect or Engineer: SHEA HOMES,,
60800 TRILOGYNC. PARKWAY APR 12 2007AUY
LA QUINTA, CA 92253
(760) 777-6005 CITY OF LAQuINTA
Lic.. No.: 672285 FINANCEDEPI:
LICENSEDCONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of -perjury that.I am licensed under provisions of Chapter 9,(commencing with 'I hereby affirm -under penalty of perjury one of the,following declarations:
Section 7000) of f Division 3 of the Bu ss 6ndPronfesi-n,,I,,Code, and my License is in full force and effect. _ I have and will maintain a cenificete.of' consent to self -insure for workers' compensation, as provided
Lice e (Jilis: B _ Li No.: 672285 for'by Section 3700•of the Labor Code, for theperformanceofthe work for which' this, permit is
issued.
ate: tractor: *4 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
OWNEWBUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm,under penalty ofrperjury+that I am;exempt from the Contractor's State License Law for the Carrier AMERICAN HOME Policy Number 1247619
following, reason (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 permit is issued, I shall not employ any
constructi alter, improve, demolish, or repair any structure, prior to its issuance, also.requiras theapplicantfor the person in. any manner so.asto oecome,subject.to'the workers' compensation laws of California,
permitao file a signed statement that.he,or she is licensed pursuant:to the provisions of the Contractor's State and, agree that, if uld������QQQQQQ icome s ject tot workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and.Professions Code) or W
0 of .the Le r he
ort• h som I Orth those provisions.
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 (8500).: D lice '
(_) I,:as owner of the property; or my employees with wages,as their sole compensation, wilbdo the work, and
the structure, is not intended oroffered for, sale (Sec. 7044„ Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not.apply to an owner of property who builds onimprovas thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINE&UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS 18100;000): IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements: are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR C6DE, INTEREST; AND ATTORNEY'S_ FEES.
one year o£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, amexclusively 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
pOrsuarru'to
the Contractors' State License Law.).
(. 1 1 am exempt under Sec. , B.&P:C. for this reason
Date: Owner:,
CONSTRUCTION.LENDINO AGENCY
I hereby affirm under penalty of perjurythat there Is -a construction lending agency for the performance of the
work for which this permlt"is issued (Sec. 3097,. Civ. C.).
Lender's Name:
Lender's Address: I I
LQPERMIT
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.. Eaeh.person upon whose behalf this application is made, each person at whose request and,for
whose benefit work.is performed under or pursuantto 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 Ouinta, 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 permitissued as a result of this application becomes nulLand void if work is not 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 applicationand state that the above information is. ect. I agree to comply with all
city a ' count ' ordinances and state laws relating it ' con ni n,and - by authorize representatives
t c nty' a er'upon th bove-mention ro r in cti pura3
te: ature (Applicant or Ag 0
Application Number . . . . 07-00001009
Permit
WALL/FENCE PERMIT
Additional desc .
.
Permit Fee . . .
. 43.00
Plan Check
Fee
.00
Issue Date . .
.
Valuation
. . .
. 187'5
Expiration Date
9/29/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
14.00 2,0000 HND BLDG.501-2,000
28.00
----------------------------------------------
Special Notes and
Comments
----------------------------
75 L.F. 6' GARDEN
WALL, ORCO SYSTEM
Fee summary
Charged Paid
Credited
Due
Permit Fee Total
43.00
.00
.00
43.00
Plan Check Total
.00
.00
.00
.00
Grand Total
43.00
.00
.00
43.0.0
LQPERMIT