04-4443 (BLCK)• ��Vlf�'IN� .
BUILDING & SAFETY DEPARTMENT
Box 1504 760 777-7012
-495 CALLE TAMPICO (760).777-7012
)
� FAX (760) 777-7011
LAi QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
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BUILDING PERMIT
Owner
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE AZ 85258
Contractor
SHEA HOMES, INC.
81260 AVENUE 62
LA QUINTA CA 92253
(760) 777-6005
WCC: NTL UNION INS
WC: 7165833 08/01/04
CSLB: 672285 06/30/05
CCC: B
----------------------------------------------------------------------------
Permit . . . . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 72.00 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 4387
Qty Unit Charge Per Extension
BASE FEE.,45.00
3.00 9.0000 THOU BLDG 2,001-25,OCO'. 27.00
----------------------------------------------------------------------------
Special Notes and Comments
107 L.F. 6' GARDEN WALL, 107,L.F. 3'
RETAINING WALL, BOTH ORCO SYSTEM
Fee summary Charged Paid Credited Due
----------------------------------------------------------
Permit Fee Total 72.00 .00 .00 72.00
Plan Check Total .00 .00 .00 .00
Grand Total 72.00 .00 .00 72.00
Application Number . . .
. 04-00004443 Date 5/21/04
Property Address . . . . .
. 60494 WHITE SAGE DR
APN:
764-270-999-112 -300231-
Application description . .
. WALL/FENCE
Property Zoning . . . . . .
. MEDIUM HIGH DENSITY RES
Application valuation .
4387
Owner
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE AZ 85258
Contractor
SHEA HOMES, INC.
81260 AVENUE 62
LA QUINTA CA 92253
(760) 777-6005
WCC: NTL UNION INS
WC: 7165833 08/01/04
CSLB: 672285 06/30/05
CCC: B
----------------------------------------------------------------------------
Permit . . . . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 72.00 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 4387
Qty Unit Charge Per Extension
BASE FEE.,45.00
3.00 9.0000 THOU BLDG 2,001-25,OCO'. 27.00
----------------------------------------------------------------------------
Special Notes and Comments
107 L.F. 6' GARDEN WALL, 107,L.F. 3'
RETAINING WALL, BOTH ORCO SYSTEM
Fee summary Charged Paid Credited Due
----------------------------------------------------------
Permit Fee Total 72.00 .00 .00 72.00
Plan Check Total .00 .00 .00 .00
Grand Total 72.00 .00 .00 72.00
P.O. BOX 1504
78-495 CALLELLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:
Architect•or Engineer:
Architect or Engineer's Address:
Lic. No..
BUILDING PERMIT DECLARATIONS
I hereby affirm un Halt of LICENSED CONTRACTOR'S DECLARATION
y perjury that I am licensed. under provisions o�f�Cha r 9 (commencing with ppm 7000) of Division 3 of the Business and Professionals
Code, and r Lice n full force and effect. Ab /^--per
License Class / --License
DateJeLl L 6
I hereby affirm under penaltyof OWNER -BUILDER DECLARATION
perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031 .5. Business and Prof
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 essions Code: Any
statement that he or she is licensed pursuant to the provisions of the Contractors' State Uoense 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 applicant fora permit subjects
the applicant to a civil penalty of not more than five hundred dollars ($500).):
(--) 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 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 or 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.).
U 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 Law.).
U I am exempt under Sec. , BA P.C. for this reason
Date- Owner
I herebyaffirm under WORKERS' COMPENSATION DECLARATION
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
rts for which this permit is issued.tp"! ill maintain worke 'compensation insurance, a y Section 3700 of the Labor Code, for the performance of the work for which this permit is
rk ' c mpe n i nce ca pcy• licy Numin the performance of the work for i h this perany person in any manner so as to become subject to the workers'
ation laws of California, and agree t t, f I should bject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
comply with those pr visio/Dateplican
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 ($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.
CONSTRUCTION LENDING AGENCYI hereby affirm under penalty ofperjury that
there is a construction fending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name
Lender's Address
IMPORTANT APPLICANT ACKNOWLEDGEMENT
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 under or prsua
rmto an
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 Le ouinta, its permit
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 rk is not Commenced within 180 dayt 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 that the above inform tion is co I agree to Comply with all city and county ordinances and state 18we relating to building
Construction, and reby authorize repres es of this sour nt u n
bo ntioned property for inspection purposes.
/te Signature (Applicant or Agent . r