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04-4433 (BLCK)w-` P O Box .1504 78°';495 CALLE TAMPIco LA�'QUINTA, CALIFORNIA 92253 a BUILDING PERMIT Application Number . . Property Address . . . APN: Application.description Property Zoning . . . . Application valuation BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 . . . 04-00004433 Date 5/21/04 . . . 60523 WHITE SAGE DR 764-270-999-74 -300231- . . . WALL/FENCE MEDIUM HIGH DENSITY RES 1625 Owner Contractor SHEA LA QUINTA SHEA HOMES, INC. C/O JEFF MCQUEEN 81260 AVENUE 62 8800 N GAINEY CENTER 350 LA QUINTA CA 92253 SCOTTSDALE. AZ 85258 (760) 7"7-6005 WCC: NTL UNION INS WC: 7165833 08/01/04 CSLB: 672285 06/30/05 CCC: B -----------------------------------------------------------------------_----- Permit . . . . . . WALL/FENCE PERMIT Additional desc Permit Fee 39.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 1625 Qty Unit Charge Per Extension BASE FEE 15.00. 12.00 2.0000 HND BLDG 501=2,000 24.00 ---------------------------------------------------------------------------- Special Notes and Comments 65 L.F. 6' GARDEN WALL, ORCO SYSTEM Fee summary Charged Paid C --edited- Due --------------------------------------------------------- Permit Fee Total 39.00 .00 .00- 39.00 Plan Check Total .00 .00 ..00 .00 Grand Total 39.00 .00 .00 39.00 P.O. BOX 1504 ��/�� 78-495 CALLE TAMPICO ` VOICE (760) 777-701: LA QUINTA, CALIFORNIA 92253 44FAX (760) 777-7011 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 0q, 44315- I Date: I' t' ApI FJ ca" . mppncanus mailing Address: Architect or Engineer: rvcnitect or t"glneer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm u natty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my LiceT n full force and effect. 16-lPa� / License Class icense No. I herebyaffirm under OWNER -BUILDER DECLARATION penalty of perjury that I am exempt from the Contractors' 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 Contractors' State License 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).): U 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 WORKERS' 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. k1have and will maintain w ers'compensation insurance• as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is s My�rqrkers' c nsation in syn a L. o !ter Cam h. (J` C of N�,nber t, 3 _ I certify tha rn the performance of the work for which this permit is issued. 1 shall not em to an y Person in any compensation laws of California, and agree t , if I should become subject to the workers' compensation provisions of anner so ar Sectis to on oft me suto Code, *shall forthwith comply with those provisions. /Bat � d App/I;�nt 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 (5100.000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under pens of CONSTRUCTION LENDING AGENCY penalty perjury that there is a construction lending 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 rsua issued as a result of this application, the owner, and the applicant, each agrees toand halll,, defend. whose and hold harwork is mless under City of La Wnta nittspermit 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 vowork 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. 1 certify that I have read this application and state that the abo information is to nter upon I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this cou abve-mentiproperty petty for inspection purposes. Date O Signature (Applicant.or A nt