04-3428 (BLCK)Tdf 4 4Q9&rw
BUILDING & SAFETY DEPARTMENT
P.O. BOX 1504 (760) 777-17012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
Application Number . .
Property Address . . .
APN:
Application description
Property Zoning . . . .
Application valuation
Owner
BUILDING PERMIT
. . . M47MOUDate 4/12/04
. . . 60573 WHITE SAGE DR
764-270-999-72-30D231-
WALL/FENCE
. . . LOW DENSITY RESIDENTIAL
. . . 1750
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). 777-60)5
WCC: NTL UNION INS
WC: 7165833 08/01/04
CSLB: 672285 06/30/05
CCC: B
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Permit . . . . . . WALL/FENCE PERMIT
Additional desc
Permit Fee 41.00 Plan Check Fee'. .00
Issue Date . . . . Valuation . . . . 1750
Qty Unit Charge Per Extension
BASE FEE 15.00
13.00 2.0000 HND BLDG 501-2,000 26.00
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Special Notes and Comments
70 L.F. 6' GARDEN WALL, ORCO SYSTEM
Fee summary Charged
----------------- ----------
Permit Fee Total 41.00
Plan Check Total .00
Grand Total 41.00
Paid Credited Due
---------- ---------- --------- -
.00 .00 41.00
.00 .00 .00
.00 -00 41.00
F
P.O. BOX 1504 a ��G�w
q VOICE (760) 777-7012
78-495 CALL$ CALIFORNIA FAX (760) 777-7011
LA QUINTA, LIFORN9225344 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 6941- &'/a8I
An lit -onto Date: ' Z 2 -O
Applicant's Mailing Address:
Architect or Engineer:
Arcnnect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of ft Business and Professionals
Codese Clamy Lic9le ss is in run force and effect
No.
Dae � ZZ L Goy, rtractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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 for a permit subjects
the applicant to a civil penalty or 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.).
ntracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors'
(, 1, as owner of the Property, am exclusively co
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 1 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 selfansure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work for which this pertnit is issued.
I 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 irysurance carver and policy number are:
banter I certify that in t --Policy Number
/ _theperformance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree7thal should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shan
1 \ f comply with those
�� 1 7
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.
1 hereby affirm under pane of CONSTRUCTION LENDING AGENCY
penalty pequry 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
Lenders Address
IMPORTANT Application is here Ino the Director of Buildin SafeAPPLICtyforCKNOWLEDGEo ENT
the
1. Each upon g permit subject to the conditions and restrictions set forth on this application.
Person u n whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any pernit
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 Quanta, its
officers, agents. and employees for any act or omission related to the work being performed under or following issuance of this pe
2. Any permit issued as a result of this application becomes null and void If work is not commenced within 180 days from date of issuance of such pertNt, or
cessation of work for 180 days will subject permit to cancellation.
1 certify that 1 have read this application and state that the above information ' rad I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives o:n7t):
nter u the above- mentioned property for inspection purposes.
Date nature (Applicant or