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04-3414 (BLCK)BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760) 777-7012 78-495 CALLE TAMPICO FAX (760).77777011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS.(760) 777-7153 BUILDING PERMIT Application Number . . . . M=- 4 Date Property Address . . . . . 60727 WHITE SAGE DR APN: 764 -270 -999 -65 -300231 - Application description . . . WALL/FENCE Property Zoning LOW DENSITY RESIDENTIAL Application valuation 1750 Owner ------------------------- SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER 350 SCOTTS.DALE AZ 85258 4/12/04 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 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 Special Notes and Comments 70 L.F. 6' GARDEN WALL, ORCO SYSTEM Fee summary Charged Paid Credited Due. Permit Fee. Total .41.00 00 00. 41.00 Plan Check Total .00 .00 .00 .00 Grand Total 41.00 .00 .00 41.00 APR 2 2 2004 clrY cr La QUINTA FI ,%l!_ `:;E DEPT. P.O. BOX 1504 • �� VOICE 7.6 0) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-70I I LA QUINTA, CALIFORNIA 92253 414INSPECTIONS.(760) 7.77-7153 . . BUILDING & SAFETY DEPARTMENT Application Number: " ,3 Date:�.�.2� Applicant: Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address: Lic. No.: J /4 BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm undeyp�nalty of perjury that I am licensed under provisigns of Cha ter 9 ( racing with Section 7000) of Division 3 of the Business and Professionals Code, and my Licee Fs in full force and effect 1 n"1 ��! �rU nse Class k J(� Li rase No. l C� [ ---'Date \Contractor, OWNER -BUILDER DECLARATION I hereby affirm under 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 constrict, 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 permt subjects the applicant to a civil penalty of not more than rive 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 appy 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, howeyer, 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: _ 1 have and will maintain a certificate of consent to self4nsure 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. 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 Insurance carrier and policy number are: lamer ,PdfttVWu—mber _ I certify that, in the performance of the work for which this pemdt is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree ff I should become* subject to are workers' compensation provisions of Section 3700 of the Labor Code, l shall fol ' comply with those proMislons. 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 AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this p@nnit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address 11"t 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. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to 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 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 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 i 'on is rrecL I agree to comply with all city and county ordinances and state laws relating to building construction, and he by authorize representatives of this county t me u above-mentioned property for inspection purposes. /B �� Signature (Applicant or Agent):