06-2086 (BLCK)P.O. BOX 1504 4
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT '
Application Number: 06-0000'2086 Owner:
Property Address: 61011 FIRE BARREL DR SHEA LA QUINTA
APN: 764-280-999-65 -300235- C/O JEFF MCQUEEN
Application description: WALL/FENCE 8800 N GAINEY CENTER 350
Property Zoning: MEDIUM HIGH DENSITY RES SCOTTSDALE, AZ 85258
Application valuation: 2665
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/19/06
Contractor:
Applicant: Architect or Engineer: SHEA HOMES, INC. D d
81260 AVENUE 62
LA QUINTa., CA 92253
(760)777-6005c
Lic.. No.: 672285 JUN 0 12006
r c1NeF&4 QUINZA
FIAL4NCIa Do ...
-------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of pe ' r that 1 am licensed under provisions of Chapter 9 (commencing with .I hereby affirm under penalty of perjury one of the following declarations:
Section 7 - 0 of Division 3 of th B ass and Pr f sionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
Licen C ss: B License No.:' 672285 for by Section 3700 of.the Labor Code, for the performance of the work for which this permit is
issued.
/ Date:i,#4 Contract - I have and will maintain workers' compensation insurance, as required by Section 3700 6f the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury 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 th' permit is issued, I shall not employ any
construct, atter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so a
J"o
cthe rkers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State an agree that,'if I sh d m t worcompensationprovisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or f the labor e, I hal mp wit ovisions.
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 ($500).: e: �/ pplicant:
(_) 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 sate (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 or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). 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 CODE, INTEREST, AND ATTORNEY'S FEES.
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.). APPLICANT ACKNOWLEDGEMENT
1 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restfictions set forth on this application. -
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request, and for
pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application,
I—) I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
Date:
Owner:
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 permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
of La Quinta, 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 cessa n of work for 180 days will subject
permit to cancellation.
I certify that I ha a read this application and stat that th abov informati is correct. I agree to comply with all
city and co ty rdinances and state la a ati it g con uction, nd hereby authorize representatives
his
of tC u y t e er upon the abov entione p rt or insp ion pu
Date ; nature (Appl a genu:
Application Number 06-00002086
Permit . . . WALL/FENCE
PERMIT
Additional desc .
Permit Fee . . . . 54.00
Plan Check
Fee
.00
Issue Date
Valuation
. . .
. 2665
Expiration Date 11/15/06
Qty Unit Charge Per
Extension
BASE
FEE.
45.00
1.00 9.0000 THOU BLDG
2,001-25,000
9.00
---------------------------------------
Special Notes and Comments.
-------------------------------------
65 L.F. 6- GARDEN WALL, 65 L.F..4'
KNEE
.WALL, BOTH ORCO SYSTEM
Fee summary Charged
Paid Credited
Due
.. Permit Fee Total 54.00
.00
.00
54.00
Plan Check Total ..00
.00
.00
00
Grand Total. 54.00
.00
.00
54.00
c
LQPERMIT