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08-0129 (BLCK)4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT _ Date: 1/14/08 Application Number: 08-00000129 Owner: Property Address: 81454 GOLDEN POPPY WY SHEA LA QUINTA APN: 764-280-999-99 -300236- C/O JEFF MCQUEEN Application description: WALL/FENCE 8800 N GAINEY CENTER 350 Property Zoning: MEDIUM HIGH DENSITY RES SCOTTSDALE, AZ 85258 Application valuation: 3250 - Contractor: D a Applicant: Architect or Engineer: SHEA HOMES, INC. 60800 TRILOGY PARKWAY LA QUINTA, CA 92253 ��� 2 3 1Q08 (760)777-6005 Lic. No.: 672285 C�OFLAQUINTA - FINANCE DEPT LICENSED CONTRACTOR'S DECLARATION Iherl by affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Secti n 7000) Division 3 of t i ess and Pr fe sionals Code, and my License is in full force and effect. Li s: License No.: 672285 Da ntract OWNER -BUILDER DECLARATION ' I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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 of not more than five hundred dollars ($500).: 1 _ 1 1, 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 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.). (_ 1 1, 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.). ( 1 I am exempt under Sec.-- , B.&P.C. for this reason ` 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: LQPERiAI IT WORKER'S 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. 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: Carrier AMERICAN HOME Policy Number CA 1593364 I certify that, in the performance of the wor for which this permit is issued, I shall not employ any p.rson in any manner so as to becomes 'ect to the workers' compensation laws of California, d 1 ree that, if I should becom®rthwa t workers' compensation provisions of Section 7 he Labor Code all ly with those provisions. WARNING: FAILURE TO SECURE WORKS 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. 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 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 cessation of work for 180 days will subject per it to cancellation. I ce ti that I ve read this application and state that the above formation is correct. I agree to comply with all cit a d count 9iLldttV//���ances and state laws relating to uilding co ruction, and hereby authorize representatives . of i q r upon the above-mentioned pr pe for in ec ' n purposes. i v S' [ure (Applicant or Agent): f , Application Number . . . . . 08-00000129 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 63.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 3250 Expiration Date 7/12/08 Qty Unit Charge Per Extension BASE FEE 45.00 2.00 9.0000 THOU BLDG 2,001-25,000 18.00 ---------------------------------------------------------------------------- Special Notes and Comments 130 L.F. 6' GARDEN WALL, ORCO SYSTEM. Fee summary ----------------- .Charged ---------- Paid Credited Due Permit Fee Total ---------- 63.00 ---------- .00 ---------- .00 63.00 Plan Check Total .00 .00 .00 .00 Grand Total 63.00 .00 .00 63.00 e LQYERMIT t