08-0104 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA. QUINTA; CALIFORNIA. 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
J �
Application Number: 08-00000104Owner:
Property Address: 81438 MOONSTONE CT SHEA LA QUINTA
APN: 764-280-999-106,-300236- C/O JEFF MCQUEEN
Application description: DWELLING - SINGLE FAMILY DETACHED 8800 N GAINEY CENTER 350
Property Zoning: MEDIUM HIGH DENSITY RES SCOTTSDALE, AZ 85258
Application valuation: 225179
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date
1/11/08
f Contractor: d
Applicant: Architect or Engineer: SHEA HOMES, INC. D. `
81.260 AVENUE 62
LA QUINTA, CA 92253• ° JAN k�o zoos
(760)777-6005
Lic. No.: 672285 CITYOIFLAQUINTA
FIN POCE Q`�P7
,
------------- -----------------------------------------------------------------------------------
LICENSED CO TRACTOR'S DECLARATION
I hereb rm and penalty of perjur h [ I am license under provisions of Chapter 9 (commencing with
Sectio 70 01 of Di 'sign 3 of the B sine and Prof ssi nals Code, and my License is in full force and effect.
Licens Cl License No.: 672285
ate: tract
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 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 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 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.).
( 1 I am exempt under Sec. , B.&P.C. for this reason r
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: r
Lender's Address:
LQPER 11T
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
_ certify that, in the performance of the work for which this permit is issued, I shall not employ any
pers in any manner so as to become subject to the workers' compensation laws of California,
and g ee that, if 1 should become subject o the workers' compensation provisions of Section
0 f ,Labor Code, all forthwith amply ith those provisions.
te: licant:
1
WARNING: FAILURE TO SECURE WORKE COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL ALTIES 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 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 t cancellation.
)cer fy hat I have r 1ad, this application and state that the above inforAn
rect. I agree to comply with all
rdi t !� and state laws relating to buildin construceby authorize representatives
e n the above-mentioned proper, r inspectDate: 'nature (Applicant or Age
LQPERMIT
Application Number .
. . . . 08-00000104
•
r
Permit . . . . . . BUILDING PERMIT
Additional desc .
Permit Fee
1080.50
Plan Check Fee
702.33
Issue Date
Valuation . . . .
225179
Expiration Date
7/09/08
Qty Unit Charge
Per
Extension
BASE
FEE
639.54
126.00 3.5000
THOU BLDG
100,001-500,000
441.00
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . .
74.50
Plan Check Fee
18.63
Issue -Date
Valuation . . . .
0
Expiration Date
7/09/08
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2.00 9.0000
EA MECH
FURNACE <=100K
18.00
1.00. 9.0000
EA MECH
B/C <=3HP/100K BTU
9.00
4.00 6..5000
EA MECH
VENT FAN
26.00
1.00 6.5000
----------------------------------------------------------------------------
EA MECH
EXHAUST HOOD, _
6.50
Permit . . . ELEC-NEW RESIDENTIAL
Additional desc .
Permit Fee . . . .
117.85
Plan Check Fee
29.46
Issue Date . . . .
Valuation . . . .
0
Expiration Date .
-7/09/08
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2599.00 .0350•
ELEC
NEW RES - 1 OR 2 FAMILY
90.97
594.00 .0200
---------------------- -----------------------------------------------------
ELEC
GARAGE OR NON-RESIDENTIAL.
11.88
Permit . . PLUMBING
Additional desc .
Permit Fee
160.50
Plan Check Fee
40.13
Issue Date . . . .
Valuation
0
Expiration Date
7/09/08
Qty Unit Charge
Per.
Extension
BASE
FEE
15.00 _
15.00 6.0000
EA PLB FIXTURE
90.00
1:00 15.0000
EA PLB BUILDING SEWER
15.00
LQPERMIT
LQPERAIIT
Application Number . . . . . 08-00000104
Permit ... . . . . PLUMBING
Qty Unit Charge Per
Extension
i 1.00 7.5000 EA PLB WATER HEATER/VENT
7.50
'1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00
1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM
9.00
8:00 .7500 EA PLB GAS PIPE >=5
6.00
1.00 15.0000 EA PLB GAS METER
- 15.00
Permit GRADING PERMIT -
Additional desc .
Permit Fee . . . . 15.00 Plan Check Fee
.00
Issue Date . . . . Valuation
0
Expiration Date 7/09/08
Qty Unit Charge Per
Extension
BASE FEE
15.00
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Special Notes and Comments
SFD - LOT 106, PLAN 5500B, 2599 SF. (149
SF. EXERCISE ROOM, 63 SF,BB, 83 SF.
GARAGE EXTENSION). PERMIT DOES NOT
INCLUDE POOL,' SPA, BLOCK WALLS OR
DRIVEWAY APPROACH.
2001 CBC, CMC, CPC,. 2004 CEC, 2005
ENERGY CODES
Other Fees . . . . . . ART IN PUBLIC PLACES-RES
62.94
DIF COMMUNITY CENTERS-RES
74.00
DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
70.23
DIF FIRE PROTECTION-RES
140.00
GRADING PLAN CHECK .FEE
.00
DIF LIBRARIES - RES
355.00
DIF PARK MAINT FAC - RES
22.00
DIF PARKS/REC - RES
892.00
STRONG MOTION (SMI) - RES
22.51
DIF STREET MAINT FAC-RES
67.00
DIF TRANSPORTATION - RES
1930.00
Fee summary. Charged Paid Credited
Due
---------------------------------------------------------
Permit Fee Total 1448.35 .00 ._00
1448.35
Plan Check Total 790.55 .00 .00
790.55`
Other Fee Total 4630.68 .00 .00
4630.68
Grand Total 6869.58 .00 .00
6869.58
LQPERAIIT