08-0103 (SFD)P.O. BOX 1504
78-495'CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tlihf
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: r1 -08r00000103 ^�
Property Address: 81450 MOONSTONE CT
APN: 764 -280 -999 -107 -300236 -
Application description: DWELLING.- SINGLE FAMILY DETACHED
Property Zoning: MEDIUM HIGH DENSITY RES
Application :valuation: 157369
Applicant: Architect or Engineer:
------------------
LICENSED CONXRACTOR'S DECLARATION
I hereb a . and r penalty of perjury th t I am license under provisions of Chapter 9 (commencing with
Sectio 7400 . ).of D ision 3 of the ire and Prof ssi naIs Code, and my License is in full force and effect.
LicensB Li se No.: 672285
e: 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).:
(_) 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 impr6vement 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.).
(_) 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.).
(_) 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 fSec. 3097, Civ. C.).
Lender's Name: �l
Lender's Address: 1�
LQPERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor: .
SHEA HOMES, INC.
60800 TRILOGY PARKWAY
LA QUINTA, CA 92253
(760)777-6005
Lic. No.: 672285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/11/08
�`• a �1 i
i
J2008 0t
JAN
CITY OF LA C.?16%TA
Fmommi-pi. .1
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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.
YI 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 cert y that, in the performance of the work for hich this permit is issued, I shall not employ any
p son in any manner so as to become subje to the workers' compensation laws of California,
a ree that, if I should become subject t e workers' compensation provisions of Section
0 of the Labor Code, I h ith those provisions. .
icant:
WARNING: FAILURE TO SECURE WORKES' MPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL P TIES 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, oAcessati 'work for 180 days will subject
pe mittocancellation.
I ,ylt`,fy that I ave read this application and state that the above inforect. I agree to comply with all
c/[y d n ordinances and state laws relating to bur. ' g construby authorize representatives
f u t o enter upon the above-mentioned pro rt for 'nspe d'
Sr. ature (Applicant or Agent):
Application.Number .
. . . . 08-00000103
'Permit
BUILDING PERMIT '
Additional desc .
Permit Fee
.842.50
Plan Check Fee
547.63
Issue Date
Valuation
157369
f" 'Expiration Date
7/09/08
Y
A` Qty Unit Charge-
Per
Extension
BASE
FEE
639.50
58.00 3.5000
--------------------------
THOU BLDG
-----------
100,001-500,000
--,-------------------------
203.00
------------
T Permit . .
MECHANICAL
Additional desc .
Permit Fee . . . .
73.00
Plan Check Fee
18.25
_ Issue Date . . .
Valuation . . . .
0
Expiration Date
7/09/08
Qty' Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 9.0000
EA MECH
FURNACE <=100K
9.00
1.00 16.5000
EA MECH
B/C >3715HP/>100K-500KBTU
16.50
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
87.78
Plan Check Fee
21.95
Issue Date . . . .
Valuation . . . .
0
Expiration Date
7/09/08
c, Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1773.00 .0350.
ELEC
NEW RES - 1 OR 2 FAMILY
62.06
536.00 .0200
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ELEC
GARAGE OR NON-RESIDENTIAL
10.72
Permit ... .
PLUMBING
Additional desc .
Permit Fee . . . .
129.00•
Plan Check Fee .`
32.25
Issue Date
Valuation
0
Expiration Date
7/09:/08
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
10.00 6.0000
EA PLB FIXTURE
60.00
1.0.0 15.0000
EA PLB BUILDING SEWER
15.00
LQPERMIT
LQPERA11T
Application Number .
. . . . 08-00000103
Permit _
PLUMBING
Qty Unit.Charge
Per
Extension
.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.
6.00 .7500
EA PLB GAS PIPE >=5
4.50
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
----------------------------------------------------------------------------
Special Notes and Comments
-
SFD - LOT'107, PLAN 4515C,
1773 SF: WITH
24 SF BOX BAY Q NOOK.
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
20.00
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
54.76
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
15.73.
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00
Fee summary Charged Paid Credited
Due
Permit Fee Total
1147.28 .00 .00
1147.28
Plan Check Total
620.08 _ .00 .00
620.08
Other Fee Total'
4565.49 .00 .00
4565.49
Grand Total
6332.85 .00 .00
6332.85
LQPERA11T