04-6738 (SFD)n �p� BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 IU1 W (760).777-7012
78-495 CALLE TAMP FAX ` FAX (760) 777-7011 -
LA QUINTA, CALIFORNr�1!A 92253 INSPECTION REQUESTS (760) 777-7153
1 �1TY OF LAQU �
BUILDIP-5' 1T
Application Number
Property .Address • . . .
APN:
Application description
Property Zoning . . . . . .
Application valuation . . .
CLI�'�T�i'+"
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE AZ 85258
C04-00006738 Date 10/14/04
60179 -HONEYSUCKLE -ST;
764-270=999=137--=300233-
DWELLING - SINGLE FAMILY DETACHED
MEDIUM HIGH DENSITY RES
166812
Contractor
SHEA HOMES, INC.
81260 AVENUE 62
LA QUINTA CA 92253
(760) 777-6005
Qty Unit Charge Per
2.00 9.0000 EA
2.00 9.0000 EA
2.00 6.5000 EA
Extension
BASE FEE '15':00
MECH FURNACE <=100K —_ 18.00
MECH B/C <=3HP/100K BTU 18.00
MECH VENT FAN --13.00
WCC: NTL UNION
INS
WC: 6.436568
08/01/05
CSLB: 672285
06/30/05
CCC: B
------------------=-------
Structure Information -------------------------
Construction Type . .
. . . TYPE V - NON RATED
Occupancy Type . . .
. . . DWELLG/LODGING/LONG <=10
Flood Zone . . . . .
. . . NON -AO FLOOD ZONE
Other struct info . .
. . . CODE EDITION
2001 CBC
FIRE SPRINKLERS
NO
GARAGE SQ FTG
488.00
PATIO SQ FTG
177.00
NUMBER OF UNITS
1.00
----------------------------------------------------------------------------
FIRST FLOOR SQ FTG
1917.00
Permit . . . . . .
BUILDING PERMIT
Additional desc
Permit Fee
874.00 Plan Check Fee
568.10
Issue Date . . .
Valuation
166812
Qty Unit Charge
Per
Extension
BASE FEE
639.50
6.7.00 3.5000
THOU BLDG 100,001-500,000
234.50.
Permit . . . . . .
MECHANICAL
Additional desc
Permit Fee
70.50 Plan Check Fee
17.63
Issue Date . . . .
Valuation
0
Qty Unit Charge Per
2.00 9.0000 EA
2.00 9.0000 EA
2.00 6.5000 EA
Extension
BASE FEE '15':00
MECH FURNACE <=100K —_ 18.00
MECH B/C <=3HP/100K BTU 18.00
MECH VENT FAN --13.00
P.O. Box 1504 •
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 51- (p 73S D e: . Q
Applicant:
nglnrlrl ri(�-� p
Applicant's Mailing Address:
Architect or Engineer's Address:
..No. ftr� 2440 \ -
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm unde a ally of perjury that I am licensed under provisions oCha
a'ter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
ode, and my Lice is in II force and effect. Cal
License`Class dense No.
�Date� "-0��Coritract.r
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 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 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 permit subjects
the applicant to a civil penalty of not more than five 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 apply 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, 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.).
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:
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
�r of the wo for which this permit is issued.
/� I ve an wi mainLain workers' compensa ion insurance, a . required y Sectio 3700 of the Labor Code, for the performance of the work for which this permit is
ued. pft�fs'�pnisati urance came and,pl�u e�
Carrier ' w lJ 1 Policy Number —1,�I _
I certify that, in the performance of the work for which this permit 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 that, should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those lXovisions.
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 permit is issued (Sec. 3097, Civ. C.).
Lender's Name
Lender's Address 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 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 i of commenced within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit to ca ellation.
1 certify that I have read this application and state that the above '7npon
is correct. gree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this co y to I. ov -mentioned property for inspection purposes.
ate ignature (Applicant or Agent):
t
Page
2
Application Number
. . . . 04-00006738 Date
10/14/04
Qty Unit
Charge
Per
Extension
1.00
6.5000
EA MECH EXHAUST HOOD
6.50
-----------------------------------------------------------------------------
Permit . . .
. . .
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee.'".
.
91.86 Plan Check Fee
22.97
.Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
•.
BASE FEE
15.00
1917.00
.0350
ELEC NEW RES - 1 OR -2 FAMILY
67.10
488.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
9.76
--4---
-,;-. Permit . . .
. . .
------------------------------------------
PLUMBING
Additional desc
Permit Fee
152.25 Plan Check Fee
38.06
Issue Date
Valuation . . . .
0
Qty Unit
Charge.
Per
Extension
BASE FEE
15.00
14.00
6.0000
EA PLB FIXTURE
84.00
1.00
15.0000
EA PLB BUILDING SEWER
15.00
1.00
7.5000
EA PLB WATER HEATER/VENT
7.50
1.00
3.0000
EA PLB WATER INST/ALT/REP
3.00
1.0.0
9.0000
EA PLB LAWN SPRINKLER SYSTEM
9.00
5.00
.7500
EA PLB GAS PIPE >=5
3.75
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.
- Qty Unit
Charge
Per
Extension
BASE FEE
15.00
-------------------
Special Notes
---------------------------------------------
and Comments
------------
SFD - LOT -137
PLAN 4520B,1917
SF, 255 SF
' CASITA. PERMIT
DOES NOT
INCLUDE BLOCK
.WALLS, POOL, SPA
OR DRIVEWAY
APPROACH
7---------------------------------------------------------------------------
Other Fees ..
. . . .
. ART IN PUBLIC -PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
56.81
Page 3 .
Application Number
04-00006738 Date
10/14/04
Other Fees . . .
. . . . . .
DIF FIRE PROTECTION -RES
97.00
GRADING PLAN CHECK FEE
00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES.
502:00.
STRONG MOTION (SMI) - RES
16.68
DIF STREET MAINT FAC -RES
15.00
,DIF TRANSPORTATION - RES
1098.00
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
1203.61
.00 .00
1203.61
Plan Check Total
646.76
.00 .00
646.76
Other Fee Total
2478.49
.00 .00
2478.49
Grand Total
4328.86
.00 .00
4328.86