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04-6758 (SFD)v _ � BUILDING & SAFETY DEPARTMENT P.O. Box 1504 NOV 1 6 ZQQ (760).777-7012 78-495 CALLE TAMPICO '* FAX (760) 777-7011 �rcv nt !.A Qt�iHTA LA QUINTA, CALIFOr SPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number. . . . . .04-0.0-0.0-67-58 Date 10/14/04 Property Address., . . . . . 60194 HONEYSUCKLE ST APN: 764-270=999-131✓300233- Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . .. MEDIUM HIGH DENSITY RES Application valuation 168671 Owner Contractor ------------------------ ------------------------ SHEA LA QUINTA SHEA HOMES, INC. C/O JEFF MCQUEEN 81260 AVENUE 62 8800 N GAINEY CENTER 350 LA QUINTA CA 92253 SCOTTSDALE AZ 85258 (760) 777-6005 WCC: NTL UNION INS WC: 6436568 08/01/05' CSLB: 672285 06/30/05 CCC: B ------ Structure Information PLAN 4520B ----- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10 Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struct info . . . . CODE EDITION .2001 # BEDROOMS. 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 488.00 PATIO SQ FTG 177.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 1940.00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee 881.00 Plan Check Fee 572.65 Issue Date . . . . Valuation . . . . 168671 Qty 'Unit Charge Per Extension BASE FEE 639.50 69.00 3.5000 THOU BLDG 100,0'01-500,000 ; 241.50 -----------------------------------------------------------'----------------- Permit . . . . . . MECHANICAL Additional desc . . Permit Fee . . . . 83.50 Plan Check Fee 20.88 Issue Date t Valuation . . . . 0 Qty 'Unit Charge Per Extension BASE FEE .' 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 9.0000 EA MECH BIC <=3HP/100K BTU --18.00 P.O. BOX 1504Tf 4• '�� 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: U (v7,18 Date: Applicant: ��EnreK,t.. Applicant's Mailing Address: or Engineer's Address: Cc. No.: Cq Zko 46 a BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm and salty of perjury that I am licensed under provisions of apter 9 corpmenrjpg with Section 7000) of Division 3 of the Business and Professionals Co e, and my Lice full force and effect. \a'LJ icense Cla1s's y—�\ 1► ,�,, ense No. /Date ``y`V'V� ractorl J 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 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 of the work for which this permit is issued. h. ve a ill maintain woo' compensation insur rice, as required by Sectio 3700 f the Labor Code, for the performance of the work for which this permit is #sued y s' com nsation in ranee cari r p li u ber6f� rrie 1. olicy Number I certify that, Ih the performance of the work for whi thi perp t Rldsued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and Joree that, f should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pr s. _-Date1 l— �kn 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.). Lenders Name Lender's Address 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 ork is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is c m ct. t agree to comply with all city and county ordinances and state laws relating to building construction, Qand hereby authorize representatives of this count o e upon/ bove-mentioned property for inspection purposes. ig/5 nature (Applicant or Agent). - ✓ ; Page 2 Application Number . . . . . 04-00006758 Date 10/14/04 i Qty Unit Charge Per Extension .3.00 6.5000 EA MECH VENT FAN 19.50 2.00. 6.5000 EA MECH EXHAUST HOOD 13.00 ---------------------------------------------------------------------------- Permit . . . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee 92.66 Plan Check Fee 23.17 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1940.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 67.90 488.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.76 . --_-------------------------------------------------------------------------- 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 1.00 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 131, 1940 SF. Plan 4520C w/Casita (255sf) & Bay MBR (23sf). PERMIT DOES'NOT INCLUDE POOL, SPA, BLOCK WALLS OR -DRIVEWAY APPROACH ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES .00 " `. 'DIF COMMUNITY CENTERS -RES 97.00 Page 3 Application Number . . . . . 04-00006758 Date .10/14/04 ---------------------------------------------------------------------------- Other Fees . . . . . . . DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 57.27 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 16.86 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due Permit Fee Total 1224.41 .00 .00 1224.41 Plan Check Total 654.76 .00 .00 654.76 Other Fee Total 2479.13 .00 .00 2479.13 Grand'Total 4358.30 .00 .00 4358.30