04-6740 (SFD)BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 NOV 16 200 11U (760).777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
�....,A
LA QUINTA, CALIFORNIA ) CITY of LA -N
2253 I'S;P_ECTION REQUESTS (760) 777-7153
r. FINANCE i,r-rl.
BUILDING PERMIT
J
Application Number . . . . 04z-00006740 ----� Datei,,10/14/04
Property Address `6020'9 HONEYS-UCKLE•-ST
APN: 764270-999-138 -300233-
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . . . . . MEDIUM HIGH DENSITY RES
.Application valuation . . . . .148309
Owner
SHEA LA QUINTA-
CIO
UINTAC/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE AZ 85258
Contractor
SHEA.HOMES, INC.
81260 AVENUE 62
LA QUINTA CA 92253
(760) 777-6005
WCC: NTL UNION
INS
WC: 6436568
08/01/05
CSLB: 672285
06/30/05
CCC: B
--------------------------
Structure Information -------------------------
Construction
Type . .
. . . TYPE V - NON RATED
Occupancy
Type . . .
. . . DWELLG/LODGING/CONG <=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
1688.00
-
Permit .
-----------
. . . . .
-----------------------------------
BUILDING PERMIT
---------------
Additional
desc . .
11 - 11
Permit Fee
. . .
811.00 Plan Check Fee
527.15
Issue Date
. . . .
Valuation . . .
. 148309
Qty
Unit Charge
Per
Extension
BASE FEE
639.50
49.00
---------------------------------------------------------
3.5000
THOU BLDG 100,001-500,000
171.50
Permit .
. . . . .
-------------------
MECHANICAL
Additional
desc
.Permit Fee
64.00 Plan Check Fee
16.00
Issue Date
. . . .
Valuation . . .
. 0
Qty
Unit Charge
Per
Extension
'
BASE FEE
r5'.-00
2.00
9.0000
EA MECH FURNACE <=100K
—_ 18.00
2.00
9.0000
EA. MECH BIC <=3HP/100K BTU
18.00
1.00•
6.5000
EA MECH VENT FAN
-- 6.50
P.O. BOX 1504 444"
VOICE (760) 777-7012
78-495 CALLE O FAX (760) 777-7011
LA QUINTA, CALIFORNIAFORN92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: Q (p % Date: 11. Ito -04
Applicant:t c ngin�:
Applicant's Mailing Address:
or Engineer's Address:
Vic. No.: z
t3UILUINU PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm underof perjury that I am licensed under provisio of apter 9 (commenc' g with Section 7000) of Division 3 of the Business and Professionals
Coe, and my Licens m II force and effect.
/License Class dense No.
/Date ontractor
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
of the work for which this permit is issued.
I a and w I rrWintain workers' compensation insuran , as required by Se tion 3700 f th abor Code, for the performance of the work for which this permit is
ed. M w ation ' y ance carrier nd tic brier tic b r
1 � l q 1p
rrier otic Number
certify that, in ormance 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 thatf I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those plovisiops. IJ
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 f�1
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 beim 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 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 1 have read this application and state that the above infopp t n is cor4amerittione
mply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county to a pon theoparty for inspection purposes.
,05te " , ( 1 Signature (Applicant or Agent):
� Jar • �x i
Application -Number . . . 04-00006740
Page 2,
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
83.84 Plan Check Fee
20.96
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
1688.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
59.08
488.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
9.76
rte• Permit . .
. . .
PLUMBING
j' Additional desc
Permit Fee .
. . .
,128.25 Plan Check Fee..
32.06
Issue Date .
. . .
Valuation
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
10.00
6.0000
EA PLB FIXTURE
60.00
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 138,
1688 SF
PLAN 4520C/BOX
BAY @ MBR -26 SF.
PERMIT DOES NOT
INCLUDE BLOCK
WALLS,
POOL, SPA OR
DRIVEWAY APPROACH
-------------------------
Other Fees
. . .
--------------------------------------------------
. . ... ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
' FI
Page 3
Application Number
04-00006740 Date
10/14/04
----7---7-------------------------------------------------------------------
Other Fees .
. . . . . .
ENERGY REVIEW FEE
52.72
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
14.83
DIF STREET.MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Charged.
----------
Paid Credited
Due
Permit Fee Total
1102.09
------------------------------
.00 .00
1102.09
Plan Check Total
596.17
.00 .00
596.17
Other Fee Total
2472.55
.00 .00
2472.55
Grand Total
4170.81
.00 .00
4170:81