09-0702 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht 4 4 Quum
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number. 09-00000702
Property Address: 81322 RUSTIC CANYON DR
APN: 764-280-999-177 -300236-
Application description: DWELLING - SINGLE FAMILY DETACHED
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 176034
A., l; +-
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am Jicensed under provisions of Chapter 9 (commencing with
Section 70,00). of Division 3 of the Businesse/rofessionals de, and my License is in full force and effect.
Lice
t :: B se C s e No.: 672285
aontractor:
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, 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.).
(_) 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 (Sec. 3097, Civ. C.). - -
Lender's Name:
Lender's Address: IY it
LQPERMIT
Owner:
SHEA LA QUINTA
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/08/09
C/O JEFF MCQUEEN.
8800 N GAINEY CENTER 350 Q
SCOTTSDALE, AZ 85258.•
Contractor: ®�
SHEA HOMES, INC.
60800 TRILOGY PARKWAY
LA QUINTA, CA 92253
(760)777-6005
Lic. No.: 672285'
WORKER'S COMPENSATION DECLARATION
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 NTL'UNION INS Policy Number WC6987825
—1 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 becomes
t to the workers' compensation laws of California,
and agree that, if I should become subje th workers' compensation provisions of Section
0 f the Labor Code, hall fon ly with those provisions.
ate. ` _F plica
WARNING:' FAILURE TO SECURE WO S' 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. -
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safetyfor 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, 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 correct. 1 agree to comply with all
city and co 'ty ordinances and state laws relating to building construction, a W hereby authorize representatives
of this /eot)y t upon t e above-mentioned property for sp ction p oses.
ate /" �Zlure (Applicant or Agent):
Application Number
. . . 09-00000702
Permit ... .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
909.00 Plan Check Fee
590.85
Issue Date . . . .
8/05/09 Valuation . . . .
176034
Expiration Date
3/28/10
Qty Unit Charge
Per
Extension
BASE FEE
639.50
77.00 3.5000
----------------------------------------------------------------------------
THOU BLDG 100,001-500,000
269.50
Permit
MECHANICAL
Additional desc .
Permit Fee . . . .
111.00 Plan Check Fee
18.25
Issue Date . . . .
8/05/09 Valuation . . . .
0
Expiration Date
3/28/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 9.0000
EAMECH FURNACE";<=100K
18.00
1.00 16.5000
EA MECH B/C >3-15HP/>100K-500KBTU
16.50
1.00 22.5000
EA MC B/C'>15 <=30HP/500K-1M BTU
22.50
5.00 6.5000
EA MECH VENT FAN
32.50
1.00 6.5000
-----------------------------------------------------------------------------
EA MECH EXHAUST HOOD
6.50
Permit
ELEC-NEW RESIDENTIAL
Additional desc .
Permit Fee
95.86 Plan Check Fee
21.74
Issue Date . . . .
8/05/09 Valuation . . . .-
0
Expiration Date
3/28/10
Qty Unit Charge
-Per
Extension
BASE FEE
15.00
2004.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
70.14
536.00 .0200
----------------------------------------------------------------------------
ELEC GARAGE OR NON-RESIDENTIAL
10.72
Permit . . .
PLUMBING
Additional desc .
Permit Fee161..25
Plan Check Fee .'
32.25
Issue Date . . ..
8/05/09. Valuation . . . .
0
Expiration Date
3/28/10
Qty Unit Charge
Per
Extension
BASE.FEE
15.00
14.00 6.0000
EA "PLB FIXTURE
84.00
Application Number
09-00000702
Permit
PLUMBING
Qty Unit Charge
Per
Extension
1.00 15.0000
EA PLB BUILDING'SEWER
15.00
2.00 7.5000
EA PLB WATER HEATER/VENT
15.00
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
1.00 9.0000
EA PLB LAWN SPRINKLER SYSTEM
9.00
7.00 .7500
EA PLB GAS PIPE >=5
5.25
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 . . . .
8/05/09 Valuation
0
Expiration Date
3/28/10
Qty Unit Charge
Per
Extension
----------------------------------------------------------------------------
BASE FEE
15.00
Permit
SOLAR PERMIT
Additional desc .
Permit Fee . . . .
22.50 Plan Check Fee
5.63
Issue Date . . . .
8/05/09 Valuation . . . .
.155429
Expiration Date
3/28/10
Qty. Unit Charge
Per
Extension
BASE FEE
15.00
1.00 4.5000
EA SOLAR COLLECTOR < 1000
4.50
1.00 3.0000
EA SOLAR EQUIP -MISCELLANEOUS
3.00
.Special Notes and Comments
SFD - LOT 177, PLAN 4515A,
2004 SF
INCLUDES 255 SF. DETACHED CASITA.
PHOTO VOLTAIC SYSTEM
(1.3A& 3JW). PERMIT
DOES NOT INCLUDE POOL,
SPA, BLOCK WALLS
-OR DRIVEWAY APPROACH.
2007 CODES.
CHANGE OF CONTRACTOR
FEE ASSESSED TO
INSERT SHEA_ HOMES INC.
AS NEW CONTRACTOR
OF RECORD.
-----------------------------------------------------------------------------
'Other Fees . . . .
. . . . BLDG STDS ADMIN (SB1473)
8.00
CHANGE OF CONTRACTOR
4:50
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
59.09
DIF FIRE PROTECTION -RES
140.00
0
LQPERMIT
Application Number
. . . . ..
09-00000702
------------------------------------------------------------
Other Fees .
. . . .
DIF LIBRARIES RES
`-
355.00
DIF PARK MAINT FAC
- RES
22.00
DIF PARKS/REC - RES
892.00
STRONG MOTION (SMI)
- RES
15.54
DIF STREET'MAINT FAC -RES
67.00
DIF TRANSPORTATION
- RES
1930.00
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
1314.61
1314.61
.00
.00
Plan Chcc]s Total
GG0.70
GG0.70
.00
.00
Other Fee Total
4562.13
4557.63 ..00
4.50
Grand Total -
6545.46
6540.96
:00
4.50
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T-4wt °f 4 Q"
BUILDING &, SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: ( 09=00000702
Property Address: 81322 RUSTIC CANYON DR
APN: 764-280-999-177 -300236-
Application description: DWELLING - SINGLE FAMILY DETACHED
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 176034
Applicant: Architect or Engineer:
AA) CAZ . -Ah
Lic. No.: ---------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
LicenClasslB LicenseNo.: 855368
Date:Contractor: �--
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. 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 oeJn 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.).
I _ I 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 (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor:
SHEA HOMES LIMITED
60800. TRILOGY PKWY
LA QUINTA, CA 92253
(760)777-6032
Lic. No.: 855368
VOICE (760) 777-7012
FAX (760) 777-7011
:TIONS (760) 777-7153
PARTNERSHIP
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 NTL UNION INS Policy Number WC6987825
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, if I should become subject to the workers' mpensation provisions of Section
3700 of the Labor Co I shal fortpwith comply provisions.
Date Applicant: .
WARNING: FAILURE TO SECURE WO ERS' 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.
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, or cessation of work for 180 days will subject
permit to cancellation.
1 certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building constructic and hereby authorize representatives
of this Cun y to mer upon the above-mentioned property for inspection urposes.
Datq Signature (Applicant or Agent):
.Application Number .
. . . . 09-00000702
Permit . . .
BUILDING PERMIT
Additional desc .
Permit. Fee
909.00 Plan Check
Fee
590.85
Issue Date
Valuation
. . .
176034
Expiration Date
1/24/10
Qty Unit Charge
Per
Extension
BASE FEE
639.50
77.00 3.5000
THOU BLDG 100,001-500,000
269.50
Permit . . .
ELEC-NEW RESIDENTIAL
Additional desc .
Permit Fee . .
.95.86 Plan Check
Fee
21.74
Issue Date . . . .
Valuation
0
Expiration Date
1/24/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2004.00 .0350
ELEC NEW RES - 1 OR 2
FAMILY
70.14
536.00 .0200
ELEC GARAGE OR NON-RESIDENTIAL
10.72.
--------- t-------------------------------------------=----------------------
Permit . . .
GRADING PERMIT
Additional desc .
Permit Fee
15.00 Plan Check
Fee
.00
Issue Date . . . .
Valuation
0
Expiration Date
.1/24/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
Permit . . .
MECHANICAL
V Additional desc .
Permit Fee
111.00 Plan Check
Fee
18.25
Issue Date . . . .
Valuation
0
Expiration Date
1/24/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 9.0000
EA MECH FURNACE <=100K
.18.00
1.00 16.5000
EA MECH B/C >3-15HP/>100K-500KBTU
16.50
1.00 122.5000
EA MC B/C >15'<=30HP/500K-1M
BTU
22.50
5.00 6.5000
EA MECH•VENT FAN
32.50
1.00 6.5000
J
EA MECH EXHAUST HOOD
6.50
Application Number . . . . 09-00000702
Permit . . . . .
PLUMBING
Additional desc .
Permit Fee
161.25 Plan Check Fee
32.25 '
Issue Date
Valuation . . .
. 0
• Expiration Date
1/24/10
Qty Unit Charge
Per
Extension
BASE,FEE
15.00
14.00 6.0000
EA PLB FIXTURE
84.00
1.00 15,nnnn
ER aL8 RUILL�INC 98i^I&R
15.00:
2.00_ 7.5000
EA PLB WATER HEATER/VENT
15.00
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
1:,00 9.0000
-EA-; PLB LAWN SPRINKLER SYSTEM
9.00
7.00 .7500
EA PLB.GAS PIPE >=5
5.25
1.00 15.0000
----------------------------------------------------------------------------
EA PLB GAS METER
15.00
Permit
SOLAR PERMIT
Additional desc .
Permit Fee
22.50 Plan Check Fee
5.63
Issue Date . . . .
Valuation
155429
Expiration Date
1/24/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 4.5000
EA SOLAR COLLECTOR < 1000
4.50
1.00 3.0000
EA SOLAR EQUIP MISCELLANEOUS
3.00
----------------------------------------------------------------------------
Special Notes and Comments
SFD - LOT 177, PLAN 4515A,
2004 SF
INCLUDES 255 SF. DETACHED CASITA.
PHOTO VOLTAIC SYSTEM
(1.3A& 3JW). PERMIT
J
DOES NOT INCLUDE POOL,
SPA, BLOCK WALLS
OR DRIVEWAY APPROACH.
2007 CODES.
-----------------------------------------------------
Other Fees. . . . . .
-----------------------
. . BLDG STDS ADMIN-(SB1473)
8.00
DIF COMMUNITY CENTERS -RES
74.00 _
DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
59.09
DIF FIRE PROTECTION -RES
140.00
DIF LIBRARIES.- RES
355.00
DIF PARK MAINT FAC - RES
22.00
DIF PARKS/REC - RES
892.00
STRONG MOTION (SMI) - RES
15.54
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00
Fee summary Charged
Paid Credited
Due
LQPERI.41T
Application Number
.. . . . .
09-00000702
Permit Fee. Total
1314.61
.00
.00
1314.61 "
Plan Check Total
668.72
.00
.00
668.72
Other Fee Total
4557.63
.00
.00
4557.63.
Grand Total
6540.96
.00
.00
6540.96.