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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.