09-0714 (SFD)P.O. BOX 1504 ^�
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 09-00000714 Owner:
Property Address: 81337 RUSTIC -CANYON DR SHEA LA QUINTA
APN: 764-280-999-38. -300236- C/O JEFF MCQUEEN
Application description: DWELLING - SINGLE FAMILY DETACHED 8800 N GAINE.Y CENTER 350
Property Zoning: MEDIUM HIGH DENSITY RES SCOTTSDALE, AZ 85258
Application valuation: 166943
Contractor:
.Applicant: Architect or Engineer: SHEA HOMES, INC.
60800 TRILOGY. PARKWAY
LA QUINTA, CA 92253
PIP(J (760)777-6005
Lic. No.: 672285
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Sectio 700 9) of Division 3 of the B sand Prof ssi nals Code, and my License is in full force and effect.
Lice s las B r/- Licens No.: 672285
ate ontraCtOr:
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 (5500).:
(_ I 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 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 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
( 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: pip
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/05/09
WORKER'S COMPENSATION DEISI,'
I hereby affirm under penalty of perjury one of the following declarations:+�i�O7. �/� `�•d/
I have and will maintain a certificate of consent to self -insure for wdtkers' compensate n, as provided
for by Section 3700 of the Labor Code, for the performance of the for whitis 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 be com subject to the, workers' compensation laws of California,
and agree tha , if I shout becomes j ct to the workers' compensation provisions of Section
/���.f" I� 8700 oft Labor Cod sh ford 'ih�comply with those provisions.
aD te"t V Applicant: �U
WARNING: FAILURE TO SECURE WORT -E S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL NALTIES 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.
I certify that I have read this application and state that the above inf rmation is correct. I agree to comply with all
city and county ordinances and state laws relating to building cons ction, and hereby authorize representatives
of t, is -�re
'the above-mentioned grope f f r ins a do purposes.
at ( (Applicant or Agent):
Application Number
09-00000714
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
539.00
PATIO SQ FTG
537.00
NUMBER OF UNITS
1.00
IST FT -OOP SQTTAPF FnnTB rF,
l sa 7 nn
_..:.. _._.... __..__...._ Permit .` . . . . .:
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
856.50 Plan Check Fee
556.72
Issue Date . . . .
Valuation. . . . .
161587
Expiration Date
2/03/10
Qty Unit Charge
Per
Extension
BASE FEE
639.50
62.00 3.5000
----------------------------------------------------------------------------
THOU BLDG 100,001-500,000
217.00
Permit. .
MECHANICAL
-Additional desc .
Permit Fee . . . .
86.50 Plan Check Fee..
21.60
Issue Date.
Valuation . . . .
0
Expiration Date
2/03/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 9.0000
EA MECH FURNACE <=100K
9.00
1.00 11.0000
EA MECH FURNACE >100K
11.00
1.00 9.0000
EA MECH B/C <=3HP/100K BTU
9.00
1.00 16.5000
EA MECH B/C >3-15HP/>100K-500KBTU
16.50
3.00 6.5000
EA MECH VENT FAN
19.50
1.00 6.5000
-------------------- --------------------------------------------------------
EA MECH EXHAUST HOOD
6.50
Permit . . .
ELEC-NEW RESIDENTIAL
Additional.desc .
Permit Fee
81.19 Plan Check Fee
15.04
Issue Date . . . .
Valuation . . . .
0
Expiration Date
2/03/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
LQPERMIT
LQPERMIT
Application Number . . . . . 09-00000714
Permit . . . . . ELEC-NEW RESIDENTIAL
Qty Unit Charge Per
Extension
1847.00.. .0300 ELEC NEW RES - MULTI FAMILY
55.41
539.00. .0200 ELEC GARAGE OR NON-RESIDENTIAL.-
----------------------------------------------------------------------------
10.78
Permit . . . PLUMBING
Additional desc -
Permit Fee. 120.00 Plan Check Fee
16.48
Issue Date Valuation _
0
Expiration Date 2/03/10
' 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
6.00 .7500 EA PLB GAS PIPE >=5
4.50
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
Expiration Date 2/03/10
Qty Unit Charge Per
Extension
BASE FEE
-----------------------------------------------------------------------------
15.00
Permit . . . SOLAR:PERMIT
Additional desc .
Permit Fee 22.50 Plan Check Fee
5.60
Issue Date . . . . Valuation . .
166943
Expiration Date 2/03/10
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 38, PLAN 5505A, 1847 sf
26 SF BOX BAY @ MBR, 83 SF. GAR.
EXT.,315 SF PATIO EXT. & PHOTOVOLTAIC
LQPERMIT
LQPERMIT
_ Application Number
. . . . .
09-00000714
Special Notes and Comments
---------------------
SYSTEM (1.7A&3KW).
PERMIT DOES
NOT
INCLUDE BLOCK WALL,
POOL, SPA
OR
DRIVEWAY APPROACH.
2007 ENERGY
CODES
Other Fees . .
. . ... .
-----------------------
ART IN PUBLIC PLACES -RES
.00
BLDG STDS ADMIN (SB1473)
7.00
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
995.00
EbTER aY REVIEW FEE -
55.67• '
DIF FIRE PROTECTION -RES
140.00
GRADING PLAN CHECK FEE
.00
-- • -- _... _ _ . _ ....
DIF LIBRARIES - RES
355.00
DIF PARK MAINT FAC - RES
22.00
DIF PARKS/REC - RES
892.00
STRONG MOTION (SMI) - RES
16.15
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
1181.69
.00 .00
1181.69
Plan Check Total
615.44
00 .00
615.44
Other Fee Total
4553.82
.00 .00
4553.82
Grand Total
6350.95
.00 .00
6350.95
LQPERMIT