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09-1111 (SFD) plan was changed, not contractorP.O. BOX`1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253' 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 09-00001111. - Owner: Property Address:, 81361 RUSTIC CANYON DR SHEA LA QUINTA APN: 764-280,-999-40 --300236-• C/O JEFF MCQUEEN Application description: DWELLING - SINGLE FAMILY DETACHED 8800 N GAINEY CENTER Property Zoning: MEDIUM HIGH DENSITY RES SCOTTSDALE, AZ 85258 Application valuation: 223553 Applicant: Architect or Engineer: Contractor: SHEA HOMES, INC. 60800 TRILOGY PARKW VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/27/09 Q �p. Ib J V 02.2663 r+ LA QUINTA, CA 92253 °�{ ,^` P (760)777-6005 Lic. No.: 672285 ' LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. Lice s allss: License No.: 672285 - _ 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 r issued. Dat ontractor: 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that 1 am exempt from the Contractor's State License Law for the Carrier NTL UNION INS Policy Number WC6987825 - following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for ich this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the - person in any manner so, as to become subject to he worke ' compensation laws of California, 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 ject to the orkers' mpensation provisions of Section a d agree that, if I sho*shfophwith 700 the La r Coc ply ith o sions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by 1 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: r' plicant: - (_ 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 - WARNING: FAILURE TO SECURE , C)RKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRI�yj��AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN - improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S'FEES. , 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.).APPLICANT ACKNOWLEDGEMENT _ (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and.Professions Code: The Contractors' State License Law does not apply town owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a comractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for . pursuant to the Contractors' State License. Law.). - _ - .. - whose benefit work is performed under or pursuant to any permit issued as a result of this application,- 1 I am exempt under Sec. , B.&P.C. for this reason - 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 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: nR. Lender's Address: • LQPERMIT 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. I agree,rt compl ith all city and "unty ordinances and state laws relating to building co�r s`tructior�y, and hereby autfiorize r pre e t fives of th's o n e er upo he above-mentioned property for nspection 1 p ses. te: ignmure (Applicant or Agent): LQPERMIT Application Number . . 09-00001111 Permit BUILDING PERMIT Additional desc . Permit Fee• . . . . 1073.50 Plan Check Fee 697.78 Issue Date Valuation . . . . 223553 Expiration Date 4/17/10 Qty Unit Charge Per Extension BASE FEE 639.50 124.00 3.5000 THOU BLDG 100,001-500,000 434.00 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 83.50 Plan Check Fee 20.88 Issue Date . . . . Valuation 0 Expiration Date 4/17/10 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 B/C <=3HP/100K BTU 18.00" 4.00 6.5000 EA MECH VENT FAN 26.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee 116.19 Plan Check Fee_. 28.50 Issue bate Valuation . . . . 0 Expiration Date 4/17/10 Qty Unit Charge Per Extension BASE FEE 15.00 2599.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 90.97 511.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 10.22 Permit PLUMBING Additional desc . Permit Fee . . . . 160.50 Plan Check Fee 40.13 Issue Date . . . . Valuation . . . . 0 Expiration Date 4/17/10 Qty Unit Charge Per -,Extension BASE -FEE 15.00 15.00 6.0000 EA PLB FIXTURE 90.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 LQPERMIT LQPERMIT -Application Number . . . . 09-00001111 Permit . . . . PLUMBING Qty Unit Charge Per Extension 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 8.00 .7500 EA PLB GAS PIPE >=5 6.00 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 4/17/10 Qty Unit Chargee Per Extension BASE FEE ----------- ---------------------------------------------------------------- 15'.00 Permit . . . SOLAR PERMIT Additional desc . Permit Fee . . . 22.50 Plan Check Fee 5.63 Issue Date . . . . Valuation '. . . . 218462 Expiration Date 4/17/10 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. 40, PLAN 5500C, 2599 SF, .149 SF. EXERCISE ROOM,63 S.F. (BOX @ _BAY MBR) & PHOTOVOLTAIC SYSTEM (1.47A & 3KW) PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2007 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . : . . ART IN PUBLIC PLACES -RES 46.16 BLDG STDS ADMIN (SB1473) 9.00 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 69.78 DIF FIRE PROTECTION REE 140.00 v GRADING PLAN CHECK FEE .00 DIF LIBRARIES - RES 355.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 893.00 LQPERMIT 0 LQPERMIT Application Number . . . 09-00001111 ---------------------------------------------------------------------------- Other Fees . . . . . . STRONG MOTION (SMI) - RES 21.85 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1930.00 Fee summary Charged PaidCredited Due Permit Fee Total 1471.19 .00 .00 1471.19 Plan Check. Total 792.92 .00 ..00 792.92 Other Fee'Total 4622.79 .00 .00 4622.79 Grand Total 6886.90 .00 .00 6886.90 0 LQPERMIT