09-0364 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253,
• Qum'
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 09-_000003.64
Property Address: 81370 RUSTIC -CANYON DR
APN: 764 -280 -999 -173 -300236 -
Application description: DWELLING - SINGLE FAMILY DETACHED
Property Zoning: • MEDIUM HIGH DENSITY RES
Application valuation: 185294
Annlirant-
Architect or Engineer:
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor:
SHEA HOMES, INC.,
81260 AVENUE 62
LA QUINTA, CA 92253
(760)777-6005
Lic. No.: 672285
VOICE (760) 777-70.12
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/23/09
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency fortheperformance of the -
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
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. -
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 toilding co Astru 'on, and hereby authorize representatives
of thi my to a ter upon the above-mentioned pr erty or inl pectio purposes.. -
te: nature (Applicant or Agent):
B
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 Businessd Profession Is ode, and my License is in full force and effect.
LicensQ.C1 s: B •ice a 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
/ _
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issued.
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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 I Policy Number WC1894819
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 which 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 the workers' 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
and agree that, if ould become subject to th worker's' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
37, 0 of the Lab r C de, sh II I hwith c mp1 v. til_ttic6g provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
-'
(l/`^V lJ
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred . dollars ($500).:
a
plicant:
(_ 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
WARNING: FAILURE TO SECURE KERS'-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 CRIMINAL 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
1 _ 1 1, 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 to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(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,
(_) 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 Ouinta, 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 fortheperformance of the -
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
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. -
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 toilding co Astru 'on, and hereby authorize representatives
of thi my to a ter upon the above-mentioned pr erty or inl pectio purposes.. -
te: nature (Applicant or Agent):
B
Application Number .
. . . . 09-00000364
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
478.00
PATIO SQ FTG
178.00
NUMBER OF UNITS
1.00
------------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
2148.00
Permit . . . . . BUILDING PERMIT
Additional desc .
Permit Fee . . . .
940.50 Plan Check Fee
611.33
Issue Date . . . .
Valuation . . . .
185294
Expiration Date
10/20/09
Qty Unit Charge
Per
Extension
BASE FEE
639.50
86.00 3.5000
----------------------------------------------------------------------------
THOU BLDG 100,001-500,000
301,.00
Permit . . . MECHANICAL
Additional desc .
Permit Fee
77.00 Plan Check Fee
21.63
Issue Date
Valuation .. . . .
0
Expiration Date ..
10/20/09
Qty Unit Charge
.Per
Extension
BASE FEE
15.00
2.00 9.0000
EA MECH FURNACE <=100K'
18.00
.00 11.0000
EA MECH FURNACE >100K
.00'
2.00 9.0000
EA MECH B/C <=3HP/100K BTU
18.00
.00 16.5000
EA MECH B/C >3-15HP/>100K-500KBTU
.00
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 . . . .
99.74 Plan Check Fee
3.77
Issue Date . . .
Valuation . . .
0
Expiration Date
10/20/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
LQPERMIT
LQPERMIT
Application Number . . . . . 09-00000364
Permit . . . ELEC-NEW RESIDENTIAL
Qty Unit Charge Per
Extension
2148.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY
75.18
478.00 -0200 ELEC GARAGE OR NON-RESIDENTIAL
----------------------------------------------------------------------------
9.56
Permit PLUMBING
Additional desc .
Permit.Fee . . . . 138.0.0 Plan Check Fee'.
34.50
Issue Date . . . - Valuation . . . .
0
Expiration Date 10/20/09
Qty Unit Charge Per
Extension
BASE FEE
15.0.0
12.00 6.0000 EA PLB FIXTURE
72.00
1.00 15.0000 -EA PLB BUILDING SEWER
15.00
1.00 7.5000 EA PLB WATER HEATER/VENT
7.50
1.00. 9.0000 EA PLB LAWN SPRINKLER SYSTEM
9.00
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 10/20/09.
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 Valuation . . . .
187396
Expiration Date 10/20/09
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;QQ
Special Notes and Comments
SFD LOT 173 PLAN 5515A, 2148 SF,
INCLUDES 26.SF BOX BAY @'MBR,
PHOTOVOLTAIC SYSTEM (1.9A-3KW).
LQPERMIT
Application.Number . . . . 09-00000364
Special Notes and Comments
PERMIT DOES NOT INCLUDE BLOCK WALL,
POOL, SPA OR DRIVEWAY APPROACH. 2007
CODES
Other Fees . . . ART IN PUBLIC PLACES -RES .00
BLDG STDS ADMIN (SB1473) 8.00
DIF COMMUNITY CENTERS -RES 74.00
DIF CIVIC CENTER - RES 995.00
ENERGY REVIEW FEE 61.13
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 18.73
DIF STREET MAINT FAC -RES 67.00
DIF TRANSPORTATION - RES 1930.00
Fee summary Charged Paid Credited Due
Permit Fee Total 1292.74 .00 .00 1292.74
Plan Check Total 676.86- .00 .00 676"86
Other Fee Total 4562.86 .00 .00 4562.86
Grand Total 6532.46 .00. .00 6532.46
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