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08-1203 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoninq: Application, valuation: Applicant: 108-00001203 T4tvl 4 4 a" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 81442 RUSTIC CANYON DR 764-280-999-167 -300236- DWELLING - SINGLE FAMILY DETACHED MEDIUM HIGH DENSITY RES 127702 Architect or Engineer P1 A - — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — - — — — LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of peJr'kkry that I am licensed under provisions of Chapter 9 (commencing with Se ti n 7000+ of Division 3 of this Bud" ess and Pro essi nags Code, and my License is in full force and effect. Lie L�rise No.: 672285 IL`•Il C actor. LL. 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.). (_ 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.). ( 1 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: 0 LQPERMIT Owner:" SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER 35( sr—OTTGTIAT R, A7. RS?SR Contractor: SHEA HOMES, INC. 81260 AVENUE 62 LA QUINTA, CA 92253 (760)777-6005 Lic. No.: 672285 VOICE (760) 777-7012 .FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date- 7/15/08 ------------------------------------------------ WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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 AMERICAN HOME Policy Number CA 1593364 _ I certify that, in the perfor nce of the work for which this permit is issued, I shall not employ any person in any manner so; to become subje t to the rkers' compensation laws of California, a d agree that, ', shoul came sub' ct to t the er 'compensation provisions of Section 3 00 f the L or Code, I s 11 forth h com y sp provisions. oO Dat plicant. " VV�— WARNING: FAILURE TO SECURE WORKERS' 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 foe 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. certify that I have read this application and state the bove infor tion is correct.. I ree to comply with all city d c unty ordin nces and state laws relating buildi nstruct , an ereby th rize representatives of o to up the above-mentione property f r in echo urpos D i re (Applicant or Age \ Application Number 08-00001203 ------ Structure Information SFD 4210A W/BOX BAY, EXT GAR, EXT PAT ----- Construction Type . . . . . TYPE V - NON RATED - Occupancy Type . . . DWELLG/LODGING/CONG <=10 Other struct info . . . . . CODE EDITION 2001 # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 557.00 PATIO SQ FTG 391.00 NUMBER OF UNITS 1.00 ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 1381.00 Permit . . . BUILDING PERMIT - Additional desc . Permit Fee . . . . 737.50 Plan Check Fee 479.38 Issue Date Valuation 127702 Expiration Date 1/11/09 Qty Unit Charge Per Extension BASE FEE 639.50 28.00 3.5000 --------------------------------------------=------------------------------- THOU BLDG 100,001-500,000 98.00 Permit ... . MECHANICAL Additional desc . Permit Fee . . . . 65.50 Plan Check Fee 16.38 Issue Date . . . . Valuation . . . . 0 Expiration Date'. 1/11/09 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 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 74.48 Plan Check Fee 18.62 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/11/09 Qty Unit Charge Per Extension BASE FEE 15.00 1381.00 .0350 ELEC NEW RES- 1 OR 2 FAMILY 48.34 557.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 11.14 LQPERMIT LQPERMIT Application Number . . . 08-00001203 ---------------------------------------------------------------------------- Permit. . . . . PLUMBING Additional desc . Permit Fee 122.25 Plan Check Fee 30.56 Issue Date. Valuation . . . . 0 Expiration.Date 1/11/09 Qty Unit Charge Per Extension BASE FEE 15.00 91.00. 6.0000 EA PLB FIXTURE 54.00 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 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM- 9.00 5.00 .7500 EA PLB GAS PIPE >=5 3.75 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 1/11/09 Qty Unit Charge Per Extension BASE FEE 15.00 ------------------------------------_---------------------------------------- Special Notes and Comments SFD - LOT 167, Plan 4210A,(1381 s ft) w box.bay (26 sqft), ext..garage (83 sqft') & patio ext. (177 sqft) Permit does not include block wall, pool or driveway approach. 2007 CBC, CMC, CPC, 2004 CEC, 2007 ENERGY CODES ---------------------------------------------------------------------------- Other Fees . . . . . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 47.94 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 12.77 Application Number 08-00001203 Other Fees . . . . . . ... . DIF -STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION = RES 1930.00 Fee summary Charged Paid Credited Due Permit Fee Total 1014.73 .00 .00 1014.73 Plan Check Total 544.94 .00 .00 544.94 Other Fee Total 4535.71 .00 .00 4535.71 Grand Total 6095.38 .00 .00 6095.38