07-0610 (SFD)Ib,
P.O. BOX'1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
T,&t 4 �4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
07-00000610 j
81721 _RUSTIC -CANYON DR
.7.64-280-999-38 -300237-
DWELLING - SINGLE FAMILY DETACHED
MEDIUM HIGH DENSITY RES
200727
,Architect or Engineer: ,
kGv, C:0nrs,(_;Lk1lV
1ZCJ4 ZIALioI '
Owner:
SHEA LA QUINTA-
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor:
SHEA HOMES, INC.
81260 AVENUE 62
LA QUINTA, CA 92253
(760)777-6005
Lic. No.: 672285
0
VOICE (760) 777-7012
FAX (760).77777011
INSPECTIONS (7.60) 777-7153
Date: 2/26/07
MAR 12-2007
�' ® UI A
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.
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License No.: 672285
License lass:r B
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
—
/�� 7 1 ^'. /
LjC ;ntractor:
issued.
Date: Y
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 I am exempt from the Contractor's State License Law for. the
Carrier AMERICAN HOME Policy Number 1247619
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 I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
. that he or she exempt therefrom and the basis for the alleged exemption. Any violation Section 7031.5 by -
3700 of the Labor Co--dee-II shall forthwith ccoomppwitthh those provisions.
0+�
red dollars ($5001::
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred
e: pplica • ' '�`
• ( 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 WORKERS' 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 (5100,000). 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 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_thisapplication,
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
_ -
- performed under or following issuance of this permit.
' Date: Owner:
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
CONSTRUCTION LENDING AGENCY
permit to cancellation.
' I hereby affirm under. penalty of perjury that there is a construction lending agency for the performance of the
I certify that 1 have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.).
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
ion urpse
the above-mentioned grope) ms�
oh!�Wre
.Lender's Name:
Ife: (Applicantor Agent '
Lender's Address:
LQPERMIT _ ,.
Application Number .
. . . . 07-00000610
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee
993.00 Plan Check Fee..
645.45
Issue Date
Valuation
200727
Expiration Date
8/25/07
Qty Unit Charge-
Per
Extension
BASE FEE
639.50
101.00 3.5000
----------------------------------------------------------------------------
THOU BLDG 100,00-1.-500, 000
353.50
Permit . . ..
MECHANICAL
Additional desc .
Permit Fee . . . .
59.00 Plan Check Fee
14.75
Issue Date
Valuation . . . .
0
Expiration Date
8/25/07
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
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 . . . .
106.43 Plan Check Fee
26.61
Issue Date . . . .
Valuation
0
Expiration Date
_8/25/07.
Qty .Unit Charge
Per
Extension
BASE FEE
15.00
2339.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
81.87
478.00 .0200
ELEC GARAGE OR NON-RESIDENTIAL
9.56
Permit . .
PLUMBING
Additional desc .
Permit Fee . . . .
141.00 Plan Check Fee
35.25
Issue Date . . .
Valuation . . . .
0
Expiration Date
8/25/07
Qty Unit Charge
Per
-Extension
BASE FEE
15.00
12.00 6.0000
EA PLB FIXTURE
72.00
1.00 15.0000.EA.
PLB BUILDING SEWER
15.00
LQPERMff
Application Number .. . . 07--00000610
Permit . . . . . . PLUMBING
Qty, Unit -Charge Per m
Extension
1.00 7.5000 EA PLB WATER.HEATER/VENT
7.50 .
1.00. 3.0000 EA PLB WATER INST/-ALT/REP
3.00
1:60_ 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 8/25/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
---------------------------------------------------------------
Special Notes and Comments
SFD - Lot 119, Plan 5515B, 2339.SF.
w/Box Bay MBR
(26sf) & Exercise RM (191sf). Permit.
does not include -block wall, pool or,
driveway approach.
2001 CBC, CMC, CPC, 2004 CEC, 2005
ENERGY CODES
------------------------
Other Fees . . . . . . . ART IN PUBLIC PLACES -RES
--------------
20.00,
DIF COMMUNITY CENTERS -RESP
74.00
DIF CIVIC CENTER -RES
995:00
ENERGY REVIEW FEE
64.55
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
20.07
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00
Fee summary Charged Paid Credited
Due
------- ---------- ---------- --•--------
Permit Fee Total 1314.43 .00 .00
-1314.43
Plan Check Total 722..06' .00 .00
722.06
Other Fee Total 4579.62 0.0 .00
4579.62„
Grand Total 6616.11 .00 .00
6616.11
LQPERMTT. _ .