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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. _ .