07-0616 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
TdY 4.4a 0"
' -
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 07-00000616 Owner:
Property. Address: -81769 RUSTIC CANYON DR SHEA LA QUINTA
APN: 764-280-999-42 -300237- C/O JEFF MCQUEEN
Application description: DWELLING - SINGLE FAMILY DETACHED _ 8800 N GAINEY CENTER 350
Property_ Zoning: . MEDIUM_. HIGH_ DENSITY _RES SCOTTS_D_ALE, AZ 8525.8
Application valuation: 162115
Applicant: rchitect or Engineer -
t --16A Cov sZ-�-
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my.License is in full force and effect.
Lic/�e Cls: B License No.: 672285
D Contractor.
-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 exempttherefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the'structure isnot 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 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.). '
(_) I am exempt under Sec. , B.&P.C. for this reason
Date: Owner: '
CONSTRUCTION LENDING AGENCY
Ihereby 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:
LQPERMIT
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: 2/27/07
--------------------------L=6-- --=-=-
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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
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 1247619
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, iffhld become subject tothe.wr s' compensation provisions ofSection
3700 of the Labs II forthwi comply wit ose provisions.
Da Applicant. �+ '
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 for 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.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
cit_yand county ordinances and state laws relating to buAigrco
ttion, and',(���`reby authorize representatives
of} co nt to enter upon the above-mentioned pr ein ecti Ryrptise5.
Date: Signature (Applicant or Agent):
Application Number
07-00000616
'
'
Structure Information
Construction Type
TYPE V - NON RATED
Occupancy Type . . .
. DWELLG/LODGING/LONG <=10
Flood Zone . .
.. NON -AO FLOOD ZONE- -
`
Other struct•info
CODE EDITION
2001 CBC
FIRE SPRINKLERS.'
NO ,
GARAGE SQ FTG'
520.00
PATIO SQ FTG
457.00
.NUMBER OF UNITS
1..Q0
-----------------------------------------
1ST FLOOR SQUARE FOOTAGE
"1805..00
- Permit . . . . . BUILDING PERMIT
Additional desc .
Permit Fee . . . . =
-860.00 Plan Check Fee'.
559.00
Issue Date_.
Valuation
162115
r Expiration Date
8/26/07
Qty Unit Charge
Per
Extension
_
_ BASE FEE
639.50
63.00 3.5000
THOU BLDG 100,001-500,000 j
220:50
Permit 'MECHANICAL
Additional desc
Permit Fee . . . .
83.50 Plan Check Fee
20.88
Issue Date . . .
Valuation
0
Expiration Date
8/26/07
_
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
a ------------- - - - - - - - - - - - - - -
EA MECH-EXHAUST HOOD
- ----- - - - - ------------------
6.50
--------- - - - - -- -•
Permit . . ELEC-NEW
RESIDENTIAL
.
' Additional desc
Permit Fee . . . .
88.58 Plan Check Fee
22.15
Issue Date . . .
Valuation
0
Expiration Date
8/26/07
Qty Unit Charge
Per
Extension _
BASE FEE
15.00
1805.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
63,18
520.00 .0200
ELEC GARAGE OR NON-RESIDENTIAL 10.40
LQPERMIT - r
'
Application Number . . . .. 07-00000616
Permit . . . PLUMBING
77
Additional desc
Permit Fee 147.00 Plan Check Fee
36.75
Issue Date Valuation . . .
0
Expiration Date 8/26/07'
Qty Unit Charge Per'
Extension
RASE FEE
15.00
13.00. 6.0000 EA PLB FIXTURE
78.00.
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
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 8/26/07
Qty Unit Charge Per
Extension.
BASE FEE
.15.00
----------------------------------------------
Special Notes and Comments
SFD - LOT 42, PLAN 4510C, 1805 SF ( 249
SF CASITA, BOX'BAY @MBR-26 SF, 120 SF.
PATIO EXT.) PERMIT DOES NOT INCLUDE
POOL, SPA, BLOCK WALLS OR DRIVEWAY
APPROACH. 2001 CBC, CMC, CPC, 2004.CEC,
2005 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
55.90
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,
16.21
DIF STREET MAINT FAC-RES
67.00
DIF TRANSPORTATION - RES
1930.00
LQPEPWIT
J
Application Number
. . . . .
07-00000616
Fee summary
Charged
Paid
Credited
Due
----------
Permit Fee Total
----------
1194.08
----------
.0.0
----------
.00
----------
1194.08
Plan Check Total
638.78
.00
.00
638.78
Other Fee Total
4547.11
.00
.00
4547.11
Grand Total
6379.97
.00
.00
6379.97