07-0661 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
�IGGIU�/
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 0-7=D-00006.61�1
Property Address: ' 81772 _-RUSTIC CANYON DR
AP.N: 764-280-999-81 -300237-
Application description: DWELLING - SINGLE FAMILY DETACHED
Property Zoning: MEDIUM HIGH DENSITY RES '
Application valuation: 127702
Applicant: I<rchitect or Engineer:
-----------------
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.
Li/ ass: - License No.: 672285
ate: ntracwr:
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 1031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
1 _) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, .
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for.sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the -projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
( ) I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/02/07
Owner:
SHEA.LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTS 3-5'0
SCOTTSDALE,• AZ 852Lr 4
8�
Contractor: MAR 12 2007
SHEA HOMES, INC.
81260 AVENUE 62 CITY OF LA QUINTA
LA QUINTA, CA 92253 G-
(760) 777-6.005 FIR�R�NCEDrai�$:
LiC. No.: 672285
-----------------------------------------------
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, if I sh uId become subject to'the workers' compensation provisions of Section
I 00 of the Lab o ode I hall forthw' c ply with those provisions.
l•
ate: pplicant:
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
whosebenefitwork 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
city and county ordinances and state laws relatinggrty
din construction, and hereby authorize representatives
of tFyyls�(c ty enter upon the above-mentioned r ins trio -pu oses.
DaYe^r ignature (Applicant or Agertl:
Application Number. .
. . . . 07-00000661
------ 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 .TTNIT,9
1.00
-1ST FLOOR SQUARE FOOTAGE
1381.00
Permit . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
737:50 Plan Check Fee
4.79.38
Issue Date
Valuation . . .
. 127702
Expiration Date
8/29/07
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
8/29/07
_ 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
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
8/29/07
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 -,
-
Application Number . . . . 07-00.000661.
Permit . . . PLUMBING
Additional desc .
Permit Fee . " . . 122.25 Plan Check Fee
30.56
Issue Date Valuation . . . .
0
Expiration.Date 8/29/07
'.
Qty - Unit Charge Per
Extension
BASF FEF
15.00
9.00 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 8/29/07
Qty Unit Charge Per
Extension
BASE FEE-
15.00
-----_---------------------------
Special Notes and Comments
SFD - LOT 81, Plan 4210A,(1381
sft)
w7box bay (26 sqft), ext. garage ('83
sgft) & patio ext. (177 sgft).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
.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
LQPERMIT - ..
Application' Number
. . . . .
07-00000661
--------------------------------------------------------
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
LQPERM[T
- _