07-0636 (SFD)Y
r •
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA,,CALIFORNIA 92253 .
F•
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BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 07-00000636
` Property Address: 81781 RUSTIC :CANYON DR
APN: 764-280-999-43 -300237-
Application description: DWELLING - SINGLE FAMILY DETACHED
Property Zoning: , MEDIUM HIGH DENSITY RES
Application valuation: 170639
Applicant:
Architect or Engineer
kLC�L ` uqo
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 35.0
SCOTTSDAL-E, AZ 052�5'0
Contractor:
SHEA HOMES, INC. D
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: 2/28/07
E r
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 (Seo. 3097, Civ. C.).
Y'Lender's Name:
Lender's Address:
LQPERMIT
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 relating to bui ding construction, and reby authorize representatives
of ou�nt�j11to5i:5)1'05ature
enter upon the above-mentioned pro t far ipe t�ijcrLpurpo
Da \ `'A (Applicant or Age
1
CMN rem. •�- --'`
----------------------------------.-------------------
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
Licsofe
lass: B - License No.: 672285
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
'7
issued.
Dale:
!� � ractor: var-•�
"
.. n[ 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 effirm 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 is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
3700 of the Labo shall forthwith c p with those provisions.
c..7
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:Date:
pplica _ '
(_ 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
WARNING: F (LURE 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 ($100,000). 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'proying 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 workis performed under or pursuant to any permit issued as a result of this application,
( I 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
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 (Seo. 3097, Civ. C.).
Y'Lender's Name:
Lender's Address:
LQPERMIT
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 relating to bui ding construction, and reby authorize representatives
of ou�nt�j11to5i:5)1'05ature
enter upon the above-mentioned pro t far ipe t�ijcrLpurpo
Da \ `'A (Applicant or Age
1
Application Number . . . . . 07-00000636
LQPERMIT
Structure Information
Construction Type
TYPE V - NON RATED'
..Occupancy Type.'
DWELLG/LODGING/CONG <=10
'Flood Zone . .
. . .
. . . NON -AO FLOOD ZONE
Other struct info
. .
. . . CODE EDITION 2001 CBC
FIRE SPRINKLERS' NO
GARAGE SQ FTG
576.00
PATIO SQ FTG
177.00
NUMBER OF UNITS
1:00 '00
7 ------------------------------------------------
18T FLOOR SQUARE VOOTA08
--------------------
154�.00
7 ---
Permit . . . .
. .
BUILDING PERMIT
Additional desc
Permit Fee
888.00 plan Check Fee
577.20
Issue Date
Valuation . . . .
170639
Expiration Date
8/27/07
Qty Unit
Charge.
Per
Extension
BASE FEE
639.50
71.00
----------------------------------------------------------
3.*5000
THOU BLDG 100,001-500,000
------------------
248,50
Permit . .. . .
. . MECHANICAL
Additional desc
Permit Fee
70.50 Plan Check Fee
17.63
Issue Date . .
. .
Valuation
0
Expiration Date
8/27/07
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
.2.60.
6.5000
EA MECH VENT FAN
13.00
1.00
----------------------------------------------
6.5000
EA • MECH EXHAUST HOOD
7 --------------
6.50
---------
Permit . . . .
. . ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee
94.53 Plan Check Fee
23.63
Issue Date
Valuation
0
Expiration Date
-8/27/07
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
1943.00.
.0350
ELEC NEW RES 1 OR 2 FAMILY
68:01'
576.00-
.0200
ELEC GARAGE OR NON-RESIDENTIAL
11.52
LQPERMIT
Application Number 07-00000636
------------------------------------------------------------------------------
Permit . . . PLUMBING
Additional desc .
Permit Fee 152.25 Plan Check Fee
35.81
Issue Date Valuation
0
Expiration Date 8/27/07
Qty Unit Charge. Per
Extension
BASE_ FEF
15.00
14.00 6.0000 EA PLB FIXTURE
84.00
- 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 8/27/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
Special Notes. and Comments -
SFD - LOT 43, PLAN 4520C, 1943 SF/ 255
SF CASITA,.BOX BAY @ MBR -26 SF 4' GARAGE
EXT.- 88 SF.PERMIT DOES NOT INCLUDE
- BLOCK WALLS,POOL,- SPA 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
57.72
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
17.06
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
193040
LQPERMIT
-
Application Number, . . 07-00000636
Fee summary.
Charged
Paid
Credited
Due
Permit Fee Total
-------
1220.28
---- - -----
.00
----------
.00
----------
1220.28
Plan Check'Total
654.27
.00
00,
654.27
Other Fee Total
4549:78
.00
.00
4549.78
Grand Total
6424.33
00
.00
6424.33