07-0638 (SFD)P.O: BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht 4.4-Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 07-00000638
Property Address: 8.1793 RUSTIC CANYON DR
APN: 764-280-999-44 -300237-
Application description: DWELLING -SINGLE FAMILY DETACHED
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 159387
Applicant:iAr_chiiiect or Engineer:
p_Ajcz 2_6CV
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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
Sec . n 70001 f Division 3 of the Busin ss nd Professio al Code, and my License is in full force and effect.
Lic B se No.: 672285
Date: ontractor:
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 703-1.5 by
' any applicant for a 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 is not intended or offeredJor 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 ofcompletion, the owner -builder will have the burden of proving that he or she did not build or
-improve for the purpose of sale.).
(_ 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
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
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENT
SCOTTSD.A,LE, AZ 852
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: 2/28/07
f
/D
MAR 12 2007
C1i°! ®(F LA
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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 d be ome subject to the orkers' compensation provisions of Section
l/ '0♦0 of th d I s[yapll for with com 1 nth those provisions.
Date:�'�V pPlic�w
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 thisperm it.
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�e:
nd c, or 'nancas a state laws relating to buildin strut[ n, and hereby authorize representatives
of ty. a er up the above-mentioned propert 'n ecti purposes.
ig ature (Applicant or Agent,:
Now..
Application Number
07-00000638
Permit
BUILDING PERMIT
Additional desc .
Permit Fee;
849.50 Plan Check Fee ..
552•.18
Issue -Date
Valuation
159387
Expiration Date
8/27/07
Qty Unit Charge
Per
Extension
BASE:FEE
639.50
60.00, 3.5000
THOU BLDG 100.001-500.0.00
21n.n•n
Permit . . .
MECHANICAL
Additional desc .
Permit Fee
65.50 Plan Check Fee
16.38
Issue Date
Valuation . . . .
0
Expiration Date
.8/27/07
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
PermitELEC-NEW
RESIDENTIAL
Additional desc .
Permit Fee . . . .
89.84 Plan Check Fee
22.46
Issue Date
Valuation
0
Expiration Date.
8/27/07
•
Qty. Unit Charge
"Per
Extension
BASE FEE
15.00
1773.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
62:06
639.00 .0200
ELEC GARAGE OR NON-RESIDENTIAL
12.78
Permit . . .
PLUMBING
Additional desc .
Permit Fee I. . . .
120.00 Plan Check Fee
30.00
Issue Date
Valuation
0
Expiration Date
8/27/07
Qty Unit Charge,
Per
Extension
BASE FEE
15.00
10.00 *6.0000
EA PLB FIXTURE
60.00
1.00 15.0000
EA PLB BUILDING SEWER
15.00
LQPERMIT
..
_.
Application .Number . . . . . . 07-00000638.
Permit . . . . . . PLUMBING
Qty Unit Charge Per
Extension
1.00 7.50001EA PLB WATER HEATER/VENT
7.50
1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00
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 .. 8/27/07
Qty Unit Charge Per
Extension
BASE FEE
15-00 '
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Special Notes and Comments
SFD - LOT 44, PLAN 4515B, 1773 SF.
WITH 4' GARAGE EXT..(103SF) & BOX BAY Q
MORNING ROOM (24 SF.). 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
20.,00
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
995.00
ENERGY. REVIEW FEE
55.22
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
x892.00
STRONG MOTION (SMI) - RES
15.93
DIF STREET MAINT FAC -RES
67.00.
DIF TRANSPORTATION - RES
1930.00
Fee summary" -Charged Paid Credited
Due
Permit Fee Total 1139.84 .00 .00
1139.84
Plan Check Total 621.02 .00 .00
621.02
Other. Fee Total 4566.15 .00 .00
4566.15
Grand Total 632.7.01 .0.0 .00
632.7.01
. LQPERMIT
.