07-1934 (SFD)) ,i
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA., CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
V Applicant:
�__07-00001934
81844 RUSTIC CANYON DR
764-280-999-75,x -300237-
DWELLING - SINGLE FAMILY
MEDIUM.HIGH DENSITY RES
159387
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT-
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
DETACHED 8800 N GAINEY CENTER
SCOTTSDALE, AZ 85258
/Architect or Engineer
Qin b
r ,
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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.
clasl B icense No.: 672285
e ntractor.
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 7031.5 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.).
(_ 1 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.' , BAP.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: I
1
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: 7/03/07
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate ofconsent 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 forwhich 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, ifSlhould become subject o the workers'compensation provisions of SectionIto 3700of the Lab, I I fWhwith omp`ly with those provisions.
11
at
plicant: ' V
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 3766 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.
certify that I have read this application and state that the above information i correct. I agree -to comply with all
city and ountyjjjordinances and state laws relating t ilding n ruction, an hereby authorize representatives
ofnclunty tQ-ettier upon the above-mentioned ny for sp fin s
DDate: 1�/Gl l(/`' nature (Applicant or Agent o
Application Number
.07-00001934
Permit
BUILDING PERMIT
Additional desc'.
Permit Fee,
849.50
Plan Check Fee
138.05
Issue Date . . .
Valuation . . . .
159387
Expiration Date
12/30/07
Qty Unit Charge
Per
Extension
BASE
FEE
639..50
6o,np i Sn00
THOU BLDG
1001001-500j000
210:00
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . . . .
65.50
Plan Check Fee
4.10
.Issue Date
Valuation
0
,Expiration Date
12./30/07.
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 9.00'00
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
89.84
Plan Check.Fee
5.62.
Issue Date
Valuation . .
0
Expiration Date ,.
12/30/07
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 . . .
120.00
Plan Check Fee'.-.
7.50
Issue Date . .
Valuation
0
Expiration Date
12/30/07
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 . . . . . 07-00001934
Permit . . . . PLUMBING
Qty Unit Charge Per
Extension
1.00 7.5000 EA 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 r.RAnTM PERMIT
-
Additional desc .
Permit Fee 15.00 Plan Check Fee
.00
Issue Date . . . Valuation . . .
. 0
Expiration Date 12/30/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
SFD - LOT 75, PLAN 4515C, 1773 SF.
WITH 4- GARAGE EXT. (103SF) & BOX BAY @
NOOK(24 SF.) PERMIT
DOES NOT INCLUDE POOL, SPA, BLOCK WALLS
OR DRIVEWAY APPROACH. 75% REDUCTION TO
PLAN CHECK FEES DUE TO MULTIPLE
:
ISSUANCE OF SAME PLAN TYEP
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
13.81
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
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 155.27 .00 .00
155.27
Other Fee Total 4524.74 .00 .00
4524.74
Grand Total 5819.85 .00 .00
5819.85
LQPERMIT