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06-2768 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 06-00002768 `81570 BALBOA CT 764-280-999-8 -300237- DWELLING - SINGLE FAMILY MEDIUM HIGH DENSITY RES 240812 Tityl 4 4a -Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: SHEA LA QUINTA C/O JEFF MCQUEEN DETACHED 8800 N GAINEY CENTER 350 SCOTTSDALE, AZ 85258 Pt rchjt: oCEngineer- ., �c�ZCetia( LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. Lice -lass: B License No.: 672285 ate: Vl ontractw. 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, cr 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.). (_ 1 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 Contractor: SHEA HOMES, INC. 81260 AVENUE 62 LA QLTTNTA, CA 92253 (760)777-6005 1 Lic- No.: 672285 f VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/24/06 AUG 0 4 2006 CITY OF LA QUINTA ------------------ 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 vYo/�ters' compensation laws of California, and agree that, if I sh Id b come suf?jec>,to the worker — compensation provisions of Section _ X 3700 of the labor o s II fort lj ith c ply with t se provisions. WARNING: FAILCIRE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 15100,0001. 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 chat I ave read this application and state at the above information is correct. 1 agree to comply with all city and c unt ordinances and state laws vela ' g co struction, andIn ,by authorize representatives of t C o to upon the above -men,' ned p p y for ' pc�cif n purpose te: ('(\��ature (Applicant o 1: Application Number . . . . . 06-00002768 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 1133.00 Plan Check Fee 736.45 Issue Date . . . . Valuation . . . . 240812 Expiration Date 1/20/07 Qty Unit Charge Per Extension BASE FEE 639.50 141.00 ---------------------------------------7------------------------------------ 3.5000 THOU BLDG 100,001-500,000 493.50 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 108.00 Plan Check Fee 27.00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 1/20/07 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 3.00 9.0000 EA MECH B/C <=3HP/100K BTU 27.00 5.00 6.5000 EA MECH VENT FAN 32.50 1.00 ---------------------------------------------------------------------------- 6.5000 EA MECH EXHAUST HOOD 6.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 124.53 Plan Check Fee 31.13 Issue Date . . . . Valuation . . 0 Expiration Date . . . 1/20/07 Qty. Unit Charge Per Extension BASE FEE 15.00 2778.00 .0350 ELEC NEW RES'- 1 OR 2 FAMILY 97.23 615.00 ---------------------------------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 12.30 Permit . . . PLUMBING Additional desc . . Permit Fee . . . . 177.00 Plan Check Fee 44.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 1/20/07 Qty Unit Charge Per Extension BASE FEE 15.00 18.00 6.0000 EA PLB FIXTURE 108.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 LQPERNIIT c LQPERMIT Application Number . . . . . 06-00002768 Permit . . . . . . PLUMBING Qty Unit Charge Per 15.00 ---------------------------------------------------------------------------- Special Notes and Comments Extension 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 . Additional desc Permit Fee Issue Date Expiration Date GRADING PERMIT 15.00 1/20/07 Plan Check Fee . . .00 Valuation . . . . 0 Qty Unit C'_-.arge Per _xtension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments .00 SFD - LOT 8, PLAN 6420C, 2778 SF (255 .00 SF. CASITA & 23 SF BAY WINDOWS AT NOOK AND MBR). 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 102.03 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 480.00 ENERGY REVIEW FEE 73.65 DIF FIRE PROTECTION -RES 140.00 DIF LIBRARIES - RES 355.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION (SMI) - RES 24.08 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION— RES 1666.00 Fee summary ----------------- Permit Fee Total Plan Check Total Other Fee Total Grand Total Charged Paid 1557.53 .00 838.83 .00 3895.76 .00 6292.12 .00 Credited Due .00 1557.53 .00 838.83 .00 3895.76 .00 6292.12