04-6297 (SFD)W 4' �_--- BUILDING & SAFETY DEPARTMENT
w4-P.O: BOx 1MSa04 (760).777-7012
_ =7-8-495 CALLE':TAMPICO FAX (760) 777-7011
LAvQU TA,u6-ALIFORNIA,92253 INSPECTION REQUESTS (760) 777-7153
.� BUILDING PERMIT
Application Number
Property -Address
APN:
Application description
Property Zoning . .
Application valuation .
Owner
. . . 04-00006297 Date 9/17/04
. . . 81266 BARREL CACTUS RD
764-270-999-26 -300233-
. . . DWELLING - SINGLE FAMILY DETACHED
. . . MEDIUM HIGH DENSITY RES
186565
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE AZ 85258
Contractor
SHEA HOMES, INC.
81260 AVENUE 62
LA QUINTA CA 92253
(760) 777-6005
WCC: NTL UNION
INS
.WC: 6436568
08/01/05
CSLB: 672285
06/30/05
CCC: B
--------------------------
Structure Information -------------------------
Construction Type . .
. . . TYPE V - NON RATED
Occupancy Type . . .
. . . DWELLG/LODGING/LONG <=10
Flood Zone
NON -AO FLOOD ZONE
Other struct info . .
. . . CODE EDITION
2001 CBC
# BEDROOMS
4.00
FIRE SPRINKLERS
NO
GARAGE SQ .FTG
539..00
PATIO SQ FTG
536.00
NUMBER OF UNITS
1.00
FIRST FLOOR SQ FTG
2090.00
----------------------------------------------------------------------------
Permit . . . . . .
BUILDING PERMIT
Additional desc
Permit Fee . . . .
944.00 Plan Check Fee
613.60
Issue Date . . . .
Valuation . . .
. 186565
Qty' Unit Charge
Per
Extension
BASE FEE
639.50.
87.00 3.5000
THOU BLDG 100,001-500,000
304.50
----------------------------------------------------------------------------
Permit . . . . . .
MECHANICAL
Additional desc
Permit Fee
83.50 Plan Check Fee
20.88
Issue Date . . . .
Valuation
0
Qty Unit Charge
Per
Extension
P.O. Box 1504�� VOICE (760) 777-7012
T&f
78-495 CALLE TAMPICo FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 04' & Date: 10 4'G ll
Applicant: itec�t �EngiQe�r:
Applicant's Mailing Address: Architect or Engineer's lddr4es6
le) KhOl" " b N I
Lic. No.: p(Jl..4F, 2 -ID
4
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm u nalty of peryury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Code, and my Licen n full force and effect.
License Class License No.
lTate lll�_ — ontractory� Ak_V
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).):
U 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 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 or 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.).
U 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.).
U I am exempt under Sec. , BA P.C. for this reason
Date Owner.
WORKERS' 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.
IAaveand �worlkers
ain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
ued. J ' com ensatioy�s�rance ca rad cn aarier �p /Policy Number���
_ 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 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith
'comply with those provisions.
�Date V�� _th` plicant
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.
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.).
Lendets Name
Lender's Address
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, indemnity and hold harmless the City of La Quints. 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 co . I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this coun to enter upon t bove-mentioned properly for inspection purposes.
Oate� S ure (Applicant or Agen
i
Page
2
Application
Number .
. .
. . 04-00006297 Date
9/17/04
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
4.00,
6.5000
EA
MECH VENT FAN
26.00
1.00
6.5000
EA
MECH EXHAUST HOOD
6.50
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Permit .
. . . . .
ELEC-NEW RESIDENTIAL
Additional
desc
Permit Fee
. . . .
98.93 Plan Check Fee
24.73
Issue Date
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
2090.00
.0350
ELEC NEW RES-- 1 OR 2 FAMILY
73.15
539.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
10.78
----------------------------------------------------------------------------
Permit .
. . . . .
PLUMBING
Additional
desc
Permit Fee
. . . .
153.00
Plan Check Fee
38.25
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
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
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
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes
and Comments
SFD - LOT
26,-5505C,
2090
SF. INCLUDES
w
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
Charged Paid
1294.43
Page
3
Application Number . . . . .
04-00006297 Date
9/17/04
----------------------------------------------------------------------------
Special Notes and Comments
.00
247 SF CASITA, 22 SF BAY@MBR,83
SF
GARAGE EXT., 315 SF PATIO EXT.
PERMIT
DOES NOT INCLUDE POOL, SPA, BLOCK WALLS
OR DRIVEWAY APPROACH
----------------------------------------------------------------------------
Other Fees . . . . . . . . .
ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
61.36
DIF FIRE PROTECTION -RES
97.00
GRADING PLAN CHECK FEE
00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
502.00
STRONG MOTION (SMI) - RES
18.65
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
Charged Paid
1294.43
.00
697.46
.00
2485.01
.00
4476.90
.00
e
Credited Due
.00
1294.43
.00
697.46
.00
2485.01
.00
4476.90