04-6730 (SFD)w
n r^
�UILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
�O��78-495 CALLE TAMPI'Af� 6 1 I FAX (760) 777-7011
N N, Y
LA QUINTA, CALIFORNIA922Z0 s53 — ECTION REQUESTS (760) 777-7153
il CSG= P,r, I-NS.R
B
Application Number . . .
Property Address . . . .
APN:
Application description
Property Zoning . . . . .
Application valuation . .
Owner
F C,
ILDING PERMIT
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE AZ'85258
04-00006730 _;Date 10/14/04
81242 BARREL --CACTUS RDS
764=270 -999 -28 -300233 -
DWELLING - SINGLE FAMILY DETACHED
MEDIUM HIGH DENSITY RES
168537
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 stfuct info . .
. . . CODE EDITION
2001 CBC
FIRE SPRINKLERS
NO
GARAGE SQ FTG
576..00
PATIO SQ FTG
177.00
NUMBER OF UNITS
1.00
FIRST FLOOR SQ FTG
1917.00
---=------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc
Permit Fee . . . .
.881.00 Plan Check Fee
572.65
Issue Date . . . .
Valuation . . .
. 168537
Qty Unit Charge
Per
Extension
BASE FEE
639.50
69.'00 3.5000
THOU BLDG 100,001-500,000
241.50.
----------------------------------------------------------
--:
---------------
Permit . . . . . . MECHANICAL
Additional desc
Permit Fee . . . .
70.50 Plan Check Fee
20.00
Issue Date . . . .
Valuation . . .
. 0
Qty Unit Charge
Per
Extension
BASE FEE
13:"00
2.00 9.0000
EA MECH FURNACE <=100K
-- 18.00
.00 11.0000
EA MECH FURNACE >100K
.00
2.00 9.0000
EA MECH B/C <=3HP/100K BTU
--18.00
P.O. Box 1504Tiht44Q"
VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
La QuINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: o4-030 Date:.. �1 !�
Applicant:.—,Architect or (neer:
Applicant's Mailing Address:
Architect or Engineer's Add
No.: �C�2
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury 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 dense No.����
Date 1 Contractor
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 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 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 1, 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
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.
� 4 have and will maintain orkers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
q sukd.`ib w rker pensation i urance carri;r a�n�d golicy nurpbeQare:
�
/Garner 64t �'11� "Policy Number V71L1
_ I certify that, in the performance of the work for which this pe it is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Califomia, and agree thaA if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those.,provisions.,, 11
WARNING: FAILURE TO SECUREWORKERS' 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.).
Lender's Name
Lender's Address A
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 that I have read this application and state that the above information is act. I agree to comply with all city and county ordinances and state laws relating to !wilding
construction, and
h►,erreebbyy, authorize representativesrAen�-
o y �toer upon above-mentioned property for inspection purposes.
�te t0 �V ` Signature (Applicant
Page
2
Application Number
.
. . . . 04-00006730 Date
10/14/04
Qty Unit
Charge
Per
Extension
.00
16.5000
EA MECH B/C >3-15HP/>100K-500KBTU
.00
2.00
6.5000
EA MECH VENT FAN
13.00
1.00
6.5000
EA . MECH EXHAUST HOOD
6.50
----------------------------------------------------------------------------
Permit . . .
.
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee .
. . .
93.62 Plan Check Fee
23.41
Issue Date
Valuation
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00.
1917.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
67.10
576.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
.11.52
-.7 ---------------------------------------------------------------------------
Permit . . .
. .
PLUMBING
Additional desc
. .
Permit Fee
. . .
152.25 Plan Check Fee
38.06
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per J
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
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
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
----------------------------------------
Special Notes
-----------------------------------
and Comments
SFD LOT 28 PLAN 4520C,
1917 SF - 255 SF
CASITA, 88 SF
GARAGE
EXT. PERMIT DOES
NOT INCLUDE BLOCK
WALL, POOL, SPA OR
DRIVEWAY APPROACH.
----------------------------------------------------------------------------
Other Fee's .
. . . .
. . . . ART IN PUBLIC PLACES -RES
.00
./
"v,
Wk
Page 3
Application Number
. . . . .
04-00006730 Date
10/14/04
----------------------------------------------------------------------------
Other Fees . . . .
. . . . .
DIF COMMUNITY CENTERS -RES
98.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
57.27
DIF FIRE PROTECTION -RES
98.00
GRADING PLAN CHECK FEE
00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
503.00
STRONG MOTION (SMI) - RES
16.85
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION --RES
1098.00
Fee summary
-----------------
Charged
----------
Paid Credited
------------------------------
Due
Permit Fee Total
1212.37
.00 .00
1212.37
Plan Check Total
654.12
.00 .00
654.12
Other Fee Total
2482.12
:00 .00
2482.12
Grand Total
4348.61
.00 .00
4348.61