04-8112 (SFD)Toihf 4 4 Q"
3
TAMPICO ,
ALIFORNIA 92253
BUILDING PERMIT
Property Address . . .
APN:
Application description
Property Zoning . . . .
Application valuation .
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
�0 4Q00i0�0�81�_ls_2� Date 1/31/05
ACTUS RD
764-270-999-34 -300233-
. . . DWELLING-- SINGLE FAMILY DETACHED
. . . MEDIUM HIGH DENSITY RES
148309
Owner
Contractor
------------------------
SHEA LA QUINTA
---- -------------------
SHEA HOMES, INC.
C/O JEFF MCQUEEN
81260 AVENUE 62
8800 N GAINEY CENTER
350 LA QUINTA
CA 92253
SCOTTSDALE
AZ 85258 (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
FIRE SPRINKLERS
NO
GARAGE SQ FTG
488.00
PATIO SQ FTG
177.00
NUMBER OF UNITS
1.00
1ST FLOOR SQUARE FOOTAGE
1688.00
---=------------------------------------------------------------------------
Permit . . . . .
BUILDING PERMIT
Additional desc
Permit Fee . . . .
811.00 Plan Check Fee
131.79
Issue Date . . . .
Valuation
148309
Qty Unit Charge
Pet
Extension
BASE FEE
639.50
49.00 3.5000
THOU BLDG 100,001-500,000
171.50
----------------------------------------------------------------------------
Permit . . . . . .
MECHANICAL
Additional desc . .
Permit Fee . . . .
64.00 Plan Check Fee
4.00
Issue Date
Valuation . . .
. 0
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
1.00 6.5000
EA MECH VENT FAN
6.50
P.O. BOX 1504�� VOICE (760) 777-7012
Taf
78-495 CALLE TAMPICo FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT `
Application Number. O L- K 11.7 -
Applicant:
1.7 -Applicant: ct rigi e
Applicant's Mailing Address: Architect or Engineer's Address:
.-1f
-ic. No.:
ate,
BUILDING PERMIT DECLARATIONS
LICENSED CONT CTOR'S DECLARATION
I hereby affirm uryd enalty of perjury that I am licensed under provi ions t 9 ( meyr g with Section 7000) of Division 3 of the Business and Professionals
Code, and my Li a is in full force and effect.
�ttcense; las — \ icenst No.
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 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
1 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 h ve and wPI maintain work rs' compensation insu nce, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
sued. rkers' com nsation i rice ca er licy b re: `
artier olicy Number
—I certify that, in the performance of the work for which pe it r su d, sha not � any person in any manner so as to become subject to the workers'
compensation laws of Califomia, an agree that, i 1 hould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
fhwt ply with tho rovis'
2�Ai
Ll
.ate plican
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.).
Lender's Name
Lenders 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,and shall, defend, indemnify and hold harmless the City of La Ouinta, its
officers, agents and employees for any act or omission related to the work beim erformed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work of commenced within 180 days from date of issuance of such permit or
cessation of work for 180 days will subject permit to cancellaf n.
I certify that I have read this application and state that the above in do is co I gree to comply with all city and county ordinances and state laws relating to building
construction, nd reby authorize re resentatives of this county e u on the abov one prop inspection purposes.
Date Signature (Applicant or Agent):
Application Number . . . . . 04-00008112
Page 2
Date 1/31/05
Qty
Unit Charge
Per
Extension
1.00
6.5000
EA MECH EXHAUST HOOD
6.50
----------------------------------------------------------------------------
Permit .
. . . . .
ELEC-NEW RESIDENTIAL
Additional
desc . .
Permit Fee
. . . .
83.84 Plan Check Fee
5.24
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
1688.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
59.08
488.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
9.76
----------------------------------------------------------------------------
M Permit .
. . .
PLUMBING
Additional
desc . .
Permit Fee
128.25 Plan Check Fee
8.02
Issue Date
. . . .
Valuation . . . .
0
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
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
34, 1688 SF
PLAN 4520A/BOX
BAY @ MBR -26
SF. PERMIT
DOES NOT
INCLUDE BLOCK WALLS,
POOL, SPA OR
DRIVEWAY APPROACH. 75%
REDUCTION TO PLAN
CHECK FEE
DUE TO MULTIPLE
ISSUANCE OFt,:
SAME PLAN
TYPE
----------------------------------------------------------------------------
Other Fees
. . . . .
. . . . ART IN PUBLIC PLACES -RES
.00
Page 3
Application Number
. . . . .
04-00008112 Date
1/31/05
----------------------------------------------------------------------------
Other Fees
. . . . . .
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
13.18
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
14.83
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Charged
----------
Paid Credited
------------------------------
Due
Permit Fee Total
1102.09
.00 .00
1102.09
Plan Check Total
149.05
.00 .00
149.05
Other Fee Total
2433.01
.00 .00
2433.01
Grand Total
3684.15
.00 .00
3684.15