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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