04-8115 (SFD)T4hf 4 4 4"
504
LE TAMPICO
CALIFORNIA 92253
BUILDING PERMIT
r . .
Property Address . . .
APN:
Application description
Property Zoning . . . .
Application valuation .
Owner
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
04-0000.811 � Date 1/31/05
. . . 81146 BARREL CACTUS RD
764-270-999-36 -300233-
. . . DWELLING - SINGLE FAMILY DETACHED
. . . MEDIUM HIGH DENSITY RES
. . . 141190
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' PLAN 4510A -----
Construction Type . . . . . TYPE V - NON RATED
Occupancy Type . . . DWELLG/LODGING/LONG <=10
Flood Zone . . . . . . . . NON -AO FLOOD ZONE a
Other struct info . . . . . CODE EDITION 2001
# BEDROOMS 3.00
FIRE SPRINKLERS NO
GARAGE SQ FTG 479.00
PATIO SQ FTG 457.00
NUMBER OF UNITS 1.00
1ST FLOOR SQUARE FOOTAGE 1556.00
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc
Permit Fee . . . . 786.50 Plan Check Fee-. 511.23
Issue Date . . . . Valuation . . . . 141190
Qty Unit Charge Per Extension
BASE FEE 639.50
42.00 3.5000 THOU BLDG 100,001-500,000 147.00
----------------------------------------------------------------------------
Permit . . . . . . MECHANICAL
Additional desc . .
Permit Fee . . . . 77.00 Plan Check Fee 19.25
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 BIC <=3HP/100K BTU 18.00
r
P.O. Box 1504 • VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 4
INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT ! 1/�l
N \` 1 L 7
Application Number:
Applicant:
Applicant's Mailing Address:
Bate:
Ar 9tSdWgi ee �SJ�
chitect or Engineer's Address:
c No.:����
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
tion 7000) of Division 3 of the Business and Professionals
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
4he
oVwers'
ich this permit is issued.
ain workers' compensation insurance, as re 'red by S on 700 of the Labor Code, for the performance of the work for which this permit is
compensation insurance canier a� PP���� um
er icy Number J!�"C
_ 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 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
rthwith comply with those visions.
to pplican
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
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, indemnify and hold harmless the City of La Ouinta, 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 ttre ve information i rrect. I agree to comply with ail qty and county ordinances and state laws relating to building
constru�r ndVreby authorize representatives of this n enter the above-mentioned property for inspection purposes.
ate Signature (Applicant o rent): -
Application Number ... . . . 04-00008115
Page 2
Date 1/31/05
Qty Unit
Charge
Per
Extension
3.00
6.5000
EA MECH VENT FAN
19.50
1.00
6.5000
EA MECH EXHAUST. HOOD
6.50
----------------------------------------------------------------------------
Permit . . .
. . .
ELEC-NEW RESIDENTIAL
Additional desc
. .
Permit Fee .
. . .
79.04 Plan Check Fee
19.76
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
1556.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
54.46
479.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
9.58
----------------------------------------------------------------------------
Permit . . .
. . .
PLUMBING
Additional desc
Permit Fee .
. . .
123.00 Plan Check Fee
30.75
Issue Date .
. . .
Valuation
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
9.00
6.0000
EA PLB FIXTURE
54.00
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 36,
1556 S.F
Plan 4510A w/Box
Bay MBR (26sf)
& Extended
Patio (120sf):
PERMIT DOES NOT
INCLUDE POOL, SPA, BLOCK
WALLS, OR DRIVEWAY
APPROACH
------------------------------------------------------7---------------------
Other Fees .
. . . .
. . . . ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
Page 3
Application Number . . . . . 04-00008115 Date 1/31/05
----------------------------------------------------------------------------
Other Fees . . . . . . . . . DIF CIVIC CENTER - RES 366.00
ENERGY REVIEW FEE 51.12
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 14.11
DIF STREET MAINT FAC -RES 15.00
DIF TRANSPORTATION - RES 1098.00
Fee summary Charged
Permit Fee Total 1080.54
Plan Check Total 580.99
Other Fee Total 2470.23
Grand Total 4131.76
Paid Credited Due
---------- ---------- ----------
.00 .00 1080.54
.00 .00 580.99
.00 .00 2470.23
.00 .00 4131.76