04-8162 (SFD)P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING PERMIT
Application Number . . . .
Property Address . . . .
APN:
Application description . . .
Property Zoning
Application valuation . . . .
Owner
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE AZ 85258
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION'REQUESTS (760) 777-7153
04-00008162
81134 BARREL CACTUS RD
764-270-999-37 -300233-
DWELLING - SINGLE FAMILY
MEDIUM HIGH DENSITY RESP
166943 t��
Contractor
-------------- _
SHEA HOMES, INC.
81260 AVENUE 62
LA QUINTA
(760) 777-6005
Date 2/14/05
DET -ACHED
e
h' R 2005
U LA QUWTA
CA 92253
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/CONG <=10
Flood Zone . . . . .
. . . NON -AO FLOOD ZONE
Other struct info . .
. . . CODE EDITION .2001
CBC
FIRE SPRINKLERS
NO
GARAGE SQ FTG
539.00
PATIO SQ FTG
537.00
NUMBER OF UNITS
1.00
1ST FLOOR SQUARE FOOTAGE
1847.00
---------------------------------------------------------------
Permit . . ... . .
BUILDING PERMIT
-------------
Additional desc
Permit Fee . . . .
856.50 Plan Check Fee
556.73
Issue Date . . . .
Valuation . . .
. 161587
Qty Unit Charge
Per
Extension
BASE FEE
639.50
62:00 3.5000
THOU BLDG 100,001-500,000
217.00
--------------------------------------------
. . . . . .
----------------
MECHANICAL
Additional desc
Permit Fee . . . .
86.50 Plan Check Fee
21.63
Issue Date . . . .
Valuation . . .
. 0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 9.0000
EA MECH FURNACE <=100K
9.00
1.00 11.0000
EA MECH FURNACE >100K
11.00
1.00 9.0000
EA MECH B/C <=3HP/100K BTU
9..00
4'
P.O. Box 1504I4 CE VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 044116001 D e: 3'y'o
Applicant: Arch in
Applicant's Mailing Address:
or Engineers Address:
ic. No.: Ace Z640)
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 2jcomme . 9 with Section 7000) of Division 3 of the Business and Professionals
Code, and my Licr�i a is in full force and effect. jr
/,icense Class icense No.
/bate 3 1 q ���ontractor IC 1 - L
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 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 thi permit is issued.
h e al maintain w kers' compensation insurance, as required by Section 3700 of the Labor Cade, for the performance of the work for which this permit is
i ued orkers' ensation insurance ca e d n f� re:
Carrier Policy Number J 9
_ 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
i
If rthwith comply with those provisions.
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 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 rrect. I agree to comply with all city and county ordinances and state laws relating to building
const ion, a d hereby authorize representatives of t , enter up he above-mentioned property for inspection purposes.
ate �� ® iS nature (Applicant or Agent):
9 (PP
Application Number . . . . . 04-00008162
Page 2
Date 2/14/05
Qty Unit
Charge
Per
Extension
1.00
16.5000
EA MECH B/C >3-15HP/>100K-500KBTU
16.50
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 .
. . .
81.19 Plan Check Fee
3.76
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
1847.00
.0300
ELEC NEW RES - MULTI FAMILY
55.41
539.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
10.78
----------------------------------------------------------------------------
Permit . . .
. . .
PLUMBING
Additional desc
. .
Permit Fee .
. . .
120.00 Plan Check Fee
16.50
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
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 3t .L,
PLAN 5505A,
26 SF BOX BAY
@ MBR, 83 SF.
GAR. EXT.,315
SF PATIO
EXT. PERMIT DOES
NOT
INCLUDE BLOCK WALL,
POOL, SPA OR DRIVEWAY
APPROACH.
----------------------------------------------------------------------------
Other Fees .
. . . .
. . . . ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
Page 3
Application Number
. . . . .
04-00008162
Date
2/14/05
----------------------------------------------------------------------------
Other Fees . . .
. . . . . .
DIF CIVIC CENTER -
RES
366.00
ENERGY REVIEW FEE
55.67
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
16.15
DIF STREET MAINT FAC
-RES
15.00
DIF TRANSPORTATION
- RES
1098.00
Fee summary
•Charged
Paid Credited
Due
-----------------
Permit Fee Total
----------
1159.19
--------------------
.00
----------
.00
1159.19
Plan Check Total
598.62
.00
.00
598.62
Other Fee Total
2476.82
.00
.00
2476.82
Grand Total
4234.63
.00
.00
4234.63