04-8163 (SFD)P.O. Box 1504
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number . .
Property Address . . .
APN:
Application description
Property Zoning .
Application valuation .
Owner
BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
. . 04-00008163 Date 2/14/05
. . . 81122 BARREL CACTUS RD
76.4-270-999-38 -300233-
. . . DWELLING - SINGLE FAMILY DETACHED
. . . MEDIUM HIGH DENSITY RES 1j�
. . . 162115
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE AZ 85258
Contractor MSR 0 4 2005
----------------------.;� V'OF
SHEA HOMES, INC. F1MAN E0 ftA
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:struct info . .
. . . CODE EDITION
2001 CBC
FIRE SPRINKLERS
NO
GARAGE SQ FTG
520...-00
PATIO SQ -FTG
457.00
NUMBER OF UNITS
1.00
1ST FLOOR SQUARE FOOTAGE
1805.00
-----------------------------------------------7----------------------------
Permit . . . . . .
BUILDING PERMIT
Additional desc
Permit Fee
860.00 Plan Check Fee
.559.00
Issue Date . . . .
Valuation . . .
. 162115
Qty Unit Charge
Per
Extension
BASE FEE
639.50
63.00 3.5000
THOU BLDG 100,001-500,000
220.50
----------------------------------------------------------=-----------------
Permit . . . . . .
MECHANICAL
Additional desc
Permit Fee.
83.50 Plan Check Fee
20.88
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
4.00 6.5000
EA MECH VENT FAN
26.00
P.O. Box 1504�� VOICE (760) 777-7012
Tlihf
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 04- 8 l% .:2 Dat :i' Li -OS
Applicant: AjIT' Mgi er:
54—UR -)
Applicant's Mailing Address: -Architect or Engineer's Address:
.4-
+ -tic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisi ns o�pter�omme�h Section 7000) of Division 3 of the Business and Professionals
Code, and my Lice in full force and effect.
icense lass �L•iL6nse No.
�Dat� ntractor
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
okhedworkfo which this permit is issued.
dI intainwoPer'tion insurance, asp re uired Section 700 of the Labor Code, for the performance of the work for which this permit is
. M ers' corn sation i ante car ier o c m r
amer licy Number -
I certify that, in the performance of the work for which t permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, a agree that, if I ould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
fo with comply with those provisi
ate plicant
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 bein erformed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work s of 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 info of is correct. a ree to comply with all city and county ordinances and state laws relating to building
const tion and hereby authorize representatives of this county t er on the° bo enti ed property for inspection purposes.
e61-ig'naturepplicant or Agent):
Application Number. . . . . . 04-00008163
Page . 2
Date 2/14/05
Qty
Unit Charge
Per
Extension
1.00
6.5000
EA
MECH EXHAUST HOOD
6.50
----------------------------------------------------------------------------
Permit .
. . . . .
ELEC-NEW RESIDENTIAL
Additional
desc . .
Permit Fee
. . . .
88.58 Plan Check Fee
22.15
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
1805.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
63.18
520.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
10.40
-7 ---------------------------------------------------------------------------
Permit .
. . . . .
PLUMBING
Additional
desc . .
Permit Fee
147.00
Plan Check Fee
36.75
Issue Date
. . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00.
13.00
6.0000
EA
PLB FIXTURE
78.00
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
38, PLAN 4510A,
1805 SF ( 249
SF CASITA,
BOX BAY @MBR -26
SF, 120 SF.
PATIO EXT.)
PERMIT DOES NOT
INCLUDE
POOL, SPA,
BLOCK WALLS OR
DRIVEWAY
APPROACH.
--------------------------
Other Fees
. . . . .
--------------------------------------------------
. .
. . ART.IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
Page 3
Application Number
. . . . .
04-00008163
Date
2/14/05
----------------------------------------------------------------------------
Other Fees . . . .
. . . . .
DIF CIVIC CENTER -
RES
366.00
ENERGY REVIEW FEE
55.90.
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
16.21
DIF STREET MAINT FAC
-RES
15.00
DIF TRANSPORTATION
- RES
1098.00
Fee summary
-----------------
Charged
----------
Paid Credited
--------------------
----------
Due
Permit Fee Total
1194.08
.00
.00
1194.08
Plan Check Total
638.78
.00
.00
638.78
Other Fee Total
2477.11
.00
.00
2477.11
Grand Total
4309.97
.00
.00
4309.97