04-8164 (SFD)BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 922.53 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number . . . . 04-00008164 Date
Property Address . . . . . . 81098 BARREL CACTUS RD
APN: 764-270-999-40 -300233-
Application description . DWELLING - SINGLE FAMILY ET
Property Zoning . . . . . . MEDIUM HIGH DENSITYS e
Application valuation . . . . 153474 lU�
Owner
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE AZ 85258
2/14/05
Contractor JULW 04 2005
SHEA HOMES , IwNC . CITY OF LAQUINTA
81260 AVENUE �6 2 FIWi3C7C .
DEPT
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 4530B -----
Construction Type . . . . . TYPE V - NON RATED
Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10
Flood Zone NON -AO FLOOD ZONE
Other struct info . . . . . CODE EDITION 2001
# BEDROOMS 3.00
FIRE SPRINKLERS NO
GARAGE SQ FTG 488.00
PATIO SQ FTG 134.00
"NUMBER OF UNITS 1.00
1ST FLOOR SQUARE FOOTAGE 1759.00
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc
Permit Fee . . . . 828.50 Plan Check Fee 538.53
Issue Date . . . . Valuation 153474
Qty Unit Charge Per Extension
BASE FEE 639.50
54.00 3.5000 THOU BLDG 100,001-500,00.0 189.00
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Permit . . . . . . MECHANICAL
Additional desc
Permit Fee 46.00 Plan Check Fee 11.50
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 9.0000 EA' MECH B/C <=3HP/100K BTU 9.00
P.O. Box 1504 • 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: 04-8(10 te: 3'y•U�
Applicant: t Engi
Applicant's Mailing Address: -Architect or Engineer's Address: (1)
10
ic. No.:J�
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm and enalty of perjury that I am licensed under provisi, s of C pier mrre_npwith Section 7000) of Division 3 of the Business and Professionals
Cod ,and my Lin �b n full force and effect.
cense Class
/ dense No.
late` ` actor
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:
1 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 lor which this permit is issued.
I h v and willnaintain workers'jbmpensation insur nce, as re9�irgd by Sec 'on 3700 of the Labor Code, for the performance of the work for which this permit is
1 ed. yly o ers' compe do urance car r
er Ii V� e
mo y Number
_ 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
fortwith comply with those p i ' s.
�at�5 Applicant
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 the above i rmation is correct. I a ee to comply with all city and county ordinances and state laws relating to building
constructio , and h reby authorize representatives of this count r upon the bo entioned property for inspection purposes.
/� Signa,"re (Applicant or Age ! .
Page
2
Application Number
04-00008164 Date
2/14/05
Qty Unit
Charge
Per
Extension
1.00
6.5000
EA MECH VENT FAN
6.50
1.00
6.5000
EA MECH EXHAUST HOOD
6.50
--------------------7-------------------------------------------------------
Permit . . .
. . . ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee .
. . .
86.33 Plan Check Fee
21.58
Issue Date
Valuation . .
0
Qty Unit
Charge
Per
Extension
BASE FEE
15.00
1759.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
61.57
488.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
9.76
--------------------------
Permit . . .
--------------------------------------------------
. . . PLUMBING
Additional desc
Permit Fee .
. . .
122.25 Plan Check Fee
30.56
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
5.00
.7500
EA PLB GAS PIPE >=5
3.75
1.00
15.0000
EA PLB GAS METER
15.00
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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
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Special Notes
and Comments
SFD - LOT 40,
1759 SF.
PLAN 4530A W/
BOX BAY AT NOOK (26 SF). PERMIT DOES NOT
INCLUDE POOL,
SPA, BLOCK WALLS, OR
DRIVEWAY APPROACH
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Other Fees .
. . . .
. ... . ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
Page 3
Application Number
. . . . .
04-00008164 Date
2/14/05
-----------------------------------------------------------------------------
Other Fees . . .
. . . . . .
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
53.85
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
15.34
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Charged
----------
Paid Credited
----------
Due
Permit Fee Total
1098.08
--------------------
.00 .00
1098.08
Plan Check Total
602.17
.00 .00
602.17
Other Fee Total
2474.19
.00 .00
2474.19
Grand Total
4174.44
.00 .00
4174.44