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04-8169 (SFD)I&f 4 4 auhqL P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number . . Property Address . . . APN: Application description Property Zoning . . . . Application valuation . BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 . . . 04-00008169 Date 2/14/05 81057 BARREL CACTUS RD 764-270-999-157 -300233- . . . DWELLING - SINGLE FAMILY DETACHED . . . MEDIUM HIGH DENSITY RE . . . 145707 Owner Contractor SHEA LA QUINTA SHEA HOMES, INC C/O JEFF MCQUEEN 81260 AVENUE 62 8800 N GAINEY CENTER 350 LA QUINTA SCOTTSDALE AZ 85258 (760) 777-6005 S n D 14: 1P-0 4 2005 CITY OF LA QUINTA FIvn m nr CA 9-2- — 3 WCC: NTL UNION INS WC: 6436568 08/01/05 CSLB: 672285 06/30/05 CCC: B ------ Structure Information PLAN 4210A'W/CASITA MBR BOX BAY ----- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Other struct info . . . . . CODE EDITION 2001 # BEDROOMS 4.00 FIRE SPRINKLERS NO . GARAGE SQ FTG 474.00 PATIO SQ FTG 318.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 1636.00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 800.50 Plan Check Fee 520.33 Issue Date . . Valuation . . . . 145707 Qty Unit Charge Per Extension BASE FEE 639.50 46.00 3.5000 THOU BLDG 100,001-500,000 161.00 ---------------------------------------------------------------------------- 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 r' P.O. BOX 1504• �� VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 La QUINTA, CALIFORNIA 92253 T. INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number:* CY4 %(D / D .41•v Applicant: Ar 't Engree) Applicant's Mailing Address: Architect or Engin r s Address: 'tic. No.:`moi BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm upcief penalty of perjury that I am licensed under provisigps of17XR with Section 7000) of Division 3 of the Business and Professionals Cod , and my Li s in full force and effect. A\G/J'1 cense Class1 �se o. fe V ntraetor )2� / 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 101ork for which this permit is issued. I ve an will maintain workers' compensation insur�nce, as r q d y Section 3700 of the Labor Code, for the performance of the work for which this permit is sued. workers' co ensation ' farce carr atrd�po y5(9 -v olicy Number �/ 11�� GG��VJJ _ I certify that, in the performance of the work for wh' h 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 tha if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply With �those ns. pate /�ppl� icant 1 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 bei performed under or following issuance of this permit. 2. Any permit issued as a result of this application beco s null and void if work not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to ca ellation. I certify that I have read this application and state that the above infNI7rT?Mis corn a co ilh all city and county ordinances and state laws relating to building construct' n, and hereby authorize representatives of this co y toon the ab -mentioned property for inspection purposes. 'A\`r VJignatum (Applicant or Agent): �d 'kit Page 2 Application Number . . . . . 04-00008169 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 . . . . 81.74 Plan Check Fee 20.44 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1636.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 57.26 474.00 =--- .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.48 ---------------- Permit . . . . ------ . . ----- PLUMBING ---------------------------------- ----------- Additional desc Permit Fee . . . . 146.25 Plan Check Fee 36.56 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 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 157, Plan 4210C, 1636 SF., INCLUDES CASITA (255 SF) & MBR BOX BAY (26 SF) . --------------------------------------------------------------------7------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.0.0 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 52.03 Page 3 Application Number . . . . . 04-00008169 Date 2/14/05 --------------------------------------------------------------------=------- Other Fees . . . . . . . . . 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 14.57 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged ---------- ---------- Paid Credited -------------------- Due ----------------- Permit Fee Total 1126.99 .00 .00 1126.99 Plan Check Total 598.21 .00 .00 598.21 Other Fee Total 2471.60 .00 .00 2471.60 Grand Total 4196.80 .00 .00 4196.80