10-1175 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
10-00001175
81219 CASPIAN CT
764-280-004-32 -35996 -
DWELLING - SINGLE FAMILY
LOW DENSITY RESIDENTIAL
157928
T -&t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
6080.0 TRILOGY PARKWAY
DETACHED LA QUINTA, CA 92253
Architect or Engineer:
----------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby'afftrm under penalty of perjury that lam licensed under provisions of Chapter 9 (commencing with
Section 7000) fDivision 3 o the Businesti and .Prof esaton Is Code, and my License is in full force 'and effect.
License.Cl I: B icense No.: 672285
ate ` gntrector•
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I _am exempt: from the Contractor's State License Law for the
following reeson'(Sec. 7031.5, Business and Professions Code: Arty 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.provsions of the Contractor's State
License Law(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he orshe is exempttherefrom.and the basis for the alleged exemption. Any violationof Section 7031.5 by
any applicant for a permit:subjects thsapplicant.to a civil penalty of not more than five,hundred dollars (8500).:
1 _) 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 town owner of property who builds or improves thereon,
and who does the work himself or herself 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.).
L_) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the projecr(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.):
(_) I am exempt under Sec. ,-B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I herebyaffirm 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: I-
Lender's Address: 01 A
LQPKRMff
Contractor:
SHEA HOMES, INC.
60800 TRILOGY PARKWAY
LA QUINTA, CA 92253
(760)777-6032
,Lie. No.: 672285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/03/10
rpt 012010 .
CITY Of LA AUINTA
FIKANCE 01".
------------------
WORKER'S COMPENSATION DECLARATION
1 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 3700of the Labor Code, for the performance of the work for which this permit is
issued.
I, have and will maintain workers' compensation insuranoe,.as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:.
Carrier .LIBERTY MUTUAL Pollcy Number WA266DO66115030
_ I certify that, In the performance of the work for which this permit is.issued, 1 shall not employ any
person in any manner so;as:to,become subject to the workers' compensation laws of California,
and agree that, tf'1 should become subject to the workers' compansetion,provisions of Section
700 of the Labor Code, I shall forthwith comply with those provisions.
ate cant
WARNING: FAI URE TO SECURE WOR" WOR'COMPENSATION COVERAGE is UNLAWFUL, AND SHALL
SUBJECT.AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS0100.000). IN. ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN -
SECTION 3706 OF THE LABOR:CODE, INTEREST, AND ATTORNEY'S.FEES,
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 M whose request and for
whose benefit work Is performed under or pursuantto any permit issued as a result of this application,
the owner; and the applicant, each agrees to, and shall defend, indemnity and hold' harmless the City
.f -La Quints, its officers, agents and employees for any act ,oroniission related to the work being
performed, under or following Issuance of this permit.
2. Any permitissued 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 certifyYhat I have read this application and state .that .the above.information:(s correct. I.agree.to comply -with all
cltyand county ordinances and state laws relating•to building construction, and hereby authorize representatives
of this -col nty.- o enter upon the above-mentioned property for'inspection purposes:
I re (Applicant or Agent):
Application Number .
. . . . 10-0000.1175
Permit.BUILDING PERMIT
Additional desc .
Permit Fee . . . .
842..50 Plan Check Fee
136.90
Issue Date . . .
valuation . . . .
157928
Expiration Date
5/02/11
Qty Unit Charge
Per
Extension.
BASE FEE
639.50
58.0.0 3.5000
THOU BLDG 100,00.1-500.,000
203.00
Permit. . . MECHANICAL.
Additional desc .
Permit'Fee . . . .
79.50 Plan Check Fee
4.97
Issue Date . . . .
Valuation
0
Expiration,Date
5/02/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 9.0000
EA MECH FURNACE; <-100K
9.00
1.00 16.5000
EA MECH B/C >3-15HP/>100K-5,00KBTU
16.50
5.00 6.5000
EA MECH VENT FAN
32.50•
i'. 60 6.5000
EA 'MECH EXHAUST HOOD
6.50
Permit. . . . ELEC-NEW RESIDENTIAL
Addi.tionaldesc .
Permit_ Fee
87.78 Plan Check Fee
5.48
Issue Date . . . .
Valuation
0
Expiration Date .
5/021/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1773-.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
62.06
536.00 .0206
ELEC GARAGE OR NON-RESIDENTIAL
1.0.72
Permit. . . .
PLUMBING
Additional desc .
Permit Fee.
123.75 Plan Check Fee
1.73
Issue Date
Valuation . . . .
0
Expiration Date
5/02/11
Qty Unit Charge
Per
Extension
BASE -FEE
15.00
9-.0.0 6.0000
EA PLB FIXTURE
54.00
1.00 15.0000
EA PLB BUILDING SEWER
15.00
LQPERMIT
Application
Number .
. . . . 10-00001175
15.00
Permit . .
. . . .
PLUMBING
INCLUDES 24 SF. BAY @ NOOK. PERMIT DOES
Qty Unit Charge
Per
Extension
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
7.00
.7500
EA PLB
GAS PIPE >=5
5.25
1.00
15.0000
EA PLB
GAS METER
15.00
Permit.
. . .
GRADING PERMIT
15.79
Additional desc . .
67.00
DIF TRANSPORTATION - RES
1930.00
Permit Fee
..
15.00
Plan Check Fee
.00
Issue Date
. . . .
5795.48
Valuation . . .
. 0
Expiration Date . . 5/02/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
--------------------------------------- --
Special Notes and Comments
SFD - LOT 32, PLAN 4515C, 177.3 SF.
INCLUDES 24 SF. BAY @ NOOK. PERMIT DOES
NOT INCLUDE POOL, SPA, BLOCK WALLS OR
DRIVEWAY APPROACH. 75% REDUCTION TO PLAN
CHECK FEES DUE TO MULTIPLE ISSUANCE OF
SAME PLAN TYPE. 2007/2008 CODES. 2010
PLAN UPDATE.
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Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
7.00
DIF COMMUNITY CENTERS -RES_
74.0.0
DIF CIVIC CENTER - RES
'995.00
ENERGY REVIEW FEE
13.69
DIF FIRE PROTECTION -RES
140.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
355.00
MULTI -SPECIES (MSHCP) FEE
1284.00
DIF PARK MAINT FAC - RES
22.0.0
DIF PARKS/REC - RES
892.00
STRONG MOTION (SMI) -`RES
15.79
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00
Fee summary Charged Paid Credited
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Due
Permit Fee Total 1148.53 .00 .00
1148.53
Plan Check Total 155.08 .00 .00
155.08
Other Fee Total 5795.48 .00 .00
5795.48
Grand Total 7099.09 .00 .00
7099.09
LQPERMIT