10-1172 (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:
T4'(t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
10-00001172
81195 CASPIAN CT_
764-280-004-30 —35996 —
DWELLING — SINGLE FAMILY DETACHED
LOW DENSITY RESIDENTIAL
157928
Architect or Engineer:
i)lA
Owner:
SHEA LA QUINTA
60800 TRILOGY
LFL QUINTA, CA
Contractor:
SHEA HOMES, INC.
60800 TRILOGY P
LA QUINTA, CA 92253
(760)777-6032
Lia. No.: 672285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
�c� p 12010
Date: 11/03/10
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---------'------"-------------------------- - - - - -
LICENSED CONTRACTOR'S DECLARATION
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--
WORKER'S COMPENSATION DECLARA770M
'I herebyeffirm under penalty of perjury that I am licensed under provisions of Chapter (commencing with
I hereby affirm under penalty of perjury one of the. following declarations:
Section 7001? Divisiom3 oYthe 8usin ss and Profesal n s Code, and my License is in full.force and effect.
I have and will maintain a certificate of consent toselYinsure for workers' compensation,:as provided
LlcenaerClas : cerise No;: 672285
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
-
/bate: ntractor:
issued.
-%,I have and will maintain workers' compensation Insurance, as required'by Section 3700 of;the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the -
Carrier LIBERTY MUTUAL Policy Number WA266D066115030
following reason: (Sec. 7031.5, Business and 'Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work'for which this permit is Issued, I shall not employ any
construct, after, improve, demolish, or repair: any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to thwprovislons of the"Contractor's State
and agree that; if I should' become;subject'to the workers' compensation provisionsof Section
License LawE(Chapter. 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code, I shall forthwith comply with those'pr&isions;
that,he oushe is exempt. therefrom, and the basis for the alleged exemption. Any violation,of,Section 7031.5`by
J
any applicant fora permit subjects the applicant toe civil penalty of not more then five hundred dollars (8500).:
at
!cant:_
1 _J I, avowner of the property, or my employees with wages ",their sole compensation, will do the work, and
the structure is not Intended or offered for sale (Sac. 7044, Business and Professions Code: The,
WARNING: FAILURE TO SECURE WORKEWCOMPENSATION COVERAGE:IS UNLAWFUL, AND SHALL.
Contractors' State License Law does not apply to an owner of property who builds "or"improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES,AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself,through his or -her own employees, provided that the
DOLLARS (8.100,0001• IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements"are not Intended. or offered forasle. If, however, the building or Improvement I' sold within
SECTION $706 OF`THE LABOR CODE,, INTEREST, AND ATTORNEY'S FEES.
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.
APPLICANT ACKNOWLEDGEMENT.
1 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec:
IMPORTANT Application is hereby made to the Director of Building and Safetyfor a permit subject to.the
_
7044, Business and Professlons Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this:applicatlon.
property who builds or Improves!thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application;is made, each person at whose request ;and'for
pursuant w1he Contractors'�Siate License. Law.).
whose benefit work- is pe0ormed;underor pursuant to:any,permit issued.as a resutt:of thWapplicatlon,
1 _) I am. exempt under Sec. , B.&P.C. for this`resson
the owner,, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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:;
Lender's Address: rl
LQPERMIT
of La Quints, 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 correct. I agree to comply with all
city and my ordinances and state laws relating to building construction, and hereby authorize representatives
ofthi cou ty enter upon the above-mentioned property for inspection purposes.
Date nature (Applicant or Agent):
Application Number . . . 10-00001172
Permit . . . . . . PLUMBING
Qty
Unit Charge
Per
15.00
---------------- -------------------- ---------------------------------------------
---------- - -.Special Notes and Comments
Special
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
892.00
Additional
desc .
DIF STREET MAINT FAC -RES
67.-00
DIF TRANSPORTATION - RES
1930.00
Permit Fee
. . . .
15.00
Plan Check. Fee
.00
Issue Date
. . . .
Valuation . . . .
0
Expiration Date . . 5/02/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
---------------- -------------------- ---------------------------------------------
---------- - -.Special Notes and Comments
Special
SFD - LOT 30, PLAN 4515A, 1773 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. 20-10
PLAN UPDATE.
------------------------------ ------------------------------------
Other Fees . .. . . . . . BLDG STDS ADMIN (SB14734)
7.00
DIF COMMUNITY CENTERS -RES
74.00
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
22.00
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
------------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
LQPERMIT
Charged Paid
1148.53 .00
155.08 .00
5795.48 .00
7099.09 .00
Credited Due
.00 1148.53
.00 155.08
.00 5795.48.
.00 70.99.09
Application Number . . . . . 10-00001172
Permit.
. . . BUILDING PERMIT
Additional
desc .
Permit Fee
. . . . 84.2.50 Plan Check Fee
136.96
Issue Date
. . . Valuation . .
157928
Expiration_
Date 5/02/11
Qty Unit Charge Per
Extension;
BASE FEE
639.50
58.00
3.5000 THOU BLDG 100,0.0,1-500,000
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 <=look
9..00
1.00
16.5000 EA MECH B/C >3-15HP/>100K-500KBTU
16.50
5.0.0
6:.5000 EA MECH VENT FAN
32.50
1.00
6..5000 EA MECH EXHAUST HOOD
6.50
Permit
. . . ELEC-NEW RESIDENTIAL
Additional�desc
.
Permit Fee,
87.7.8 Plan Check Fee
5.48
Issue Date
. . . . Valuation . . . .
0
Expiration Date 5/02/11
Qty Unit Charge Per Extension
BASE FEE 15.00
1773.00 .0350 ELEC NEW RES, 1 OR 2 FAMILY 62.06
536.00 .020.0 ELEC GARAGE OR NON-RESIDENTIAL 10.72
Permit.. . . . PLUMBING
Additional desc .
Permit Fee . . 123.75 Plan. Check Fee 7.73
Issue Date Valuation . . . . 0
Expiration Date 5/02/11
Qty Unit Charge Per Extension
BASE FEE 15.00
9.00 6.0000 EA PLB.FIXTURE. 54.00
1..00 15.000.0 EA PLB BUILDING SEWER 15..00
LQPK*IT