10-1124 (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:
10-00001124
81188 CASPIAN CT
764-280-004-23 -35996 -
DWELLING - SINGLE FAMILY
LOW DENSITY RESIDENTIAL
180549
Ta�v 4 4v Quum
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
60800 TRILOGY PARKWAY
DETACHED LA QUINTA, CA 92253'
Architect or Engineer:
P 1r^ .
-----------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I. herebyaffirm under penalty of perjury that I amdicensed under provisions of Chapter 9 (commencing with
Section 7000) _Division 3 of the Business and Professionals Code, and my License is in full force and effect:
License Cl a a: License No.: .672285
/Data Z .( ontractor:
OVMER4 3UILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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 0500).:
(_ )' I, as owner of the property, or my, employees with wages as their sole compensation, will do the work, and
the structure; Is notintended or offered for sale (Sec., 70", Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds orimproves thereon;
and who does the work himself or herself through his or her own employees; provided that the.
improvements are notimended or°offered for'sale. It, 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.).
(_ ► I, as owner of, the property, amexclusivelycontracting with licensed contractors to construct the project (Sec.
7644, Business and Professions Code: The Contractors' State Licenselaw does not apply to an owner of
property who builds or improves thereon, and -who contracts for the projects with a contractor(s) licensed
pursuanitto the Contractors''State.Upense Lew.).
(_)
lam, exempt under Sec. , BAP.C. for this reason
Date: Owner:
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 issusd (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address: ►/l
WPERMIT
Contractor:
SHEA HOMES, INC.
60800 TRILOGY PARKWAY
LA QUINTA, CA 92253
(760)777-6032
Lie. No.: 67:2285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/28/10
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 3700 of the Labor Code, for the performance of the workfor, which thispermit is
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
insurence,.cerrier and policy number are:
Carrier LIBERTY MUTUAL Policy Number WA266D066115030
I certify that, in the performance of the work for which this permitis'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 1 should''become subjectAo the workers'compensation provisions of Section.
211700 of the Labor Code; i shall forthwith comply with those provisions.
Date:'j�J� plicam•
WARNING: FAILURE TO SECURE WORKERS' 0 PENSATION COVERAGEIS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENAL S AND.CIVIL FINES UP TO ONE HUNDRED' THOUSAND
DOLLARS (4100,000)• 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 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 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 tie application, becomes null and void If work^is not commenced
within 180 deye from date of issuance of.such permit, or cessation of work for ISO days -will subject
permit to cancellation.
I. certify that.) have read this application and state that the above Information is correct. I agree to comply withall
city and county ordinances and'state laws relating to building construction, and hereby authorize representatives
of-th�totsw he above-mentioned pr arty for inspection purposes.
ee (Applicant or Agent
Application Number . . . . . 10-00001124
Permit.
. . . BUILDING PERMIT
Additional
desc . .
.Permit Fee
. . . .
923.00 Plan Check Fee
599.95
Issue Date
. .
Valuation. . . . .
180549
Expiration
Date . .
4/26/11
Qty Unit Charge
Per
Extension
BASE FEE
639.50
81.00
3.5000
THOU BLDG 100,00.1-500,000
283.50
.Permit.
. . . MECHANICAL
Additional
desc . .
Permit Fee
. . . .
110.50 Plan Check Fee
27..63
Issue Date
Valuation . . . .
0
Expiration
Date
4/26/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00
9.0600
EA MECH FURNACE <=100K
18.00
1.00
9.0.000
EA MECH B/C <=3HP/100K BTU
9.00
1.00
16.5000
EA MECH B/C >3-15HP/>100K_-500KBTU
16.50
6.00
6.5000
EA MECH VENT FAN
39.60
2.00
6.5000
EA MECH EXHAUST HOOD
13.00
Permit.
ELEC-NEW RESIDENTIAL
Additional
desc .
Permit Pee
. . . .
98.76 Plan Check Fee
24.69
Issue Date
. . .
Valuation
0
Expiration
Date . .
4/26/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2028.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
70.98
639.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
12.78
Permit.
. . . PLUMBING
Additionaldesc
.
Permit Fee
147.75 Plan Check Fee
.36.94
Issue Date
. . .
Valuation . . . .
0
Expiration
Date . .
4/26/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
13.00
6.0000
EA PLB FIXTURE
78.00
LQPRRMIT
Application Number . . . . . 10-00001124
Permit . . . . .. . PLUMBING
Qty Unit Charge Per
Extension
1:.00 15.000.0 EA PLB BUILDING SEWER
15.00
1.00 7.5000 EA PLB WATER HEATER/VENT
7.50
1;.00 3.0000 EA PLB WATER INET/ALT/REP
3.00
1.00 9.000'0 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
PermitGRADING PERMIT
Additional desc .
Permit Fee . . . . 15.00 Plan Check Fee
.00
Issue Date Valuation
0;
Expiration Date 4/26/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
--------------------------------- - -----
Special Notes and'Comments
SFD - LOT 23, PLAN 4515C, 2.028 SF.
INCLUDES 255 SF: DETACHED CASITA,24 SF
BAY @ NOOK & 103 SF. GARAGE EXTENSION.
PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK
WALLS OR DRIVEWAY'APPROACH. 2007/2008
CODES. 2010 PLAN UPDATE.
-----------------.-------------- ------------------ -------------
Other Fees . .. .: BLDG STDS ADMIN (SB1473)
---------
8.00
DIF COMMUNITY CENTERS -RES
74.'00
DIF CIVIC CENTER - RES
995.0'0
ENERGY REVIEW FEE
6.0.00
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
18.05
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00
Fee summary Charged Paid Credited
Due
Permit Fee.Total 1295.01 .00 .00
.1295.01
Plan Check Total 689.21 .00 .00
689,.21
Other Fee Total. 5845.05 .00 .00
5845.05
Grand Total 7829.27 .00 .00
7829.27
LQPERMIT