10-1159 (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:
10-06001159
81183 CASPIAN CT
764-280-004-29 -35996
DWELLING - SINGLE FAMILY
LOW DENSITY RESIDENTIAL
152896
T4hf 4 4 agha
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
60800 TRILOGY PARKWAY
DETACHED LA QUINTA,, CA 92253
Architect or Engineer:
A 1 k
Contractor:
�D
SHEA HOMES, INC.
60800 TRILOGY PARAWA
LA QUINTA, CA 92253
(760)777-6032.
Lic. No.: 672285
VOICE (760) 777-7012
FAX (760)'777-7011
INSPECTIONS (760) 777-7153
Date: 11/03/10
1611 _U -7
C 012010 s
(A
LICENSED CONTRACTORS DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under perielty of perjury that I am licensed under provisions of Chapter. 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7
00) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
_ I `have -and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License CI
ss:
icense,No.: 672285 _
for by,Section 3700 of the Labor Code, for tlie:performanee-of the Work for which this permit is
Dat
t
tactor:
issued.
X have and will maintain workers' compensation insurance, as required by Section;3700 of the Labor
Code, forthe performance of the work for which this permttis issued. My workers' compensation
OWNER -BUILDER DECLARATION
insuranceperrier and policy number are:
I hereby affirm under penalty of perjury that am exempt from the Contractor's State License Law for the
Cartier LIBERTY MUTUAL Policy Number WA266D066115030
following reason (Sec..7031.5, 2usiness 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, alter, Improve, demolish, or repair any structure, prior to its Issuance; also requires the applicant for the
person imanymanner so as to,becomesubject to the workers' compensation laws of California,
permit to file s elgned,statement that.he or she is licensed pursuant to the provisions.of the Contractor's State
and agree that, if should become subject to the workers' compensation provisions of Section
I
License Law (Chapter 9.Ieommencing with Section 7000) of -Division 3 of the Business and Professions Code) or
`
of the Labor Code, I shall forthwhh comply with those provisions.
that he or sheds exempt therefrom and -the basis for the alleged exemption. Any vloladon:of Section 7031.5 by
ILj`
113700
iV�
any applicantfor&permit subjects the applicant,to a civil penalty of not more than five=hundred dollars 05001•:
ffi
licant:
1 _ 1 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
WARNING: FAILURE TO SECURE WORK S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apphto 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 hWor her own employees, provided that the
DOLLARS (8100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 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.).
APPLICANT ACKNOWLEDGEMENT
(_ 1 1, 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 Safety for a permit subject to the
70", Business and,Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth`on this application.
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 to the Contractors' State License Law.).
whose benefit work -is performed under or pursuant to any permit issued as a resultof this application,
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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 permltis issued (Sec. 3097, Civ. C.)•
Lender's Name:
Lender's Address:
LQPBRMIT
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.
[,certify that I have read this application and state thauthe above information is correct. I agree to.comply with all
city and ounty ordinances=and:state laws.relating to building -construction, and hereby authorize representatives
of this c to enter upon the.above memfonor�p1`eny for Inspection purposes.
nature (Applicant or AgenU 1 _
Application.Number . . . . . 10-00001159
Permit
. . . BUILDING PERMIT
Additional
desc .
Permit Pee
. . . .
825.00. Plan Check Fee
536.25.
Issue Date
. . .
- Valuation . . . .
152896
Expiration
Date . .
5/02/11
Qty Unit Charge
Per
Extension
BASE FEE
639.50
53.00
3.5000
THOU BLDG 100,001-500,000
185.50
Permit
. . . MECHANICAL
Addit'io_nal
desc . .
Permit Fee
. . . .
66..50 Plan Check Fee ..
16.63
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
1.0.0
16.500.0
EA MECH B/C >3-15HP/>100K-500KBTU
16.50
3.00
6.5000
EA MECH VENT FAN
19.50
1.00
6.5000
EA MECH EXHAUST HOOD
6.50
Permit
. . . ELEC-NEW RESIDENTIAL
Additional
desc . .
Permit Fee
. . . .
86.62 Plan Check Fee
21.66
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date . ..
5/02/11
Qty Unit. Charge.
Per
Extension
BASE FEE
15.00
1717.00
.0150
ELEC NEW RES - 1.OR 2 FAMILY
60.10
576.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
11.52
Permit
. .
PLUMBING
Additional
desc .
Permit Fee
. .
142.50 Plan Check Fee
35.63
Issue Date
. . . .
Valuation
0
Expiration
Date
5/02/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
10.00
6.0000
EA. PLB FIXTURE
60.00
1.00
15.0000
EA PLB BUILDING SEWER
15.00
LQPK MIT
•
LQPERMIT
Application Number . . . . . 10-00001159
Permit . . . . PLUMBING
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 9.0060 EA PLB LAWN SPRINKLER SYSTEM
9.00
6.60 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
18.00
1.00 15.000.0 EA PLB GAS METER
-----------------------
15.00
Permit.�. . . GRADING_ PERMIT
Additional desc . .
Permit Fee . . . . 15.00 Plan Check Fee:.
.00
Issue Date . . . Valuation . . .
. 0
Expiration Date . . 5/02/11.
Qty Unit Charge PerExtension
BASE FEE
15..00
---------------------1-------------------------------------------------------
-----------------------------------
Special
Special Notes and Comments
------ -- -
SFD - LOT 29, PLAN 4520C, 1717 SF.
INCLUDES 26 SF BOX BAY @ MBR & 88 SF
GARAGE EXTENSION. PERMIT DOES NOT.
INCLUDE POOL, SPA, BLOCK WALLS OR
DRIVEWAY APPROACH 2.007/2007/ CODES. 201.0
PLAN UPDATE.
-------------------.-_---------------------------------------------------------
Other Fees .. . . . . . BLDG SIDS ADMIN (SB1473,)
7.00
DIF COMMUNITY CENTERS -RES
74.0.0
DIF CIVIC CENTER - RES
995..00
ENERGY REVIEW FEE
53.63
DIF FIRE PROTECTION -RES
140.00
DIF LIBRARIES - RES
355.00
MULTI-SPECIES.(MSHCP) FEE
1284.00
DIF PARK MAINT FAC - RES
22..00
DIF-PARKS/RBC - RES
892.00 .
STRONG MOTION (SMI) - RES
15.24
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00
Fee summary Charged Paid Credited
----- -------- --- ---
Due
--------
----------
Permit Fee Total 1135.62 .00 .00
1.135.62
Plan Check Total 610.17 .00 .00
610.17
Other.Fee Total 5834.87 .00 .00
5834.87
Grand Total 7580.66 .00 .00
7580.66