10-1128 (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:
10-00001128
81-152 CASPIAN CT
764-280-004=26 -35996 -
DWELLING - SINGLE FAMILY
LOW DENSITY RESIDENTIAL
226539
4
BUILDING &,SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
60800 TRILOGY. PARKWAY
DETACHED LA QUINTA, CA 92253
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
I hereby nder penalty of perjury that I am licensed under p'ovisionsof Chapter 9 (commencing -with
Section 70 0► Di ision 3 of the Busi end Profession Code, and my License:is in full,force and effect.
Li nse 1 nee"No.: 672285
Date• actor..
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjurythat1 am exemptfrom the Contractor's State License Law for the
following reason (Sec. 7031.5,.Business and Professions Cada: 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 (Chapter9 (commencing with Section 70001 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).:
(_ ) 1, aspwner of the property, or -my employees with wages as their sole compensation, will do the work, and
the -structure ismot Intended or offered for saie'fSec. i044,` 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 of 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 (wilder will have the burden of proving that he or she did not build or
improve for ther purpose of sale.).
(_ 1 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,).
(_) 1 am exempt under Sec. B.&P 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 issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Contractor:
SHEA'HOMES, IN
60800 TRILOGY
LA QUINTA, CA
(760)777-6032
Lic. No.: 6722
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/28/10
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ 1 have and wilLmaintain a certificate of consent to -self -unsure for workers' compensation, as,provided
for by Section 3700 of the. Labor Code, for the performance of the work for which this permit is
1�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 thWpermk'is Issued. My workers' compensation
insurance carrler.and policy number are:
Carrier LIBERTY MUTUAL Policy Number WA266DO66115030
I certity.,that, in the performance of the work for which this permit is issued, I shall not employ any
. arson In any manner so as. to become.subject to the workers' compensation laws:of'California,
e , agree that, if'I should become subject to the workers' compensation provisions of'Section
3
CA wit the Labor,Code, l shall forthwith c ply with.those provisions.
ate: I v plicant:
WARNING: FAILURE TO SECURE WORKE COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED"THOUSAND
DOLLARS (8100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLI CANT. AC KNO W LEDGEM ENT
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 requestand for
whose benefit work is performed under or pursuant. any permit issued as a result of this application,
the owneri and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quints, its officers, agents and employees for arty actor omission related to the, work being
performed undoror following issuanceofthis. permit.
2. Any permit Issued as a result ofthisapplication becomes null and void if work; Is commenced
within 180. days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
1 4andordinanc
ead this application and state that the above information is correct. I agree to comply with all
Cies' and state laws relating to building construction, and hereby authorize representatives
of er upon t above-mentioned propefor Inspection purposes.
slurs (Applicant or Agent):
4.1' _ '-..
Application Number . . . . . 10-00001128
Permit.
. . . BUILDIN_G PERMIT
Additional
desc . .
Permit Fee
. . . .
.1084.00 Plan Check Fee
704.60
Issue Date
. . .
Valuation
226539
Expiration
Date
4/26/11
Qty Unit Charge
Per
Extension
BASE FEE
639.50
127.00
3.5000.
THOU BLDG 1,00,001-500,000
444,50
Permiti
. . . MECHANICAL
Additional
desc . .
Permit Fee
. .
111.50 Plan Check Fee
27.88
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
4/26/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00
9.0000
EA MECH FURNACE <=100K
18.00
2.0.0
16.5606
EA MECH B/C >3-15HP/>100K-500KBTU
33.00
6-.00
6.5000
EA MECH VENT FAN
39.00
1.00
----------------------------------------------------------------------------------
6.5000
EA MECH EXHAUST HOOD
6.50
Permit.
. . . ELEC-NEW RESIDENTIAL
Ad'ditionaldesc
. .
Permit Fee
. . . .
119.17 Plan Check Fee
2:9.79
Issue Date
Valuation . . . .
0
Expiration
Date
4/26/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2599.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
90.97
660.00
.02.00
ELEC GARAGE OR NON-RESIDENTIAL
13.20
Permit.
PLUMBING
Additional
desc . .
Permit Fee
. . . .
160.50 Plan Check Fee
40.13
Issue Date
Valuation . . . .
0
Expiration
Date . .
4/26/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
15.00
6.0000
EA PLB FIXTURE
90.00
1.00
15.0000
EA PLB BUILDING SEWER
15.00
LQPERMIT
Application Number . . . . . 10-00001128
Permit . . . . PLUMBING
Qty
Unit Charge
Per
BASE FEE
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
8.00
.7500
EA
PLB
GAS PIPE >=5
6.00
1.00
15..0:000
EA
PLB
GAS METER
15..00
Permit. . . . GRADING PERMIT
Additional desc .
Permit Fee 15.00
Issue Date . . . .
Expiration Date 4/26/11
Plan Check Fee .00
Valuation 0
Qty Unit Charge Per
Extension
BASE FEE
15.0.0
------------------------------------------
Special Notes and Comments
SFD - LOT 26, PLAN 5500B,..259.9 SF.
INCLUDES 149 SF. EXERCISE ROOM & 63 SF.
BAY @ MBR. 2007/2008 CODES.
2010 PLAN
UPDATE..
--------- ---------:--------- ----------------
Other Fees. . .
-
. ART IN PUBLIC PLACES -RES
66.35
BLDG STDS ADMIN (SB1473-)
10.00
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER -RES
99.5.00
ENERGY REVIEW FEE
70.46
DIF FIRE PROTECTION -RES
140.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
355.00
MULTI -SPECIES (MSHCP) FEE
1284.00
DIF PARK MA INT FAC'- RES
22.00
DIF PARKS,/REC - RES
892.00
STRONG :MOT.ION (SMI) - RES
22.65
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
1490.17 .00
8.02.40 .00
592.8.46 .00
8221.03 .00
Credited Due
.00 1490.17
.00 602.40
.00 5.928.46
.00 8221.03