HomeMy WebLinkAbout0305-234 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
640934 B 6/30/03
Date Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section , B&P.C. for this reason
Date Signature of Owner
WORKER'S.COMPENSATION DECLARATION
I 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 work for which this permit 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 insurance carrier & policy no. are:
Cartier NATIONAL UNION F: Policy No. 7085309
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) I certify that in the performance of the work for which this permit is 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 I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
Date: Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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 State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) Date
BUILDING PERMIT PERM
0305-234
DATE VALUATION $165,003.40 LOT 183 TRACT 30023
JOB SITE
ADDRESS 60-260 POINTSETTIA PLACE
AP" 764-270-017
OWNER
CONTRACTOR / DESIGNER / EN (NEER
SHEA HOMES FOR ACTIVE ADULTS
SHEA HOMES
60-311 TRILOGY PARKWAY
81.260 AVENUE 62
LA QUINTA CA 92253
THERMAL CA 92883
(909)833-8996 CBL# 6876
USE OF PERMIT
SINGLE FAMILY DWELL NG
WALLS, POOL, SPA OR DRIVEWAY APPROACH
CUSTOM CONSTRUCTION 1,943.00 SF
PORCH/PATIO 177.00 SF
OARAGE/CARPORT 576.00 SF
ESTIMATED COST OF CONSTRUCTION
165,003.40
PERMIT FEE SUMMARY
CONSTRUCTION FEE 101-000-418-000 $870.50
PLAN CHECK FEE 101-000-439-318 $707.35
MECHANICAL FEE 101-000-421-000 $80.00
ELECTRICAL FEE 101-000-420-000 $113.03
PLUMBING FEE 101.000-419.000 $146.75
STRONO MOTION FEE - RESID 101-000-241-000 $16.50
GRADING FEE 101-000-423-000 $15.00
DEVELOPER IMPACT FEE $1,407.00
SUB -TOTAL CONSTRUCTION AND PLAN CHECK
$4,356.13
LESS PRE -PAID FEES
$0.00
TOTAL PERMIT FEES DUE NOW
$4,356.13
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
P.O. BOX 1504 TEL 760-777-7012
78-495 CALLE TAMPICO INSPECTION REQUESTS
LA QUINTA, CALIFORNIA 92253 760-777-7153
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INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings 017
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
O.K. to Wrap i
Exhaust Fans
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall /10
Exterior Lath
Drywall - Int. Lath
f
Final
Final
BLOCKWALL OVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Pininn
PLUMBING APPROVALS
i
Gas Test
Electric Final
Waste Lines Obi
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test r
Appliances
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole I
Underground Conduit _
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power �-
Final
Utility Nolice (Perm)
Final
COMMENTS;
Coachella Valley Unified S( col District
P.O. Box 847, Thermal, CA 92274
(760) 398-5909 — Fax (760) 398-1224
Project Name:
This Box For District Use Onl,
DEVELOPER FEES PAID
AREA:
AMOUNT
LEVEL ONE AMOUNT:
LEVEL TWO AMOUNT:
MITIGATION AMOUNT:
COMM/IND. AMOUNT:
DATE
RECEIPT
CHECK N
INITIALS
CERTIFICATE OF COMPLIANCE
(California Education Code 17620)
Date: 6 4(o 03
Owner's Name: Shea Homes Trilogy at a iji nta Phone No. 777-6032
Project Address: Pni nteetti a Pl ace. Tmpal a Drive La QUinta. CA 92253
Project Description: 11 siqnle fami 1 y homes
APN: 764-270-017
Tract #: 30023
Lot #'s: 84-90,181-184
Type of Development: Residential XXXXX�yyy _ Commercial Industrial
Total Square Feet of Building Area: 23,620 sq. ft.
Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement
under penalty of perjury and further represents that he/she is authorized to sip on beha"f the owner/developer.
Dated: Signature:
SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN
ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE)
Education Code Gov. Code Project
17620 65995 Approval
Number of Sq.Ft. 23,620
Amount per Sq.Ft. $ .34
Amount Collected $ 8,030.80
Building Permit Application Completed: Yes/No
By: Carey M. Carlson
Asst. Supt., Business Serv.
Agreement Existing Not Subject to Fee
Prior to 1/1/87 Requirement
Note: This is a Adult complex, (age -related)
and is deemed Adult qua i ing residents.
r
Certificate issued by: Elyi ra" Mattson Signature:
Office Technician
NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES
Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to
the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90-day period to protest the imposition of
these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall
serve to advise you that the 90-day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of
any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether
payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This
Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School
District, and up to three (3) such extensions may be granted. At such time as this Certificate expires, if a building permit has not been issued for the project
that is the subject of this Certificate, the owner will be reimbursed all fees that were paid to obtain this Certificate of Compliance.
MV:c/mydocs/devfees/certificate of compliance 09/30/02
1
Date
P.O. Box 1504
78-495 CALLE TAMPICO (760) 7 7 7 - 7 0 0 0
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7101
May 29, 2003
Owner: Shea La Quinta, LLC
60-311 Trilogy Parkway
La Quinta, Ca 92253
PERMIT FEE SUMMARY
Builder: Shea La Quinta
60-311 Trilogy Parkway
La Quinta, Ca 92253
—a -- i - r% :-.... 11 cCn T.-,..'2lV194 1 -+f QA-QA IQI-1QA
Lot
Plan
Sq. Ft.
Address
APN
Permit #
Fees
90
5505B
2,098
60-299 Poinfsettia Place
764-270-017
D30tp-2t1-
$4,438.78
89
5505C
1,821
60-277 Poinj4ettia Place
764-270-017
o3es-127
$4,229.82
88
5210A
2,208
60-255 Poinysettia Place
764-270-017
305 -t 2
$4,491.08
87
551513
2,456
60-233 Poinsettia Place
764-270-017
0305.2.)-q
$4,660.36
86
6420A
2,777
60-211 Poinjsettia Place
764-270-017
0.905 .230
$4,940.17
85
6420C
2,754
60-189 Poinysettia Place
764-270-017
0, 05-231
$4,926.24
84
5210A
2,163
81-624 Impala Drive
764-270-017
0.30 5 -232
$4,447.82
184
521 OA
2,208
60-282 Poinjsettia Place
764-270-017
D305 -W3
$4,476.14
183
4520B
1,943
60-260 Poinjsettia Place
764-270-017
0 305-2.4
$4,356.13
182
4520A
1,662
60-238 Poinysettia Place
764-270-017
305 -23
$4,155.09
181
4510A
1,530
60-216 Poinsettia Place
764-270-017
03os-23
$4,110.55
Total Area
23,620
Total Permit Fees
49,232.18
* Denotes 75% reduction to plan check fee due to multiple issuance of same plan type. All
other permits full fee.
(760) 777-7012 - Building & Safety Department - Fax (760) 777-7011 ���