HomeMy WebLinkAbout0304-283 (SFD)U)
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LIULNStU UUN I KAL; I UH ULULAKAI IUN
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 k 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:
Carrier 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, 1 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]
0304-2M*
DATE VALUATION $1g 7,231.70 LOT 91 TRACT 30023
JOB SITE i
ADDRESS 60-321 POINTSETITA PLACE
AP" 764-270-017
OWNER
CONTRACTOR / DESIGNER / EN INEER
SHEA LP, Q=A, LLC
SHEA HOMES
60-311 TRILOGY PARKWAY
81-260 AVENUE 62
LA QUINTA CA 92233
TIEERMAL CA 92883
(909)833-8996 CBL# 6876
USE OF PERMIT
SINGLE FAMILY DWELL IlJG
WALLS, POOL, SPA OR DRIVEWAY APPROACH
CUSTOM CONSTRUCTION 2,208,00 SF
PORCH/PATIO 221.00 SF
GARAGEICARPORT 627,00 SF
ESTIMATED COST OF CONSTRUCTION
187,231.70
PFJZbHT FEE SUbD&ARY
CONSTRUCTION FEE 101-000-418-000 $947,50
PLAN CHECK FEE 101-000-439-318 $762.54
MECHANICAL FEE 101-000-421.000 $75,00
ELECTRICAL FEE 101-000-420-000 $123.32
PLUMBING FEE 101.000-419-000 $142.00
STRONO MOTION FEE - RESID 101-000-241-000 $18.72
GRADING FEE I01.000-423-000 $15.00
DEVELOPER IMPACT FEE $2,405.00
SUB -TOTAL CONSTRUL. ON AND PLAN CHECK
$4,489.08
LESS' PRE -PAID FEES
$0.00
TOTAL PERAM FEES DUE NOW
$4,489.08
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
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
,j4 (*:;,A
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). 11
() 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
S96tion 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:
Carrier WATHMAL+l ACIN !f: Policy No. V'1 309
(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' compensationEprovisions of Section 3700 of the Labor
Co,dej I shall forthwith comply'iWh those pr'o'visions.,
Date.'e e'1L;.-. Applicants
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, indemnity
& hold harmless the City of La Quinta, its officers, agents and employees. r
2. Any permit issued as a result of this application becomes null and void if l
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 Cifoifoenter upon
the above-mentioned property for inspection purposes.
% f F
Signature (Owner/Agent) ,€ r"~" Dater -T'
PERMIT #
BUILDING PERMIT
DATE VALUATION $187,231.70 LOT j� TRACTJOB dl
S ii 321 VMUM�i��i.�r.�',��ACIK`
ADDRESS
APN
OWNER
CONTRACTOR / DESIGNER / ENGINEER
►g11;1.sA LA QUfW.aA,1 TJ_-
T�ietL.U�"rt
€��1r•�•2.c��OA�����i NCTS 62�
A
LAatJf_r,3'{.�t�i. Qk 922S.i
[(ss
en���N�ivtt•:.L. CA 72MIZZ
USE OF PERMIT
M."LIT-2 FA.?•11i Y IMM.f M10
SI.13 • S4TT 9.1, FL -12l ;� t1t3. i'L!� l:x lJIJIti ,i�{J'Y LRL;. l'.i}S� DLAJW:
WALIA KART„ SPA OR iN.Rf 'ls'WAY.ApPft('%.A.Crl
PO11 1.41PA°.f 10 Xil.00 SP
.yAYLA.OWCat:�'t`PORT t"n'. 0 CIA`
FS"ITIV'Fr'1,l C'C+YV0FCCt!q=VC-M aN
1133,23.,70
1;"h'A+M:fT YKE 911MMi1;,ky . . .
CONSVIU4,"3'3013 FZZ 103-0(043idti(>!0 SM61a
[ri W s (` F9:it 101,000-439-318
1wiFCHAHICIhLME 101-000-421.000 �7Jt.tJQ
FLF,CTRIC,;.A3, M, Y 611-000-4?Q_f00 7x3.33
P1JlAtit3THOr"'C13,?.. 10I.-OM4)�.00�
al'i'T:ca.K-0YC)TI0£1PEE -RZMD
GRADING Pt?Ts $15.0
f)EVZA.0>'0 IMPAC PRE ���®�•f10
9U.B-T'OTII . r'..O�T2 TP,U0. 1101,1 AWD PLAN i.'�.H'
T 3 :ME-1'AU :, SES
$I).00
LrNA XOTA , P.T.t.�: twin'` v:L� ",S .S?ut NC.`►W
APR 2 8 2003.
CITY OF LA QUINTA t•
FINANCE DEPT
RECEIPT
DATE
BYD
T FI D
INSPEffR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms 8 Footings 4 44 4�2Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck —
Exhaust Fans
O.K to Wrap
Framing
F.A.U.
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING AP ROVALS
Gas Test
Electric Final
Waste Lines LIZ
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
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Condit
Rough Wiring
Low VoRage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacle£
G.F.I.
Smoke Detectors
Temp. Use of Powee
Final
Utility Notice (Perm) D. 1'5-0;1
COMMENTS:
1-chella Valley Unified Si .)ol District
f This Box For District Use Only
P.U. Box 847, Thermal, CA 92274 DEVELOPER FEES PAID
(760) 398-5909 — Fax (760) 398-1224 tDATE7RECtEIWPT
AMOLINT
: MITIGATION AMOUNT: COMWIND. AMOUNT:
CHECK # MITIALS
CERTIFICATE OF COMPLIANCE
(California Education Code 17620)
Project Name: Date: �3
Owner's Name: Shea La Oui n _a - L C Phone No. 777- 32
Project Address: Trilogy. La QUinta, CA 92253
Project Description: 5 single fami 1 v homes
APN: 764-270-017 Tract #• 30023 Lot #'s: 91-93, 185-186
Type of Development: Residential XXXXX Commercial Industrial
Total Square Feet of Building Area: _ 9,375 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 sign on be of the owner/developer.
Dated: ( 3 Signatur . -&C
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
17620
Number of Sq.Ft.
Amount per Sq.Ft.
Amount Collected
Gov. Code Project
65995 Approval
9,375
$ 3,187.50
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: Adult Qualifying Resident (55 yrs +)
Certificate issued by: E1yi ra' Mattson Signature:
Office Technician -4z�
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 (i°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.
M V:c/mydocs/devfees/certificate of compliance 09/30/02
4/24/2003 15:01 FAX 760 777 6039 TRILOGY
1� 003
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P.O. Box 1504
78-495 CALVE TAMPICO (760) 7 7 7 - 7 0 0 0
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7101
PERMIT FEE SUMMARY
Date: April 24, 2003
Owner: Shea La Quinta, LLC Builder: Shea La Quinta
60-31 1 Trilogy Parkway 60-311 Trilogy Parkway
La Quinta, Ca 92253 La Quinta, Ca 92253
Prniert- Trilnnv I a niflntn 5 CFI) T,.,-* 7nn99 I .,*. 01-01 lar;-*ua
Lot
Plan
Sq. Ft.
Address
APN
Permit A'
Fees
93
5505A
1,843
60-365 POINTSETTIA PLACE
764-270-017
0304-281
$4,257.21
92
5505C
1,821
60-343 POINTSETTIA PLACE
764-270-017
0304-28
$4,244.07
91
6210B
2,208
60-321 POINTSETTIA PLACE
764-270-017
0304-28:,,
$4,489.08
186
4210E
1,381
81,8� PRISM DRIVE
764-270-017
0304-2841
$4,016.84
185 1
5515E
2,122
60-304 POINTSESTTIA PLACE
764-270-017
0304-28!
$4,404.93
Total Area
9,375
Total Permit Fees
527,412.13
(760) 777-7012 - Building & Safety Department - Fax (760) 777-701 1 ���