06-1971 (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:
L�
T-vy 4 4 Q"
BUILDING & SAFETY DEPARTMENT .
BUILDING PERMIT
06-00001971
61275 PORTULACA DR
764-280-999-162 -300235-
DWELLING - SINGLE FAMILY DETACHED
MEDIUM HIGH DENSITY RES
166970
(p
--'A, t or Engineer): PAY
O
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with j
Section 7 00) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
Lic icense Nc.: 672285
Date. tR ontractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I ani 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 ($500).:
(_) 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
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or 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 -builder will have the burden of proving that he or she did not build or
improve for the 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 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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: IIX
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777=713
Date: 5/12/06
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor:
SHEA HOMES, INC.
81260 AVENUE 62
LA QUINTg, CA 92253
(760)777-6005
Lic. No.: 672285
--------------- - - -
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 and policy number are:
Carrier AMERICAN HOME Policy Number 1247619
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner o as to beffsbjecthe workers' compensation lawsof California,
and agree that,if I s comorkers' compensation provisions of Section
3 00 of the Labo e, hall fith those provisions.
a 0 scant:
WARNING: FAIEURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001. 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 Quinta, 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.
I certify that I have read this application and state that thea ove informat' n is corre I agree to comply with all
city and co ty or finances and state laws relating to builds on5truc i and her authorize representatives
of this n upon the above-mentioned Drop y o sped r s
ate. ature (Applicant or Agent):
LQYERMIT
Application Number .
. . 06-00001971
Permit
BUILDING PERMIT
Additional desc . .
Permit Fee . . . .
874.00 Plan Check Fee
568.10
Issue Date
Valuation . . . ..
166970
Expiration Date
11/08/06.
Qty Unit Charge
Per
Extension.
BASE FEE
639.50
67.00 3.5000
-------------------------------------------------------------------------------
THOU BLDG 100,001-500,000
234.50
Permit
MECHANICAL
Additional desc .
Permit Fee . . .
77.00 Plan Check Fee
19.25-
9.25Issue
IssueDate
Valuation
0
Expiration.Date
il/08/06 �-
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 9.0000
EA MECH FURNACE <=100K
18.00
2.00 9.0000
EA MECH B/C <=3HP/100K BTU
18.00
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 . . .
89.59 Plan Check Fee ..
22.40
Issue Date -.
Valuation . . .
0
Expiration Date
11/08/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1847.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
64.65
497.00 :0200
-------------------------------
ELEC GARAGE OR NON-RESIDENTIAL
---------------------------------------------
9.94
Permit . .
PLUMBING
Additional desc .
Permit Fee . . . .
129.00 Plan Check Fee
32.25
Issue Date . . . .
Valuation .. . . .
0
Expiration Date
11/08/06
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
r -
LQPERMIT
Application Number . . . . . 06-00001971
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- 9.0000 EA PLB LAWN SPRINKLER SYSTEM
9.00
.6.00 .7500 EA PLB GAS PIPE >=5
4.50
1.00 15.0000 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*. 11/08/06
.. Qty Unit Charge- Per.
Exter-.Fion
BASE FEE
15.00
---------------------------------------------------------
Special Notes and Comments
------------
SFD - Lot162 Plan 5505C w/MBR Box
(26sf) Garage Ext (41sf) Patio Ext
(315sf). Permit does notinclude
blockwall, pool or driveway approach.
Other Fees. . . . . . . ART IN PUBLIC PLACES -RES
20:00
DIF COMMUNITY CENTERS -RES
74.00 '
DIF CIVIC -CENTER - RES.
480.00,
ENERGY REVIEW FEE
56.81
DIF'FIRE PROTECTION -RES
140.00
DIF LIBRARIES - RES
355.00
DIF PARK MAINT.FAC -.RES
22.00
' DIF PARKS/REC - RES
892.00
STRONG MOTION (SMI).- RES
16.69
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1666.00
• Fee summary Charged Paid Credited
Due
Permit Fee Total 1184.59 .00 .00
1184.59
Plan Check Total'. 642..00 .00 .00
642.00
Other Fee Total 3789.50 .00 .00
-3789.50
Grand Total 5616.09 .00 .00
5616.09
LQPERMIT