09-0691 (SFD)- "t
P.O. BOX 1504
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
1- 09-00000691
81297 CANTOR CT'
764-280-999-184 -300236-
DWELLING - SINGLE FAMILY
MEDIUM HIGH DENSITY.RES
262715
Tu!t 4 XP Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
DETACHED 8800 N GAINEY CE
SCOTTSDALE, AZ 8 5
Architect or Engineer:
Alp _
LICENSED CONTRACTOR'S 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 Businesand Professionals Code�andmy cense is in full force and effect.License Class:License 285
at : ontractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am 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).:
(_ 1 1, as owner of the property, or my employbes 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 1, 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. , BAP.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: ti lix
LQPERMIT
Contractor:
SHEA HOMES, INC.
60800 TRILOGY PARKWAY
LA QUINTA, CA 92253
(760)777-6005
Lic. No.: 672285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
.Date: 11/06/09
350 \
F�O1 �
F
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 NTL UNION INS Policy Number WC6987825
_ I certify that, in the performance of f work for which this permit is issued, I shall not employ any
person in any manner so as to be o e subject to the workers' compensation laws of California,
and agree that, if I sh dvvvCCC,,,ecom s j t to the workers' compensation provisions of Section
/�1! 7 0 of the abor de, II h i comply with those provisions.
Date ( 64
plicant:
WARNING: FAILURE TO SECURE WVRKPIRS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($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.
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 the above infor tion is correct. I agree to comply with all
city and county Iordinances and state laws relating to building construc o , and hereby authorize representatives
of this co ty/tt , enter upon the above-mentioned proper for inspecti purposes.
a3ate ignature (Applicant or Agent):
Application Number . . . . . 09-00000691
Permit
. . . BUILDING PERMIT
Additional
desc .
Permit Fee
. . . .
1210.00
Plan Check Fee
786.50
Issue Date
. . . .
Valuation . . . .
262715
Expiration
Date
2/03/10
Qty Unit Charge
Per
Extension
BASE
FEE
639.50
163.00
----------------------------------------------------------------------------
3.5000
THOU BLDG
100,001-500,000
570.50
Permit
. . . MECHANICAL
Additional
desc .
Permit Fee
. . . .
114.50
Plan Check Fee
5.22
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
2/03/10
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
3.00
9.0000
EA MECH
FURNACE <=100K
27.00
3.00
9.0000
EA MECH
B/C <=3HP/100K BTU
27.00
6.00
6.5000
EA_ MECH
VENT FAN
39.00
1.00
----------------------------------------------------------------------------
6.5000
EA MECH
EXHAUST HOOD
6.50
Permit
ELEC-NEW RESIDENTIAL
Additional
desc .
Permit Fee
. . . .
135.22
Plan Check Fee
7.82
Issue Date
. . . .
Valuation
0
Expiration
Date .
2/03/10
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
3024.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
105.84
719.00
-----------------------
.0200
----
ELEC
------------------------------=------------------
GARAGE OR NON-RESIDENTIAL
14.38
Permit
PLUMBING
Additional
desc .
Permit Fee
. . . .
205.50
Plan Check Fee ..
10.09
Issue Date
. . . .
Valuation . .
0
Expiration
Date
2/03/10
Qty
Unit Charge
Per
Extension
`
BASE
FEE
15.00
_ 21.00
6.0000
EA PLB FIXTURE
126.00
1.00
15.0000
EA PLB BUILDING SEWER
15.00
LQPERMIT
i
LQPERMIT
Application Number . . . . . 09-00000691
Permit . . . . . . PLUMBING
Qty
Unit Charge
Per
Extension
Extension
2.00
7.5000
EA
PLB
WATER HEATER/VENT
15.00
1.00
3.0000
EA
PLB
WATER INST/ALT/REP
3.00
1.00
9.0000
EA
PLB
LAWN SPRINKLER SYSTEM
9.00
10.00
.7500
EA
PLB
GAS PIPE >=5
7.50
1.00
----------------------------------------------------------------------------
15.0000
EA
PLB
GAS METER
15.00
Permit
Additional desc .
Permit Fee . . .
Issue Date . . .
Expiration Date .
. GRADING PERMIT
15.00 Plan Check Fee .00
Valuation . . . . 0
2/03/10
Qty Unit Charge Per Extension
BASE FEE 15.00
----------------------------------------------------------------------------
Permit . . . SOLAR PERMIT
Additional desc . .
Permit Fee . . . . 22.50 Plan Check Fee 1.40
Issue Date . . . . Valuation . . . . 220402
Expiration Date . . 2/0.3/10
Qty Unit
Charge Per
Extension
BASE FEE
15.00
1.00
4.5000 EA
SOLAR COLLECTOR < 1000
4.50
1..00
3.0000 EA
SOLAR EQUIP MISCELLANEOUS
3.00
----------------------------------------------------------------------------
Special Notes
and Comments
SFD - LOT 184,
PLAN 6430C,
3024 SF,
INCLUDES 255 SF
DETACHED CASITA,
& 108
SF PATIO EXT.
PHOTO VOLTAIC
SYSTEM
(1.11C & 3KW).
PERMIT DOES
NOT INCLUDE
POOL, SPA, BLOCK
WALLS OR DRIVEWAY
APPROACH. 2007
CODES.
-------------------------------------------------7--------------------------
Other Fees .
. . . . . .
. ART IN PUBLIC PLACES -RES
156.79
BLDG STDS ADMIN (SB1473)
11.00
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
78.65
DIF FIRE -PROTECTION -RES
140.00
DIF LIBRARIES - RES
355.00
DIF PARK MAINT FAC - RES
22.00
DIF PARKS/REC - RES
892.00
Application Number
. . . .
09-00000691
----------------------------------------------------------------------------
Other Fees . . . .
. . . . .
STRONG MOTION (SMI) - RES
24.42
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00
Fee -summary
Charged
Paid Credited
Due
-----------------
Permit Fee Total
----------
1702.72
------------------------------
.00 .00
1702.72
Plan Check Total
811.03
.00 .00
811.03
Other Fee Total
4745.86
.00 .00
4745.86
.Grand Total
7259.61
.00 .00
7259.61
LQPERMIT