05-2480 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
ce
•44-
S r. �..
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 05 00'002480
Property Address: 81154 SANTA ROSA CT
APN: 764-270-999-26 -300234-
Application description: DWELLING - SINGLE FAMILY DETACHED
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 182699
Applicant: Architect. pr Engineer:
Owner:
SHEA LA QUINTA
C/O,JEFF MCQUEEN
8800 N.GAINEY CENTER 350
SCOTTSDALE,/AZ 85258
Contractor: .
-SHEA HOMES, INC.
81260 AVENUE 62
LA QUINTA, CA 92253
(76.0)777=6005
Lic. No.: 672285,
VOICE (760) -777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/21/05
JUL 15 2005 I�
CITY OF LA QUINTA'
F11WAjIdl^i ..__—.-. . .
----------------------------------------.
LICENSED CONTRACTOR'S_ DECLARATION
I hereby affirm under penalty.f perjury that Iam licensed under, provisions of Chapter'9'(commencing with
'^ WORKER'S COMPENSATION DECLARATION
I hereby affirmunder .penalty of perjury one of the following declarations: + -
Section 7000) of,Division 3 of'the Business and Pr of essionals.Coder and my License is in full force and effect.
I haveind,will maintain a certificateof consent to self -insure for workers' compensation; as provided
LjcenseClass B' _ License No -x6722,85
for by Section 3700 of the Labor Code, for the: performance of the work for which this permii is '
Date.? f!� ontractoc {f ` `�16r"6.
.� I have and'will maintain workers°compensation insurance, as required by Section 3700 of the Labor
Code; for the performance of the. work for vi hick this permit is issued My;workers' "compensation
f - OWNER -BUILDER DECLARATION . -
insurance cirrier'and policy num er are:
hereby affirm under penalty of perjury'that I am exempt from the Contractor's State License Caw for the
Carrier NTL..UNION INS Policy Number` . 643,6568 ;
following reason ISec.7031,5, Business and Professions Code: Any city or. county that requires a -permit to
for for
_ I certify that,:in the performance of the work for which thi's permit is issued:, 1. shpll'not employ any
in any manner so as to become subject to the work6es' compensation Iaws'of California,
construct ,alter, improve, demolish, repair any structure, prioi to its issuance, also requires the applicant the
permit to file a signed statement that he or she is-licens"ed. pursuant to the provisions of.the Contractor's State
person
and agree that; if 1 should become subject,to the workers"compensation,provisions of.Se'ction
License Law (Chapter.9.(commencing with Section 7000) of Division 3°of the Business and Professions Code) or
3706 of the Labor.Code .shall"forth it 6omply.with those provisions.
that he or'she is. exempt'therefiom'and the basis for the alleged exemption. Any,violation'of,Sectiom7031.5 by
- {,/,I ,.4 q_ "' C `
N
any applicant far a permit subjects the applicant to acivil-penalty of not more than five hundred dollars IS500).:
ate :-% I pplicant: / E`''LI/(.-�
(_) I, as owner of: the property, or my employees with,wages as their sole compensation will do the work, and
.. - • ,. ' - ` -
the,structure isnot intended or offered for -sale :(Sec: -7044, Business and Piofessions Code:tThe
WARNING: FAILURE•TO SECURE WORKERS, COMPENSATION COVERAGE IS;UNLAWFUL, AND SHALL
= GontracYors' State' License•Law'does not apply to an.owner,of'property wlio'builds or improves thereon," - -
SUBJECT AN EMPLOYER'T( CRIMINAL`P,ENALTIES AND CIVIL FINES U.P�TO ONE•HUNDRED THOUSANDr
and who does the work himself or herself his or;her own employees, provided that the
DOLLARS.(S 100,000).• 1N ADDITION TO THE COST OF COMPENSATION? DAMAGES`'AS PROVIDED_ FOR IN
improvements ere not intended of offered.for sale. 'If;'however,.the building orjmprovement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.,
one year;of completion, the owner-bu_ildei will have the burden of proving that he or she did not build or
- •.. -
'improve for the purpose. of sale:). ' ''•
- . APPLICANT ACKNOWLEDGEMENT - -
(_ 1 I, as owner of the property am exclusively contracting. with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the .
•- 9044;•Business and'Professions Code: The Contractors' State License`Law does not apply to an owner'of
con tlitions and restrictions set -forth'on'this application'.` "
property who builds or improves thereon, and'who contracts for the projects with a contractorls) licensed
1. Each person upon whose behalf this application.is made; each person at whose request and for
pursuant to the Contractors' State License: Law.).,
whose benefit work is performed under or pursuant to any permit issued.as a result of,this application,
( 1 I am exempt under Sec. - ,'B.&P.C. for this reason
the owner, and the applicant, each'agrees to, and shall defend,. indemnify and hold harmless the City
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
of La Qumta, 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 andvoid.if.work isnot 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 county ordinances•and state'laws relating to building construction, and hereby authorize representatives
of this co ty/t enter upon the above-mentioned propert or inspection pu - s.
Date: [ I U ature (Applicant_or Agent):
i
Application Number .
. . . . 05-00002480-
Permit . . . . . ..
BUILDING PERMIT
Additional desc
Permit Fee . . . .
930.00 Plan Check Fee
604.50
Issue Date
Valuation . . . .
182699
Expiration.Date
1.2/18/05
Qty- Unit Charge
Per
Extension
BASE FEE
639_50
83.-00 3.5000
----------------------------------
THOU BLDG-100,001-500,000
------- 7 -----------------------------------
290.50
Permit . . . . . .
MECHANICAL
Additional desc
PerMi� Fee.,
83*50 Plan Check�'Fee
20.88
,..
I'
:s'sue-. Date . . . .
Valuation . . . .
0
ExpiXat ion' Date -
12/18/05'
Qty Unit Charge
Per.
Extension
.BASE FEE
15.00
2-:00 9.0000
EA MEC14--'�-F*URNACE <=100K
18-00
2-00 9.0060
EA -MEC4,.,B/C <=3HP/100k BTU
18.00
4.00 6..-5000
EA MECH-VENT FAN
26.00
i:.., ob .'6..5000
7 - - - - - - - - --- - - - - - - -- 7 - - -
EA. MECH EXHAUST HOOD.
- - - - 7- - - --- - ---- - - - - - - - - - - - - - - - - - -
6.50
- - - - - - -
Pe rmi.E, -ELEC7NEW
RESIDENTIAL
Addi-tional desc
P�prffiit ..Fee
9q. 0j-- Plin Gheck:76e
24-.77
Is'siie-Date
Valuati.-6n
0
Expiration . Date
12/.18/05
Qty- Unit Charge
Per
Extensiop�,�,.
BASE FEE
15.0'0.
.2094-:00 ..0350
ELEC,: NEWRESOR 2-FAMILY
73-29
0 .:.0200
------------------------------
ELEC"GARAGE OR N.0 N-RESIDENT-IAL-
7 -------- ------ ----------------- I ---------------
10.78'.
Permit . . . . . .
PLUMBING
Additional desc
153-.00 Plan Check Fee
39".25
Issue' Date -. . . . -
r Valuation
Exp`irat i . cin-Date
12/16`/05
-Qty Unit Charge,
Per
Extension.
BASE FEE
15.00
14.00 6.0000
EA PLB FIXTURE
84.00
1.00 15.0.000
EA PLB BUILDING SEWER
15.00
LQPERAIIT
LQPERAIIT
Application'.9umber
. . . 05-00002480
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 tAWN SPRINKLER SYSTEM
9.00
6.00: .1500
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 Plah-Check Fee
.00
Issue Date
Valuation
0
Expiration Date...
12/18/05
Qty Unit Charge
Per
Extension
BASE..FEE
15.00
- - - - - - - - - - - ----- - --- - - - - - - - --- --- - - - - - - - - -
Special Notes. and Comments
- - - - - -- : - - - - - - - -
.SFD,..-'-Plan 5505B, Lot
26..w/tasita- (241
sqft),.-MBR-Box Bay '(2
6 sqf t.) &, Garage
Ext. (83 sqfO. Permit
does not include'
block 'wall., pool. or driveway.
app"roach"
- - - - - - --- 7 - -
6s - - - --- - - - - - 7 - -
-Other Fees
- - --- - - - - - - - - --- - - - - - - - - - - 77 - - - - - - - - - -
ART IN.PUBLIC.PLACE87,RES-
- - - - - - - - - - - - - -
20.00
DIF -CENTERS -RES'
'97.0'0
_COMMUNITY
DIF. -CIVIC CENTER RES.
366.00.,
ENERGY REVIEW
60.45.'
-
DIF 'FIRE: PROTECTION -RES
57.0di
GRAbIN'G.PLAN CHECK FEE
-00
DIFLIBRARIES,.- RES
225.0.0
DIF . PARK-MAINT FAC - RES
5.00
DIF'PARKS/REC'- RES
502.00
STRONG -MOTION -(SMI). --RES
18-.26
DIF STREET MAINT FAC -RES
—.15.00
-,:
DIF TRANSPORTATION -::RES
1098.00
Fee summary Charged
----------
Paid Credited
------ ---- ----------- ----------
Due
------------------
Permit Fee Total
12.80.57 _00 .00
1280.57
Plan Check Total
688.40 .60 00,
68. .40
Other Fee total
00 .00
25:03.71. .
Grand -Total
4472.68 ..00 ...00
4472.68