05-2931 (SFD)P.O. BOX 1504 ^
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05-000.02931
Property Address: 81166 SANTA ROSA CT
APN: 764-270-999-25 -300234-
Application description: DWELLING - SINGLE FAMILY
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 123721
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
DETACHED 8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
L/J
Date: 7/14/05
Contractor: JULApplicant: Archite'ct or Engineer: SHEA HOMES, INC. JULA15 2005
81260 AVENUE 62
Cys , ' �in�e 1 LA QUINTA, CA 92253 CITY OFLA(�UINTA
(760) 777-6005 FIAIANCEpEIP�
Lic. No.: 672285
C, vic)[
LICENSED CONTRACTOR'S'DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under -provisions -of Chapter -9 (commencing with I hereby affirm under penalty of, perjury one of the following declarations:
Section 7000) of Division 3 of.the Business and Professionals Code; ii d my,License is in full force and effect. _ I have and will maintain a certificate of.consent to self -insure for workers' compensation, as provided
License Class: B License No.: 672285 - for by Section 3700 of the Labor Code, for.the performance of the work for which this permit is
issued
/ate: I ontractor.-0�►'l'e 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
- OWNER -BUILDER DECLARATION -: insurance carrier and policy number are:
I hereby, affirm. under penalty of perjury that I am exemptfrom the Contractor's State License Law for.the Carrier NTL UNION..INS Poli'y Number 6436568
following reason (Sec. 7031.5, Business andProfessions Code, Any cityor. county that requires a permit to _ I certify that,'in the'performance-of.the work for which this permit is issued, I shall not employ any
construct, alter, improve„demolish, or repair any structureprior to its issuance, also requires the.appticant for the person in any manner so as'to become subject.to the workers' compensation laws o_ f California,
permit to file-asigned. statement that he or. she is licensed "pursuant to the, provisions of the, Contractor's'State and agree that, if I should.become subject to the workers' compensation provisions of Section
License Law '(Chapter 9 (commencing with Section 7000) of Division &of -the Business and Professions Code) or 700 of-theLabor Code, 1 shall forthwith comCply with those provisions.,
that he`or she is eicdmpt.theiefrom and'the-basis forthealleged exemption. Any violation of Section 7031.5 by, 7 fi.
any. applicant for a permit subjects the doplicant to acivil penalty of not more than five hundied,dollars 1$500)1: ate: plicant:
(_ 1 1, as:owner•of the property, or my employees with wages as their solecompensation; will do the work, and -
the;structure ismot intended or offered for sale -(Sec.'7044, B'Usinesi and Professions Code: The' WARNING: FAILURE TO SECURE WORKERS' CONIPENSATION'COVERAGE IS UNLAWFUL, AND SHALL
Contractors State License Law does not apply to`anowner of -property who builds.or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ANDVVIL FINES UP TO ONE HUNDRED THOUSAND
and who doesthe;work'himself or herself through his orher own employees,: provided that the DOLLARS '($100,000).� IN.ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvemenis are not intendedr or offered for sale;. If, however,. the building or.improvernent is sold within _ - SECTION 3706 OF THE IABOR CODE, INTEREST, AND ATTORNEY'S FEES.
one yeai.of completion;•theowner-builder will have the burden of.proving that he or she didnotbuild or
improve for the purpose of sale:):.. l - APPLICANT ACKNOWLEDGEMENT.
1 _ 1 1, 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
7044, Business and.Professions Code:, The:Contractors"State LicenserLaw does•not apply.to anowner of - conditions and restrictions serforth•on this -applicati6ri-, 'Z.
property who builds or improves thereon, and who contracts for the projects with contractor(s)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 .
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.
Date: Owner: 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
CONSTRUCTION LENDING.AGENCY permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building construction, and hereby authorize representatives
' of this co my to enter upon he above-mentioned property fop inspectiop purposes.
Lender's Name: �('/t
Date: gnature (Applicant or Agent). e%/1We
Lender's Address:
LQPERMFF
Application Number .
. . . . 05-00002931
------ Structure Information
PLAN 4210A W/26 SF BOX
-----
Construction Type . .
. . . TYPE V - NON RATED
Occupancy Type . . .
. . . DWELLG/LODGING/CONG <=10
Other struct info . .
. . . CODE EDITION 2001
# BEDROOMS
3.00
FIRE SPRI-NKLERS NO
GARAGE -SQ FTG
474.00 '
PATIO SQ FTG
214.00
NUMBER OF UNITS
1.00
1ST FLOOR SQUARE FOOTAGE
1381.00
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee
723.50 Plan -Che ckFee
117.57
Issue Date . . .
Valuatio'
-123721
Expiration Date
1/10/06
`
Qty Unit Charge
Per
Extension,
BASE FEE
639.50
24.00 3.5000
THOU BLDG 100,001-500,000
84.00
- Permit
MECHANICAL
Additional desc .
Permit Fee . . . .
.65.50. Plan. Check Fee
4.10
Issue DateValuation
..
. .
0
Expiration.Date
— 1/1'0/06'.'
Qty` Urd,-t Charge
Per
Extension
BASE FEE
15._00
1.00 9. 00,00
EA. MECH-FURNACE <=100K-'
9 . 00
1,:00 9. 06,00
,EA� MECH B/C ,<-3HP/10.0K BTU
9': 00 '
4:00` 6:5:0.00
EA MECH VENT FAN
2:6.0,0
-i-.06 6.5000
EA_'.,. MECH-EXHAUST HOOD_
6:50
Permit. _.
ELEC-NEW RESIDENTIAL,
9dditional desc
Perm -it -Fee . . . .
72.82 Plan Check Fee
4.55
.Issue Date.
Valuation
0
Expiration Date
1/10/06`
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1381.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
- 48.34
474.00 .0200
ELEC GARAGE OR NON-RESIDENTIAL
9.48
LQPERNIIT
Application Number . .. . . . 05-00002931
Permit . . . PLUMBING
Additional desc .
Permit Fee 122.25
Issue Date . . . .
Expiration Date . . 1/10/06
Plan Check Fee . . 7.64
Valuation . . . . 0
Qty
Unit Charge
Per
Extension
Extension
BASE FEE
----------------
15.00
-----------------------------------
BASE
FEE
15.00
9.00
6.0000
EA
PLB
FIXTURE
54.00
1.00
15.0000
EA
PLB
BUILDING SEWER
15.00
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
5.00
.7500
EA
PLB
GAS PIPE >=5
3.75
1.00
----------------------------------------------------------=-----------------
15.0000
EA
PLB
GAS METER
15.00
Permit . . . GRADING PERMIT
Additional desc . .
Permit Fee . . . . 15.00
Issue Date . . . .
Expiration Date . . 1/10/06
Plan Check Fee .
Valuation . . .
Qty
Unit Charge Per
-
Extension
BASE FEE
----------------
15.00
-----------------------------------
Notes and Comments
SFD Lot
25 Plan 4210B (1381
SF) w/MBR
Box Bay
(26 sgft).PERMIT DOES NOT
INCLUDE
POOL, SPA, BLOCK WALLS OR
DRIVEWAY APPROACH.
-------------------------------=--------------------------------------------
Other Fees .. . . . . . .
. ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
11.76
DIF FIRE PROTECTION -RES
97.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
502.00
STRONG MOTION (SMI) - RES
12.37
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary Charged
LQPERMIT
Paid Credited Due"
Application Number
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
LQPERMIT s
. . . . 05-00002931
999.07
.00
.00
133.86
.00
.00
2429.13
.00
.00
3562.06
.00
.00
999.07
133.86
2429.13
3562.06