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05-2337 (SFD)P. 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant:. ' O.Q002373 T" 81178 SANTA ROSA CT 764-270-999-24 -300234- DWELLING - SINGLE FAMILY MEDIUM HIGH DENSITY RES 148309 4 s BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: SHEA LA QUINTA C/O JEFF MCQUEEN DETACHED 8,800 N GAINEY CENTER 350 SCOTTSDALE, AZ 85258 /rchitect or Engineer: La�eF� Contractor: SHEAHOMES, INC. 81260 AVENUE 62 LA; QUINTA', CA 92253 (760)777-6005 Lie. No.: 672285 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/14/05 AUL 15 *2005. .---------------------------- ,:.� LICENSED. CONTRACTOR'S DECLARATION of th t WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am -licensed under provisions of Chapter 9 (commencing with Ihereby affirm under penalty of perjury one of the following declarations:, Section 7000) of'Division3 of the Business and Professionals Code; -and 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 C ass' B-- License No.:'...672285-• - y - - .,..issued. for. by Section 3700 of the Labor.Code, for theperfoimance"of the work for which this permit is - Dater tractor: �.%t-tPi•� 1 have and will maintain workers'.compensatio_ n insurance, as re_quired'by Section 3700.of.the Labor - - Code, forthe�performance of ,the work for whicti this permit is issued: My workeis' compensation ' - OWNER -BUILDER DECLARATION - insurance carrier and policy number are:. I hereby affirm under penalty of perjury that I am exempt from' the, Contractor's State License�.Law for the : ' Carrier NTL UNION ;INS 'Policy Number- 6436568 - following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to I certify'that, in the performance of,thework for which this permit is'issued, I'shall not employ: any construct,•alt&, improve, demolish,'or repair, any structure prior to itsissuance, also requires the applicant for the person.irnany manner'.'so as to become subject to the workers'`compensation laws of California, permit to file,a,signed statement that he:or she isticensed,p6rs"scant to the provisions of the'Contractor's State and•agree that„if I should become'subjectto'the workers' compensation provisiarisof Section Licehse Laov'(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 theallegedexemption. Any violation of SeaionJ031.5 by , 700 of the L bor Code, I shall forthwit c mplywith those provisions. ..>. f�� - �• any applicant for a permit subjects the applicant to a_civil•penalty of, not more than five hundred dollars ($500):: D e: pplicant: (— 1 1, as owner of.the property; or my employees with wages as their. sole compensation, will do the work, and - - T . tl a structure is not intended or offered forsale (Sec. 7044, Business and Professions CoCe: The' WARNI G: AILURE.TO SECURE WORKERS' COMPENSATION COVERAGE IS.UNLAWFUL;.AND SHALL .. - 'Contractors'State License Law,does not apply to an owner of property. who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL: FINES UP TO;ONE HUNDRED THOUSAND. and who does thaw' ork:himself or-herself•through his or her own employees, provided that DOLLARS ($100,000). IN ADDITIONTO THE COST OF COM PENSATION'DAMAGES AS PROVIDED FOR IN . improvements are not intended or offered for sale. If, however, the building•or improvement is sold within one ear com Ietion the owner -builder will have the b rden o . h h did b 'Id SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. - T , p. u pr wng a e or s e not ui or improve for the. purpose •of sale.). (_) I, as,owner.;of the.property,:am exclusively comracting 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 theprojects 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: AJ 1 yt LQPERMIT APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permt.subject to the coriditions`andrestrictions"set forth on this'application: 1 . Each person upon whose behalf.this application is made, each person atwhose request and for Whose benefit work is performed underor 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 perfor med 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 information is correct. I a r. to comply with all city and county ordinances and state laws relating to buildingconstruction, and hereb oriz representatives of this co y enter upon above-mentioned property f pection purposes Date 4I mN ,gnature (Applicant or.Agentl: - v LQPERMIT Application Number . . . . : 05-00002337 Structure Information Construction Type . . . TYPE V - NON RATED Occupancy Type . . . DWELLG/LODGING/LONG <=10 Flood Zone . . . . NON -AO .FLOOD ZONE Other struct info CODE EDITION 2001 CBC FIRE SPRINKLERS NO GARAGE SQ FTG 488.00. PATIO .SQ FTG 177.00 NUMBER.OF UNITS 1.00. ------------------------------------------------------------------------ 1ST`FLOOR SQUARE FOOTAGE 1688.00 Permit BUILDING PERMIT. Additional desc Permit:Fee 811.00 Plan Check 527.15 Issue Date` _Fee Valuatign,' . . . 14.830;9 Expiration Date 12./11/05 Qty Unit Charge Per. Extension BASE FEE 639._50 49.00, 3.500'0. THOU °BLDG 100,001-500;000:.. 171.50 Permit. . . MECHANICAL Additional-desc . Permit Fee . . . 64.00 Plan Check, Fed 16.00 tI s'sue"Date Valuation. 0 Expiration Date `. 12/11/`05. .. Qty .Unit Charge; Per Extension BASE, . • FEE ` 15.00* 2.00 - 9. 00.00, EA . MECH FURNACE <=10,OK i8. 00. 2,.00 9 000'0: EA.- MECH B/C <=3H,P/100K :BTU-. 18.00 1.00 `6 500,0 :EA MECH 'VENT- FAN, .6'50. 1.00 6.5000 EA " MECH EXHAUST HOOD 6".'S0 Permit ELEC=NEW RESIDENTIAL Additional desc . Permit Fee 83..84 Plan Check Fee 20.96.- 0.96:I4ssue I s sU'eDate „ , Valuation 0; . Expiration Date 12/11/05 Qty Unit Charge Per Extension BASE FEE 15.00 1688.00 .0350 ELEC NEW.RES.- 1 OR 2 FAMILY 59.08 488.00 .0200 ELEC GARAGE R NON-RESIDENTIAL O 91.76 LQPERMIT Application Number . . . . . 05-00002337 ---------------------------------------------------------------------7------ Permit . . . PLUMBING Additional desc . Permit Fee . . . . 128.25 Plan Check Fee 32.06 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/11/05 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 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 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/11/05 Qty Unit Charge Per Extension BASE FEE 15.00 ------------------------------------------------------------------=--------- Special Notes and Comments SFD - LOT 24, 1688 SF PLAN 4520B/BOX BAY Q MBR -26 SF. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH ---------------------------------------------------------------------------- Other Fees ti. . . . . . . ART IN•PUBLIC PLACES -RES. .00,. DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 52.72 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 502.06 STRONG MOTION (SMI) - RES 14.83 DIF STREET.MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due LQPERMIT �.��. NZ16 LQPERMIT Application Number . . . . . 05-00002337 --------------------------- Permit Fee Total 1102.09 -------------------- .00 .00 ---------- 1102.09 Plan Check Total 596.17 .00 .00 596.17 Other Fee Total 2472.55 .00 .00 2472.55 Grand Total 4170.81 .00 .00 4170.81