05-2336 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
i'4'
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/14/05
Application Number: O'Sa0'0'0?023`36 Owner:
Property Address: 81190' SANTA ROSA CT SHEA LA QUINTA
APN:. 764-270-999-23 -30.0234- C/O JEFF MCQUEEN
Application description: DWELLING - SINGLE FAMILY DETACHED 8800 N GAINEY CENTER 350
Property Zoning: MEDIUM HIGH DENSITY RES SCOTTSDALE, AZ 85258
Application valuation: 139594
Contractor: J D
Applicant: /rchitect or ngineer: SHEA HOMES, INC.
81260 AVENUE 62, ,' uUL 15 2005
LA QUINTA-, CA .92'253
(76'0)777-6005
Lic. No-.: 672285 CITYOF AOUINTA
C4G co FINANCE DEPT.
'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 followiog',declarations:
Section.7000) of Division 3`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 Glass B - License.No!: •672285 for.by,Section 3700 of the Labor Code, for the performance of the work for whicfi this permit is
,t U (' issued.
• Contraaor-. _ . 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 permitis issued. My workers' compensation;
.OWNER -BUILDER DECLARATION • _ insurance.carnerand policy number are: cx
I hereby affirm under penalty of .perjury that I amexempt 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 [,certify that; in tfie performance of the work for which this.permit.is issued; I shall not employ any
construct, alter, improve, demolish, or. repair any structure, prior. to its issuance, also requires the applicant for the person in any manner so.as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he, she'is licensed pursuant to.the-provisions of;tfie Contractor's -State :and agree that, if I should become subject tothe workers' c'ompensationprovisions'of Section
License, Law. (Chapter.9 (corimmencing,wrtfi"Section 7000) of Division3 oftheBusmess and Professions Code) or 700 of;the Labor Code, I shall forthwiii'cbmply with those provisions.
that he.oi she is exempt therefrom and the basis for.the alleged exemption.- Anywolation,of Section.7031.5 by /_
any applicant for a permit subjects the applicant to'a civil penalty of not more than'five hundred. dollars IS50o).: ate. ' iN pplicant: SY ti� ��Y•✓t�� -
(=) I, as owner of the property, or my employees with wages.as their sole compensation wiil d&ihe'work, and '
the structure is not intended-oroffered for saleF(Sec..7044, Business and Professions Code: The - WARNI G: AILURE;TO SECURE WORKERS' COMPENSATIOWCOVERAGEIS UNLAWFUL, AND SHALL'. _
Contractors' State License Law'does not apply to,an owner of 'ho builds or improves -,thereon, SUBJECT AN ENIPLOYER.TO CRIMINAL PENALTIES ANDCIVILFINESUP TO ONE HUNDRED THOUSAND ,
and who does the.woik himself.or herself.through.his or her owmemployees, provided that -the- `" DOLLARS (5 100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN -
improvements are not intenoeobroffeed ug .0
the ouddmg,or improvementtjs.sold within ' SECTION 3706OFTHE LABOR CODE; INTEREST; AND ATTORNEY'S FEES.'t•
one year of completion, the owner builder.wiI have the burden of provingtthe he orshe'did'not build or M
improve*fo-r the purpose of. said). APPLICANT, ACKNOWLEDdiMENT
(_) I, as owner of Jhe,yroperty, am. exclusively 'contracting with licensed contractors to construct the project (Sec. 'IMPORTANT Application is hereby made to the.Director of Building and Safety for permit subject to the
7044; Business and Profession s Gode The".Contractors' State License Law does'not ap
ply to'an owner of conditions and-restriction`s set forth oi%this application.'
property who builds or improves thereon, and who contracts for the projects with a 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
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: lerX
Lender's Address: -
LUPERMI.1'
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 1 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 hereb authorize representatives
of this count�y/ t enter upon above-mentioned propert nspection purp _
(Ste: `' ignature (Applicant or Agent)'
Application Number . . . . . 05-00002336
------ Structure Information SFD PLAN 4510 W/MBR BAY 26SF
-----
Construction Type . .
. . . TYPE V - NON RATED
Occupancy Type . .
. . . DWELLG/LODGING/CONG <=10
Other struct info
CODE EDITION 2001
# BEDROOMS
3.0.0
FIRE SPRINKLERS NO
GARAGE SQ FTG
479.00
PATIO SQ FTG
337.00
NUMBER OF UNITS
1.00
-=--------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
1556.00
Permit . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
779.50 Plan Check Fee
506.68
Issue Date . . . .
Valuation . . . .
13`9594
Expiration Date
12/11/05
Qty Unit Charge
Per
Extension
BASE FEE
639.50
40.00 3.5000
----------------------------------------------------------------------------
THOU BLDG 100,001-500,000
140.00
Permit . . .
MECHANICAL
Additional desc,.
Permit Fee . . . .
83.50 Plan Check Fee
20.88
Issue Date .. . . .
Valuation . . . .
0
Expiration Date
12/11/05
Qty Unit Charge
Per
Extension
•
BASE FEE
15.00
2.00 9.0.000
EA MECH FURNACE <=100K
18.00
2.00 9.0000
EA MECH B/C <=3HP/100K BTU
18.00
4.00 6.5000
EA MECH VENT FAN
26.00
1.00 6.5000
----------------------------------------------------------------------------
EA MECH EXHAUST HOOD
6.50
Permit . . .
ELEC-NEW RESIDENTIAL
Additional desc . .
Permit Fee . . . .
79.04 Plan Check Fee
19.76
Issue Date . . . .
Valuation . . . .
0
Expiration Date . .
12/11/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1556.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
54.46
479.00 .0200
ELEC GARAGE OR NON-RESIDENTIAL
9.58
LQPERMrr
dff
Application Number 05-00002336
----------------------------------------------------------------------------
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . . 123.00 Plan Check Fee
30.75
Issue Date Valuation . . . .
0
Expiration Date 12/11/05
Qty Unit Charge Per.
Extension
BASE FEE
15.60
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/VEN.T.
7.'50
1.00'- 3.0000,EA PLB.WATER-INST/ALT/REP
3.00
1.00 9 . 0.0 0 0, EA PLB, LAWN, , SPRINKLER SYSTEM
9.00'
6.00 .1500 EA PLB GAS RIPE >=5
.4,:50
1.00 15.0000 EA PLB GAS METER15.00.
-Permit GRADING PERMIT
Addit-ional, desc
Permit Fee 15.00 Plan Check Fee
s00
Issue Date Valuation . . . .
0
Expiration Date 12/11/05
Qty. Unit Charge Per a
BASE FEE.
.,Extension-'-
15.00
{
--------------------------------,----------------------------------.-----------
Special Notes and Comments
a••
"SFD - Lot'.13 Plan 4510A .(1.556 sgft)
w/MBR.Bo_x-Bay (26. sgft) Permit does not
y=.
include block wall, pool or. driveway.-' .�
,
approach. 2001 :CBC
-------------------.---------------------------- -------- =--- --.--
--------- ----
Other Fees . . . . . . 'ART IN PUBLI.C,.,PLACES.=RES
..00,
DIF COMMUNITY,-CENTERS,RES
97:00
D,IF "CIVIC -CENTER - RES,
366:00
ENERGY ;REVIEW FEE
50..67-..
DIF FIRE^PROTECTION.-RES
97.00'
GRADING PLAN`'CHECK FEE,
.00
'
DIF' LIBRARIES '' `. •RES.
225.00
DIF` PARK'.'MAINT FAC - RES'`'"
DIFd. PARKS/REC --R
502:00 ' ..
STRONG'MOTION (SMI).- RES
13.95
DI-F.STREET MAINT'FAC-RES
15.00
DIF- TRANSPORTATION - RES
1098.00
Fee summary Charged Paid Credited
Due
LQPERMIT
LQPERAIIT .
App'lication'.-Number
05-000,02336
Permit Fee Total
---
1080:04
---- - - - - -----
.00
- - - - - --
.00
---- - -----
1080:04
Plan Check Total
578.07
.00
..00
578.07
Other Fee Total
2469.62
.00
00
2469.62
Grand Total
4127.73
.00
.00
4127.73
LQPERAIIT .