05-2932 (SFD)P.O. BOX 1504 .
78-495 CALLE TAMPICO '
LA QUINTA,. CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
05-000029;TAPROSA
81202 SANCT
764-270-999-22 -300234-
DWELLING - SINGLE FAMILY
MEDIUM HIGH DENSITY RES.
121621
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
DETACHED 8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Applicant: Architect or Engineer:
CaC��to l
-------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that Lam licensed under provisions of..Chapter 9 (commencing with
Section 7000) of Division 3"of.the Business and'Professionals Code; and my License is in full force and effect.
License Class:;. B/ License No:: 672285
/� �/n�S
OWNER -BUILDER DECLARATION
I hereby affirm under penaltyof:perjury that -lam 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 permit to '
construct, alter, improve, demolish, or repair any structure, prior to its issuance, alsorequiies the applicant'for the
permit to file a signed stateme'nt.that-he'or she is licensed pursuant to the pr6visions ofahe•Contrictor's State
License Law (Chapter 9 Icommencmg:wi,th.Section 7006) of Division 3' of trte; Business and Professions Code) or
that he'orshe 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 penaity.,of not mare.than five hundred dolla-rs ($5001:: .010
f_) 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 Pr6fessions Code: The "
Contractors' State License Law does notapplyto 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 isaold within
one )iear of coinpletion,•the owner -builder will have the burden of proving that he or she did not build'or
improve'forthe purpose'of sale.).
f_ 1 I, as owner of the properfy; 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. , B.&P.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: ` A
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS. (760) 777-7153
Date: 7/14/05
- A 15 2005
WORKER'S COMPENSATION DECLARATION
OFl:ggUPll T
ae.i.� _—
I hereby affirm under penalty of. perjury one of the following declarations:
I tiave'and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3760 of the Labor Code, for the performance of the work for which-this.perni it. is
issued. t . :' - r-,
I have•and will maintain workers' compensation insurance, as -required by Section 3700of-the Labor
Code, for the performance of the'workfor which this "permit 'is issued. My workers' compensation
- insurance carrier and policy `number are:
Carrier NTL ',UNION INS. -' Policy Number 6436568
I_ certify that, W-the.performance of the woik.for which this permit is issued, I shall not employ any
person in any manner so as to`become,subject to the workers' compensation laws of California,
and ag'r'ee that;' if,I should become subject to the workers' compensation provisions of.Section
3700 of the Laboi Code, I shall forthwith comply with those provisions.
y
ate: pphcant: S G�� ��/� GS
WARNING: FAILURE TO SECURE WORKERS'', COMPENSATION -COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN -EMPLOYER TO -CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE'HUNDRED THOUSAND
DOLLARS ($100,0001.. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS'P,ROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES..
APPLICANT. ACKNOWLEDGEMENT -
IMPORTANT Application is herebymade to the Director of Building and Safety for a permit subject to the
conditions and restrictions set iorth;h this application.
1 . Each person upon whose behalf.this application is. made, each person at whose request and for
whose benefit work. isperformed 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 issuanceofsuch 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 horize representatives
of this �enterabove-mentioned property for ' pection purposes.
/fste:Applicant or Agent):
Contractor:
D
SHEA HOMES, INC.
' ^�
81260 AVENUE 62
LA QUINTA, CA 92253
KR;
(760) 777-6005
Lic- No.: 672285
I hereby affirm under penalty of perjury that Lam licensed under provisions of..Chapter 9 (commencing with
Section 7000) of Division 3"of.the Business and'Professionals Code; and my License is in full force and effect.
License Class:;. B/ License No:: 672285
/� �/n�S
OWNER -BUILDER DECLARATION
I hereby affirm under penaltyof:perjury that -lam 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 permit to '
construct, alter, improve, demolish, or repair any structure, prior to its issuance, alsorequiies the applicant'for the
permit to file a signed stateme'nt.that-he'or she is licensed pursuant to the pr6visions ofahe•Contrictor's State
License Law (Chapter 9 Icommencmg:wi,th.Section 7006) of Division 3' of trte; Business and Professions Code) or
that he'orshe 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 penaity.,of not mare.than five hundred dolla-rs ($5001:: .010
f_) 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 Pr6fessions Code: The "
Contractors' State License Law does notapplyto 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 isaold within
one )iear of coinpletion,•the owner -builder will have the burden of proving that he or she did not build'or
improve'forthe purpose'of sale.).
f_ 1 I, as owner of the properfy; 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. , B.&P.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: ` A
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS. (760) 777-7153
Date: 7/14/05
- A 15 2005
WORKER'S COMPENSATION DECLARATION
OFl:ggUPll T
ae.i.� _—
I hereby affirm under penalty of. perjury one of the following declarations:
I tiave'and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3760 of the Labor Code, for the performance of the work for which-this.perni it. is
issued. t . :' - r-,
I have•and will maintain workers' compensation insurance, as -required by Section 3700of-the Labor
Code, for the performance of the'workfor which this "permit 'is issued. My workers' compensation
- insurance carrier and policy `number are:
Carrier NTL ',UNION INS. -' Policy Number 6436568
I_ certify that, W-the.performance of the woik.for which this permit is issued, I shall not employ any
person in any manner so as to`become,subject to the workers' compensation laws of California,
and ag'r'ee that;' if,I should become subject to the workers' compensation provisions of.Section
3700 of the Laboi Code, I shall forthwith comply with those provisions.
y
ate: pphcant: S G�� ��/� GS
WARNING: FAILURE TO SECURE WORKERS'', COMPENSATION -COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN -EMPLOYER TO -CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE'HUNDRED THOUSAND
DOLLARS ($100,0001.. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS'P,ROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES..
APPLICANT. ACKNOWLEDGEMENT -
IMPORTANT Application is herebymade to the Director of Building and Safety for a permit subject to the
conditions and restrictions set iorth;h this application.
1 . Each person upon whose behalf.this application is. made, each person at whose request and for
whose benefit work. isperformed 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 issuanceofsuch 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 horize representatives
of this �enterabove-mentioned property for ' pection purposes.
/fste:Applicant or Agent):
Application Number
. . . . 05-00002932
Structure Information
Construction Type ..
. . TYPE V - NON RATED
Occupancy'Type . . ..
. . . DWELLG/LODGING/LONG <=10
Flood Zone . .
. . . NON-AO FLOOD ZONE
Other s.truct info . .
. . . CODE EDITION. 2001 CBC
FIRE SPRINKLERS NO
GARAGE.SQ FTG
474.00'
PATIOSQ FTG
214.00
NUMBER:OF UNITS
1.00 .
--------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
1355.00
Permit• BUILDING PERMIT
'Additional desc
-
Pmit=,Fee . . :
er
716:50 Plan Check Fee
465.73
Issue Date .:
Valuation
121621
Expiration Date
1/,10/`06
` Qty Uriit Charge
Per
Extension
BASE FEE
639.50
22.002• 3.5060
THOU BLDG 100,001-5.00,000
77.00
Permit .,. MECHANICAL
.,Additional.desc .
:-Permit Fee: . .
65'.50. Plan•Check Fee
16.38
Issue`gDate
- Valuation
0
Expiration,-Date
1/10/06
Qty Unit Charge,
Per
Extension
BASE FEE
15.00
J1 . 00 �9-: 0000.
EA. = MECH 'FURNACE. <=100K
9;: 0.0 s
1_.00. 9'000'0
EA ME CH B/C;-<=3HP/100K:.BTU
9.00
4.,0:0: 6.5000
EA MECH_ VENT :. ... -
26:00
1<:'00 6.5000
.FAN
EA MECH EXHAUST HOOD,...
6.50 .
-----=--------------------
-- - - -----
---=----. -- --
Permit . . ELEC-NEW RESIDENTIAL .
Additional desc .
Permit Fee
71..91 Plan-Check Fee -:`.
17.98
Issue-Date:
- .. Valuation,. _ .: -:
0 ..,.
Expiration Date
1/10/06
Qty Unit.Charge
Per
Extension
BASE FEE
15.00
1355.00 .0350
ELEC NEW .RES - 1 OR 2 FAMILY
47.43
474.00 .0200
ELEC GARAGE OR NON-RESIDENTIAL
9.48
LQPERAIIT
0
LQPERWIIT
Application Number . . . . . 05-00002932
Permit . . . PLUMBING
Additional desc . .
Permit Fee. . . . . 122.25
Issue Date . . . .
Expiration Date . . 1/10/06
Plan Check Fee . . 30.56
Valuation . . . . 0
Qty
Unit Charge
Per
L------------------------------------------------------------------
BASE FEE
Extension
Special Notes and Comments
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 RIPE >=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
L------------------------------------------------------------------
BASE FEE
15.00
Special Notes and Comments
SFD - LOT 22,PLAN 4210B, 1355
SF. PERMIT DOES NOT INCLUDE
BLOCK
WALLS, POOL, SPA 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
46.57
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
12.16
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary Charged
---------------------------
Paid Credited
------------------------------
Due
Application Number . . . . . 05-00002932
Permit Fee Total 991.16 .00 .00 991.16
Plan Check Total 530.65 .00 .00 530.65
Other Fee Total 2463.73 .00 .00 2463.73
Grand Total 3985.54 .00 .00 3985.54
LQPERAIIT