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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