05-2533 (SFD)P.O. BOX 15o4
78-495 CALLE TAMPICO
LA.QUINTA, CALIFORNIA 92253
BUILDI.NG.& SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 05-00002533 .
Property Address: 81207 SANTA ROSA CT
APN: 764-270-999-28 -300234-
Application description: ' DWELLING - SINGLE FAMILY DETACHED
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 237751._
Applicant. /rchitect or Engineer:
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER. 350
SCOTTSDALE, AZ 85258
Contractor:
SHEA HOMES, INC.
81260.AVENUE 62
LA" QUINTA,. CA 92253.
(.760)777-6005
Lic. No.: 672285
VOICE (760) 777 -7012 -
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/23/05
JUL 15 2005
OF
-----------------------�- �O-----------_-----------
--------------------------------
I --------------------------------------
LICENSED CONTRACTOR'S DECLARATION
LICENSED
_ WORKER'S COMPENSATION DECLARATION -
"I hereby affirm underpenalty of perjury that'( am licensed under provisions of. Chapter 9 (commencing withJ.
I hereby affirm under penalty of perjury.one of tfie,following declarations: r
Section 70001 of:Division.3 of the Business and Professionals Code, and my License is in full farce and effect.
_ I have: and will maintain a certificate"of consent to self -insure for workers' compensation, as provided -
license Class 13 '- . • License No.:.6.722 85
for_by Section 3700 of the Labor Code, for the performance of the work for which this permit is ..;
/ate: �� ontractor: �I r�14,.' f//I"-LS -
issued. "
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: 4...
' -
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 Coae: Any city or 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 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 or she is licensed pursuant to•the provisions. of the;Contractor's, State
and •agree:that; if I shouldebecome subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of -Division 3 ofthe Business and Professions Code) or
700 of. the La r Code, I shall forthwith comply,with those provisions.
that he or she 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 penalty of not more than hve tiundred dollars ($500).:
pplicant:
(_ 1 1, as owner of the-property,.or my employees with wages as their sole compensation, will .do -the work, and
the structure is not intended or offered -for. sale (Sec. 7044; Business and -Professions Code: The
WARN NG: FAILURE TO.SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors'tState 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 the work himself or.herself.through his or her own employees, provided that the
-"DOLLARS ($100,000). IN ADDITION 'TO THE COST OFCOMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building,or improvement is sold within
.
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES: '
. one yearofcompletion, the owner -builder' will -have the burden of proving thafhe or she did not build or `
improve for'the purpose of sale.).
APPLICANT ACKNOWLEDGEMENT
(_) 1, as owner.ofthe: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.License Law does not apply.to an owner -of
conditions and restrictions set forth on this application" " " .
property who builds or improves.the-reon a_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 _ 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:
Lender's Address:
LQPEIZA11T
of La�Ouinta, 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 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 authorize representatives
of this cou t�y-/t eCntJe�rypon the above-mentioned property f r inspection p os
Data- (�J Si ure (Applicant or Agent):
LQPERAIIT
Application Number .
. . . . .05-00002533
Structure Information
Construction Type . ...
. . TYPE V = NON RATED
Occupancy Type
DWELLG/LODGING/LONG <=10
F1ood.Zone . .
. . NON -AO FLOOD ZONE
Other'struct info . .
. . CODE EDITION 2001 CBC
FIRE.SPR�INKLERS . NO
GARAGE.SQ FTG
755.00
PATIO- SQ FTG
488.00
NUMBER.OF UNITS
1.00.
1ST.FLOOR;SQUARE FOOTAGE
2679.00
--= -------- ---------------
---=---------- '----_----------- =------------------- �-`
Permit
BUILDING PERMIT
Additional, desc
Permit -Eee
1122 5Q' Plan Check Fee
-.729.,63:,
Issue,Date ... . . .
Valuation
237751
Expiration Date
12/20/05
Qty'.. Unit Charge
Per
Extension,
BASE. FEE
;
138.00 3 .5,0.00
THOU BLDG,�100, 001-500~;,000
4639.50"
"483.00
Permit.
MECHANICAL '
Additional desc
Permit. Fee, _
99-.50 Plan -Check Fee
6. 0.0
Issue'"`Date
Valuation" . .
0
Expiration Date
12/20/05
Qty Unit Charge
Per'`
Extension
BASE.'FEE
is 00
'1,,00 9.0000
EA, MECH FURNACE <=100K
9.00
1%0.0 11:0060;,EA'
MECH':FURNACE> >100K •
11.00
1`..00 9 000.0
.EA MECH. B/C <-3H! 100K BTU
9.00
1.00' 16 5000:'
-EA ,.. MECH -B/C• >3 1.5HP/.>.100K-500KBTU
16 :5'0
5.00 &'.5000
.:EP, MECH -VENT `iA&'I.''
32 "50
1.00" 6.:=5000`
-,EA MECH EXHAUST'HQOD
6.50 .
Permit . .
ELEC-NEW RESIDENTIAL
Additional desc .
Permit Fee
-`' '15.06 P1'aii Check Fee
3.77
Issue Date_
Valuation
0
Expiration Date
12/20/05
Qty Unit Charge
Per
Extension
BASE. FEE
15.00
LQPERAIIT
Application Number
05-000.02533
Permit . . . . . . ELEC-NEW RESIDENTIAL
Qty Unit.Charge
Per
Extension
.0350
ELEC NEW RES 1 OR.12 FAMILY
.04
1.00 .0200
--------------------------------------------------------------------
ELEC GARAGE OR NON-RESIDENTIAL
.02
7 - - - - - - - - -
Permit .. . . . . . PLUMBING
Additional desc
permit Fee
.177.00 Plan Check Fee-
44.25
Issue Date . . . .
Valuation . . . .
0
Expiration Date.
12/20/05
Qty Unit Charge
Per
Extension
BASE FEE
18,00 6.0000
EA PLB..FlXtURE
108.00
1.00 15.0000
EA PLh BUILDING -SEWER-
15.00
11. 0,0 7':5000
EA PL -13 WATER HEATER/VENT
7`:50
3.00:60
EA PLE WATER IN§T./-ALT/R)EP
3.66'.
1-00 9':;0000
EA PLB JAWN SPRINKLER SYSTEM
9.00
'6.00 .,-7500
EA PuB GAS. PIPE, >=5
4.50
1.00 15.'0000
-----------------------------------------
EA PLB GAS METER
7 -------------------------------------
15.00'
Permit GRADING,. -PERMIT
Additional desc
Permit --F ee
15..:00 Plan, Check Fee'
.00
Issue Date . . . .
Valuation .. . . .
0
. 8xpiration-'-pat6
12/20/05
Qty Unit Charge
Per
Extension
�'BASE FEE,
15.00
- - - - - - - - - - - - 7 - - - --- -7 - --- - - - - - - - - - - - - - - - - ---------- ---------------------------
-Special Notes, and Comments
SFb-,LOT,`28 PLAN 6505A,
2679 SF.INCLUDES.,..
255'SF-CAS-ITA, 26 SF BOX BAY.@ MBR.
P�tRMIT.DOES NOT INCLUDE BLQCK.WAjL,
POOL, "SPA OR DRIVEWAY
APPROACH.
------------------------------.--------
Other--------------------
Fees . . . . .
--------Other
. ... . ART IN PUBLIC PLACES -RES
94..37
DIF COMMUNITYc'CENTERS-RES
97.00
DIF.,CIVIC,.CENTER- _RES,
..366..00
ENERGY REVIEW' FEE.
145-.92
PIF FIRE PROTECTION -RES
97.0.0
GRADING PLAN CHECK FEE
-..00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC.- RES
502..00
LQPERMIT
Application Number . . . . . 05-00002533
------------------------------------------------------------=-------------=-
Other Fees . . . . . . . . . STRONG MOTION (SMI) - RES 23.77
DIF STREET MAINT FAC -RES 15.00
DIF TRANSPORTATION - RES 1098.00
Fee summary Charged
Permit Fee Total 1429.06
Plan Check Total. 783..65
Other Fee Total 2669.06
Grand Total 4881.77
LQPERMIT
Paid Credited Due
.00 .00 1429.06
.00 .00 783.65
.00 .00 2669.06
.00 .00. 4881.77