05-2343 (SFD)P.O. BOX 1504 W
78-495 CALLE TAM: PIC O
LA QU.INTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
';05000,02343 ,�
may- - - - - - - - - - - � .� � - - � - � - - - - � � � � 7 � � � � � � � � � � � � � � �.� � �
-- LICENSED;CONTRACTOR'S DECLARATION
Owner:
Property Address:
81226 SANTA ROSA" CT
SHEA LA QUINTA
APN:
764-270-999-20 -300234-
I have and twill maintaincertificate of consent to self-insuie for workers' compensation,.as provided
C/O JEFF MCQUEEN
Application description:
DWELLING-- SINGLE FAMILY DETACHED
_
'
��- MGS
/nate raaoc -.
8800 N GAINEY CENTER 350
Property Zoning:
MEDIUM HIGH DENSITY RES
SCOTTSDALE, AZ 85258
Application valuation:
185294
- insurance.carner and.policy number are: -
'I he eby.affirm-under penalty bfperjury that I am exempt from the 'Contracto_r;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
Contractor:
Applicant:
rchitect orEngineer:
�A
SHEA HOMES , INC.
812 6 0 _,AVENUE 62
permit to,file a signed statement that twor she,is licensed pursuant to the.provisions,of'the Contractor's State
and agree that; if I, should become. subject to the workers' compensation provisions of Section
License
LA, QUINTA, CA 92253
- 3700'of the Labor Code, jI shall-frth it comply with those provisions.
"
a
(760) 7;77-6005
I
any applicant for a -permit subjects the'applicantto a•civil�penalty of not more than five hundred dollars ($5001.:
Lic.:No.: 672285
1 1 I, as,owner of.the property, or my employees with•ecWages, as their sole compensation, will do the work, and "
_
the'structur0s not intended or offered.fovsale (S. 7044; Business and Professions Code:'The
VOICE (760) 777-7012
..FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/14/05
JUL 15 2005.
CITY. -OF LA QUINTA
FINANCE DEPT.
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:
LQPERMIT
o a u nta, its o kers, agents,an emp oyees or any act or omission re ate tot a wor eing
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 ee t comply with all
city and county ordinances and state laws relating to building construction, and hereb authorize epresentatives
of this coynty Jo enter upon tye'above-mentioned property Iaripspection purposes.
(Applicant or Agent):
_ _ - _ _ _ _ - - - - - - - - - - - - ---- _ _
may- - - - - - - - - - - � .� � - - � - � - - - - � � � � 7 � � � � � � � � � � � � � � �.� � �
-- LICENSED;CONTRACTOR'S DECLARATION
�
� � � � � � � � � � � � � � � � � - - -
7 --
WORKER'S COMPENSATION'DECLARATION
I hereby affirm under penalty of perjury that.1 am licensed sunder provisions of:Chapter 9 (commencing with
I hereby affirm under penalty of perjury, one of the following declarations:.: -
Section 7000) of Division 3 of the Business and Professionals Code, and my: License is in full force-and_effect: _
I have and twill maintaincertificate of consent to self-insuie for workers' compensation,.as provided
License Cl ss: B . - License No : , 672285
.,
.a
.. for by. Section 3700 of the Labor. Code, for the performance -of the work for, which. this permit is
•"
_
'
��- MGS
/nate raaoc -.
-
_ issued''.
I have and,wdl maintain workers compensation insurance, as required by Section 3700'of the Labor
�� •
Code for the performance of the work for ,which this,permrt is issued. My workers'.compensation
.OWNER -BUILDER DECLARATION
- insurance.carner and.policy number are: -
'I he eby.affirm-under penalty bfperjury that I am exempt from the 'Contracto_r;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
I certify. that, in the performanceof the work -.for which this permit is issued, !,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 asto become subject to the workers' compensation laws.of California,
permit to,file a signed statement that twor she,is licensed pursuant to the.provisions,of'the Contractor's State
and agree that; if I, should become. subject to the workers' compensation provisions of Section
License
Law (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 the alleged exemption. Any violation of Section 7031.5 by
- 3700'of the Labor Code, jI shall-frth it comply with those provisions.
"
a
I
any applicant for a -permit subjects the'applicantto a•civil�penalty of not more than five hundred dollars ($5001.:
ate : 1 plicant:
1 1 I, as,owner of.the property, or my employees with•ecWages, as their sole compensation, will do the work, and "
_
the'structur0s not intended or offered.fovsale (S. 7044; Business and Professions Code:'The
WARNING: FAILURE:TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Con tractors`'State License, Caw does not apply to an owner of property who builds or improves thereon,
. SUBJECT AN'.E 4 Co R TO;,CRIMINAL PENALTIESANDCIVIL FINES.UP TO ONE HUNDRED THOUSAND
and who does the work himself'or'herself through his or her own employees_ provided that the -
,DOLLARS 1$100,000).. IN`ADDITION TO THE COST OF�COMPENSATION, DAMAGES AS PROVIDED.FOR IN
improvements:arenotintended or offered for sale. If, however, the building or improvement is sold within
.SECTION 3708 OF THE LABOR'CODE, INTEREST, AND ATTORNEY'S FEES.
one year of completion, the owner -builder will have the burden ofproving that he or she did not build or
-
improve for the purpose of sale.).
- APPLICANT ACKNOWLEDGEMENT
as owner of the property, awexclusively contracting with licensed contractors to construct,theproject (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. whobuilds 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,
I—) I am exempt under Sec.. BAP.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
fL O' f£ d I f I d h kb'
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:
LQPERMIT
o a u nta, its o kers, agents,an emp oyees or any act or omission re ate tot a wor eing
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 ee t comply with all
city and county ordinances and state laws relating to building construction, and hereb authorize epresentatives
of this coynty Jo enter upon tye'above-mentioned property Iaripspection purposes.
(Applicant or Agent):
Application Number .
. . . . 05-00002343
------ Structure Information
PLAN 5515C W/MBR 26SF
-----
Construction Type . .
. . . TYPE V - NON RATED
Occupancy Type . . .
. . . DWELLG/LODGING/CONG <=10
Flood Zone . . .
. . . NON,, -AO FLOOD ZONE
Other struct info . .
. ... CODE_:EDITION 2001
# BEDROOMS
3.00
FIRE SPRINKLERS NO
GARAGE SQ FTG
478..00
.
PATIO SQ-FTG.178.00
NUMBER OF UNITS
1:0'0..
IST -FLOOR SQUARE FOOTAGE..+
2148;.00
.:".,Permit
BUILDING PERMIT
A t-ional desc-"
Per—mi ,:Fee
94-0..50 Plan Check Fee
611.33,.
Issue Date
Valuation
185294
tion.Date ..
1.2/11/05
Qty". Unit Charge
Per
Extension
r
BASE 'FEE
639.50
86.00 3..500'0
a - ------------ - - - - - - - - - --------------.-
THOU- BLDG 100,001-500,0.00
- --------------.----------
301.•00_
-------------
-Permit ,MECHANICAL
`Additional desc
`
Permit Fee:
6:6..5'0 Plan,: -'Check. ".Fee
16:.63
Issue Date::
Valuation
:0
Expiration Date
12/11/05
a
Qty Unit Charge
Per
-Extension-
Extension-BASE•FEE
BASE-FEE
15.00
11.00 9.0000
EA MECH FURNACE <=100K
9.00
1.00 16.5,000
EA MECH B/C >3=15HP/>lOOK-50OKBTU-:
16.5'0.
3.00 6:50:00
EA', :MECH-VENTFAN
19.50
1.00 6.5000
'EA MECH EXHAUST,' HOOD..;
6-.50
Permit
ELEC-NEW RESIDENTIAL
Additional desc:...
Permit.Fee
9.9.74 Plan. -Check Fee
24.94
Issue• Date., . . . .
Valuation
0
' Expiration Date
12/11/05
Qty Unit Charge
Per
Extension
•
BASE FEE
.15.00
2148.00" .0350
ELEC NEW RES - 1 OR 2 FAMILY
75.18
LQPERMIT
c
LQPERMIT
Application Number . . . . . .05-00002343
Permit . . . . . . ELEC-NEW RESIDENTIAL
Qty Unit Charge Per Extension
478.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.56
----------------------------------------------------------------------------
Permit . . . PLUMBING
Additional desc . .
Permit Fee . . . . 141.00 Plan Check Fee 35.25
Issue Date . . . . Valuation 0
Expiration Date . . 12/11/05
Qty"Unit Charge
Per
Extension
BASE FEE
15.00
12.00
6.0000
EA PLB FIXTURE
72.00
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
6.00
.7500
EA PLB GAS PIPE >=5
4.50
1.00
----------------------------------------------------------------------------
15.0.000
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 - PLAN
5515C LOT
20, 2148 SQFT
W/MBR 26SF.
PERMIT DOES
NOT INCLUDE
BLOCK WALL,
POOL 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
61.13
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
18.52
DIF STREET MAINT FAC -RES
15.00
Application Number . . . . 05-00002343
Other Fees . . . . . DIF TRANSPORTATION - RES 1098.00
Fee.summary Charged Paid Credited Due
Permit.Fee Total 1262.74' .00 .00. .1262.74
Plan Check Total 688.15 .00 .00 688.15
Other Fee Total 2484.65 .00 :00... 2484.65
Grand Total 4435.54 .00 .00 4435.5.4
3
LQPERMIT - .