04-5053 (SFD)CAMPICO
LIFORNlk 92253
BUILDING PERMIT
APN: T
Application description
Property Zoning
Application valuation .
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
04=0.00!50 35 Date 6/21/04
6061-2 SILVER TORCH CIR
'764-270-999-72 -300233-
DWELLING - SINGLE FAMILY DETACHED
MEDIUM HIGH DENSITY RES
2,18,3 5 0
Owner Contractor-
SHEA LA QUINTA
SHEA HOMES, INC.
C/O JEFF MCQUEEN
81260 AVENUE 62
8800 N GAINEY CENTER
350 LA QUINTA
CA 92253
SCOTTSDALE
AZ 85258 (760) 777.-6.005
WCC: NTL UNION
INS
WC: 7165833
08/01/04
CSLB: 672285
.06/30/05
CCC: B
------ Structure Information.
PLAN 6420C
-----
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
':615'. 0.0
PATIO - SQ FTG
323'. 00
NUMBER OF UNITS
1.00
FIRST FLOOR SQ FTG
2500.00
Permit . . . . . .
BUILDING PERMIT
Additional desc
Permit Fee . . .
1056.00 Plan Check Fee
171.60
Issue Date . . . .
Valuation
218350
Qty Unit Charge
Per
Extension
BASE FEE
639.50
119.00 3.5000
THOU BLDG 100;001-500,000
416.5)
---------------------------------------------=------------------------------
Permit . . . . . .
MECHANICAL
Additional desc
Permit Fee
65.50 Plan Check Fee..
4.1-)
Issue Date
Valuation
)
Qty Unit Charge
Per
Extension
.f
P.O. Box 1504 • VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 641,50513 LArchitec.ar
Date: •v2 -O
Applicant: Enfteer- A
Applicant's Mailing Address:
Architect or Engineer's Address:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under po ty of perjury that I am licensed under provisi�s� ter encing with Section 7000) of Division 3 of the Business and Professionals
Code, and my License I force and effect.
cense Class .EiEe No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Contractors' State 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 any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars ($500).):
U 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 Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work
himself or herself or through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is
sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.).
U I, as owner of the property, 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.).
U I am exempt under Sec. , B.8 P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
I have will maintai orkers' compensation insur ce as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issu d M workers ompensation licy N m e rI r�d��i 81b� re.
�arrier /Policy Number �
_ I certify that, in the performance of the work 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 and agree t t, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those p California,.si s
.^Date UWpplicaql
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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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 '1
Lender1
Lender's Address 3 /A
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed 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 ' 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 i tion is r I agree to comply with all city and county ordinances and state laws relating to building
construction, an hereby authorize representatives of this cou en t r upon above-mentioned property for inspection purposes.
oate�L �� gnature (Applicant or Agent �`�~
' j us=q>rS-.�:Sti� raFitt �a��y
rt z� Il i
Page
2
Application Number
.
. .
. . 04-00.005053
Date
6/21/04
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
1.00
9.0000
EA
MECH
FURNACE <=100.K
9.01)
1.00
9.0000
EA
MECH
B/C <=3HP/100K BTU
9.00"
4.00
6.5000
EA
MECH
VENT FAN
26.01)
1.00
6.5000
EA
MECH
EXHAUST HOOD
6.50
Permit. . . .
. . . ELEC-NEW RESIDENTIAL
---------------------------------
Additional desc
Permit Fee .
. . .
114.80
Plan Check Fee
7.13-
I.ssue Date
Valuation
�)
Qty Unit
Charge
Per
Extension
BASE,FEE
15.00.
2500.00
-.0350
ELEC
NEW RES- 1 OR 2 FAMILY
87.51)
615.00'`.0200
ELEC
GARAGE OR NON-RESIDENTIAL
12.30
Permit . . ..
. . .
PLUMBING
Additional desc
Permit Fee
153.00
Plan Check -Fee
9.56
Issue Date .
. . .
Valuation
0
Qty Unit
Charge
Per
Extension
BASE
FEE
15:00
14.00
6:.0000
EA
PLB
FIXTURE
84.00
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
15.0000
EA
PLB
GAS METER
15.00
--------------------------------------------------------------------
Permit . . .
. . .
GRADING
PERMIT
Additional desc
Permit Fee .
. . .
15.00
Plan Check Fee
.00
Issue Date
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
Special Notes
and Comments
SFD - LOT 72 -
Plan 6420C
w/Bay
Nook
r
o
Page
3
Application Number
. . . . .
04-00005053 Date
6/21/04
-------------------------------------------'---------------------------
Special Notes and
Comments
(23sf) PERMIT DOES
NOT INCLUDE
BLOCK.
WALLS, POOL,,SPA OR
DRIVEWAY A?PROACH.
.75% REDUCTION TO PLAN
CHECK FEE
DUE;TO
MULTIPLE ISSUANCE
OF SAME PLAN
TYPE
Other Fees . . .
. .. . . . .
ART IN PUBLIC PLACES -RES
45.87
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
17.16
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
21.83
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION -,RES
10.98.00.
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
1404.30
.00 .00
1404.30
Plan Check Total
192.44
.00 .0.0
192.44
Other Fee Total
2489.86
.00 .00
2489.86
Grand Total
4086.60,
.00 .00
4086.60