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10-1143 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT = Application Number: 10-00001143- Owner: Property Address: 61120 TALEA DR ' SHEA ,LA QUINTA APN: 764=280-004-1 -35996 - 60800 TRILOGY PARKWAY ,Application description: DWELLING - SINGLE FAMILY DETACHED LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 174086 rd VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/09/10 Contractor: O Q Applicant: Architect'or Engineer: SHEA HOMES, INC . 60800 TRILOGY P AY. 9 LA QUINTA, CA 9 5 (i�r 01 2U10 _ (760)777-6032' LiC.. No:: 67228 CITYOF . LA QlIiNTA FIAIA;ICE n pT pipt ------------------- _ LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby a irm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7 0) f Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, *as provided Lice CI s: I Lhense No.: 672285 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. at ontractor: X-1 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: 1 hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier LIBERTY MUTUAL Policy Number WA266D06611503 0 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the workfor 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 Fpon 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 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 abor 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 i any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).: te: ��A.Ln t: (_ 1 I, as owner of the.property, or my employees with wages as their sole compensation, will do the work, and 10 the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERSMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State 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 OF COMPENSATION, 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 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.). - APPLICANT ACKNOWLEDGEMENT (_ 1 1, as owner of the'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 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. , B.&P.C. for this reason 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 Date: Owner: r 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 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 Mure cancellation. - - - - I ad this application and state that the above information is correct. - I agree to comply with all cnces and state laws relating to bu'Id' construction, and hereby authorize representatives or upon the above-mentioned property r inspection purposes. ure (Applicant or Age Application Number 10-00001143 Permit . . . BUILDING, PERMIT Additional desc - Permit Fee 902.00 Plan Check Fee 586.30 Issue Date' Valuation 174086 Expiration Date 4/30/11 Qty Unit Charge .Per Extension BASE FEE 639.50 . 75.00 .3:5000 THOU BLDG".100,001-5001,000 -------------------------- .262.50 Permit." MECHANICAL -Additional desc•. Permit ',Fee . . . . 82.00 Plan Check Fee 24..38 Issue Date Valuation 0" Expiration.Date .". 4/30/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00, 9.0000:EA MECH FURNACE.<=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 4.00 6.5000 EA. MECH VENT FAN 26.00 1.00 . 6.5000 EA MECH EXHAUST HOOD 6.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 95.54 Plan Check Fee 23.89 Issue Date ". Valuation . . 0 Expiration Date 4/30/11 Qty Unit Charge Per Extension -" BASE FEE 15 A 0 1972:00" .0350 ELEC NEW RES - 1 OR 2 FAMILY 69.02 576.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 11.52 Permit PLUMBING Additional desc . Permit Fee 153.00 Plan Check Fee . 38.25. Issue:Date Valuation 0• Expiration Date 4/.30/11 Qty Unit Charge, Per Extension BASE FEE 15.00 ' 14'.00 6.6000 EA PLB FIXTURE 8.4.00 Application Number . . . . . 10-00001143 Permit PLUMBING Qty- Unit_Charge..Per Extension. 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 Expiration Date 4/30/11 . Qty. Unit Charge Per - Extension BASE FEE 15.00 Special Notes and Comments SFD.- LOT 1, PLAN 4520C," 1972 SF. . INCLUDES 255 SF. CASITA. 26 SF. -•- BOX BAY @ MBR & 88 SF. GARAGE EXTENSION. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2007/2008 CODES. 2010 PLAN UPDATE. ----- - ----------------- --------------------- 7 ------------------------------------ Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) Other 7 7.00 DIF COMMUNITY'CENTERS-RES 74.00 DIF CIVIC CENTER -RES 995.00 ENERGY REVIEW FEE 58:63 DIF FIRE PROTECTION -RES 140.00 GRADING PLAN CHECK FEE .00 DIF.LIBRARIES - RES 355.00" MULTI SPECIES (MSHCP) FEE. 1284.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 DIF STREET-MAINT FAC -RES 67.00 - DIF TRANSPORTATION - RES 1930.0.0 Ree summary Charged ° Paid Credited Due Permit Fee Total 1247.54 .00 .00 .1247.54 Plan Check Total 672..82 .00 .00 672.82. Other Fee Total 5824.63 00 00 5824.63 Grand Total 7744.99 .00 .00 7744.99 LQPERMIT -