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 -