06-3771 (SFD)P.O. BOX 1504
78-495 CALL TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: - 06-00003771 1"1. -
Property Address: 61547 TOPAZ DR
APN: 764-280-999-18 _300237 -
Application description: DWELLING - SINGLE FAMILY DETACHED
Property Zoning: . MEDIUM HIGH DENSITY RES
Application valuation: 225179
Annlirant - - AfChltecOr E In� '
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)77776005
Lic. No.:,672285
VOICE (760) 77777012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/23/06
LQPERMIT
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` LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
' I hereby affirm 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 fallowing declarations:
Section 7000) of 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
License I s: B
License No.: 672285
_-
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
ate:
ntractor:
-
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
001 R
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: .
- I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier AMERICAN HOME Policy Number 1247619
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 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 anymanne 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 -
subject tote workers' compensation provisions of SectionLicense
nd agree that, if I o d becJ�oojwi0co
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
700 of the L or od I shly with thoseprovisions.
+
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)::
-
ate. plicam:'
(_ 1 I, 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 I
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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—) I, 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:l. -
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
_
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 .
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.
Date: Owner:
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
CONSTRUCTION LENDING AGENCY
permit to cancellation. T
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). —
- - .- - - - - - - - - - - - - - - -
'Name:
city and co' my o dinances and state laws relating to i in c struction, and h reby authorize representatives
of thi F u ty,to nter upon t 'above-mentioned pr -for in�ecY�Pn purpos
Lender's
1
Lender's Address:
ate: ature (Applicant or Agent):
-
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Application Number
06-00003771
Permit
BUILDING_PERMIT
Additional desc .
Permit Fee... . ..
1080.50
Plan Check Fee.
175:58
-.Issue Date`...
Valuation
225.179
- Expiration Date-.-."
4/21/07
- •• -
Qty Unit Charge
Per
Extension
BASE
FEE
639.50.
126.00. -3.5000
.THOU BLDG
100,-001=500,000
441.00
Permit,
MECHANICAL
Additional desc .
Permit Fee . . . .
74.50
Plan_Check Fee
4.66,
_ Issue - Date, _
Valuation
0
Expiration Date
4'/21/07
Qty Unit Charge
Per
Extension
BASE
,FEE
1.00
5
2.00— 9.0000
EA MECH
FURNACE) <=100K
18.00
1.00 9.0000
EA MECH
B/C.<=3HP/100K BTU
9.00
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
117.85
Plan Check Fee
7.37
Issue Date . . . .
Valuation . .
0
Expiration Date
4/21/07
Qty Unit Charge.
Per-
Extension
BASE
FEE
15.'00
2599.00, .0350
ELEC
NEW RES_ - 1' OR 2 FAMILY
90._97
594.00 0200
ELEC
GARAGE OR NON-RESIDENTIAL
11.88
. Permit
PLUM13ING
Additional desc .
Permit Fee
160:50
Plan Check Fee
10.03
Issue Date
Valuation
0
Expiration .Date
4/21/07
Qty Unit Charge
Per
Extension
BASE
FEE
15.00...
- .15.00 6.0000 -EA
'PLB FIXTURE
90.00.-
1-00 15.0000
EA PLB BUILDING
SEWER
15..00..
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Application Number 06-00003771
Permit . . . . . . PLUMBING
Qty Unit Charge Per
Extension
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 i 9.0000 EA PLB LAWN SPRINKLER SYSTEM
9.00
8.00 .7500 EA PLB GAS PIPE >=5
6.00
1.00 15.0000 EA PLB GAS METER
------------------------------•----------------------------------------------
15.00
Permit . . GRADING PERMIT .
Additional desc .
Permit Fee . . 15.00 Plan Check Fee'...
.00
l Issue Date . . . . Valuation . . .
. 0
_w. Expiration Date . _4/21/07
-
Qty Unit Charge Per
Extension
BASE FEE
15.00.
----------------------------------------
Special Notes and Comments
--------------
SFD - LOT 18, PLAN 5500A, 2599 SF. (149
SF. EXERCISE ROOM, .63 SF,BAY, 83 SF. -
'GARAGE EXTENSION). PERMIT DOES NOT
INCLUDE POOL, SPA, BLOCK WALLS OR,
DRIVEWAY APPROACH -75% REDUCTION TO
PLAN CHECK FEES DUE TO MULTIPLE.
ISSUANCE OF SAME PLAN TYPE
2001 CBC, 'CMC, CPC, 2004 CEC, 2005
ENERGY CODES
--------=--------------------------------------------------------------------
Other Fees . . .. .`. . . . ART IN PUBLIC PLACES -RES,
62.94,
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
17.56
.._ _ DIF FIRE'PROTECTION-RES
140.00•
GRADING PLAN" CHECK FEE
.00
DIF LIBRARIES - RES,
355.00
DIF PARK.MAINT FAC - RES
22.00 -
DIF PARKS/REC = RES
'892.00. "
STRONG MOTION (SMI) - RES
22.51
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00
' Fee summary Charged Paid Credited
Due
--------- ---------- ---------- ----------
Permit Fee Total 1448.35 .00 .00
.1448.35
Plan Check Total 197.64 .00 .00
197,.64
Other Fee Total 4578.01 .00 .00
.4578.01
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