07-0893 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Annlirant-
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
t-0:7-OOoo0893
61589 TORO CANYON WY
-764-280-99.9-120 -300237--
DWELLING - SINGLE FAMILY `DETACHED
MEDIUM HIGH'DENSITY•RES
225179
rchitect or Engineer:C—OVIVS C.
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 852
Contractor:
SHEA HOMES, INC.
81260AVENUE 62
LA-QUINTA, CA,92
(760)777-6005
Lic. No.: 672285
VOICE (760) 77777012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/26/07
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 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 will maintain a certificate of consent to self -insure for workers' compensation, as provided
Li ns lass: Li ense No.: 672285
for. by Section 3700 of the Labor Code, for the performance of'the work for which this permit is
issed.
ate:
' C factor:
I 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: ;
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,.l 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 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
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
x700 of the -Labor Cod I all fai hw- h � those provisions. .
�`�']� lei`-\�
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
ate: plicant:
• ("_) 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 Coder The
WARNING: FAI E 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. , BAP.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
•
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 issuanceof suc permit,:or cessation of work for 80 days will subject
_ - - CONSTRUCTION LENDING AGENCY
permit to cancellation. -
• I hereby affirm under penalty of perjury that there is a construction lending agency for the performance -of the
ect. I ag to comply with all
I certify that I have read this application and state that the a ve informatioodhe
work for which this permit is issued (Sec. 3097, Civ. C.).
city and unty ordinances and state laws relating to build' ction,by a presentatives
of tis t nter upo the above-mentioned prope for ins ion pu
91
Lender's Name:
.
Da • ignature (Applicant or Agent):
" Lender's Address:
'
1100
LQPERMIT
Application Number
07-00000893.
Permit . . .
BUILDING-'PERMIT
-Additional desc
-- -
- -. -
Permit Fee
. 1080.50 Plan Check Fee
702.33
Issue'Date."
Valuation
225179 -
Expiration.Date
9/22/07
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"..
18..63,'
Issue Date
Valuation
0
-Expiration Date
9/22/07
-
`'Qty' Unit Charge
Per
Extension
BASE FEE
15.00
2.00 9.0000
EA MECH FURNACE r=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
29.46'
Issue• Date
Valuation
0.- .
Expiration Date
9/22/07
Qty Unit•Charge
Per
Extension
BASE FEE
15.0`0
2599.00 .0350
ELEC NEW.RES - 1 OR 2.FAMILY
90.97
594.000200
ELEC GARAGE OR,NON-RESIDENTIAL
11.88,
- Permit =PLUMBING
'Additional desc"
Permit Fee
160.50 Plan Check Fee..
40.13
Issue Date
.-Valuation
0
Expiration Date
9/22/07
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
LQPERMIT
Application Number 0,7-00000893
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 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
Issue Date . . . . Valuation
0
Expiration Date .9/22/07 H.. ..
Qty Unit Charge Per
Extension.
BASE FEE
15.00
-- - - - - - - - --
Special Notes and Comments
SFD - LOT 120., PLAN 5500A, 2599 SF. (149
SF. EXERCISE ROOM, 63 SF,BB, 83 SF. .
GARAGE EXTENSION). PERMIT DOES NOT
INCLUDE POOL, SPA, BLOCK WALLS OR
DRIVEWAY APPROACH.
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
70.23
-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
PlanCheck Total 790.55.. .00 .00
790.55
Other Feel' Total 4630.68 00 .00
4630.68
Grand Total 6869.58 .00 .00
6869.58.
LQPERMIT