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07-0892 (SFD)P.O. BOX 1504 �^� VOICE 760 777-7012 »78-495 CALLE TAMPICO FAX (760) 777-7011 ' LA QUINTA, ;CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 - BUILDING PERMIT Date: 3/26/07 Application Number:. 07-00000892 s Owner: ' Property Address: 61611 TORO CANYON WY SHEA LA QUINTA It 71 tAP!R1 APN: -764-280-999-121 -300237- » C/O JEFF MCQUEEN Application description: DWELLING - SINGLE FAMILY DETACHED 8800 N GAINEY CENTER 3 Property Zoning:. -MEDIUM HIGH DENSITY RES SCOTTSDALE, AZ 85'258Application valuation: 210828 2 2007 Contractor: CITY OF LA QUINTA Applicant: 4rchitect or Engineer:. SHEA HOMES, INC - FINANCE DEPT. z�.o \ ; ' 81260. -AVENUE 62 � c LA QUINTA,' CA 92253 Y W Ki C•CS`� M -(760)777-6005 - - - LiC'. No.': '672285 r 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 License Cass - License No.: 672285 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is Il issued. Date:. tractor: - 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 fo which this mit is issued, I shall not employ any • construct, alter, improve, demolish, or repair any structure, prior toitsissuance, also requires the applicant for the - person in any manner as to become ubje o the wor s' 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 nd agree thaF,if 1 sho a subje to th worke pe��'W```ation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 700 the Labor , I sh I orthw comp) with th a provions. 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).: �tepcant1, as ownerof 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 NING: FAIL RE 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 buildindor 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 • a (_ 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.). whose benefit work is performed under or pursuant to any permit issued as a result of this application," (_) 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 performed under or following issuance of this permit. - - .Date: Owner: - 2. Any permit issued as a result of this applic ion becomes null and void if work is not commenced _ - within 180 days from data of issuance of ch permit, or cessation of wo for 180 days will subject CONSTRUCTION LENDING AGENCY - per it to cancellation. ' _ I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certif that I h e read hisapplicationand state that t above informkion)her orec I agree tocomply with all work for which this permit is issued (Sec. 3097,Civ. C.). ity ty rdinances and state laws relating t nstruct1eb a horize representatives _ f t o nt to ri on the above-mentione rope r i spectios. `Lender's Name: ate: ignature (Applicant or Age Lender's Address: + - - el • LQPERMrT - . , Application Number 07-00000892 Structure Information • -- Construction Type,-. TYPE -V -. ' NON RATED Occupancy'Type -DWELLG/LODGING/CONG <=10 Flood Zone NON. -AO FLOOD ZONE Other struct info . . . CODE EDITION 2001 CBC FIRE SPRINKLERS NO_ GARAGE SQ FTG 478.00'" PATIO SQ FTG 17.8.00 NUMBER OF UNITS_ 1.00 1ST FLOOR:SQUARE•FOOTAGE 2464.00 Permit BUILDING PERMIT Additional desc- esc Permit Fee Permit 1028.00 Plan Check Fee 668.20 Issue Date 'Valuation 210828 Expiration Date 9/22/07 Qty Unit Charge Per Extension BASE FEE 639.50 . 111.00,- .3.5000 -THOU BLDG 100,001-500,-000 388._50 Permit . . MECHANICAL. Additional desc . Permit Fee . . . . 77.00 Plan Check Fee 19.25 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 <=100K 18.00 . 2.00 9.b000 EA MECH B/C <=31AP/100K BTU 18.00 3.00' 6.5000 EA MECH VENT FAN 19.50 1.00 6.5000 EA MECH EXHAUST HOOD --------------- 6.50 Permit ELEC-NEW RESIDENTIAL Additional desc . Permit Fee 110.80. Plan Check Fee 27.70 ' Issue Date Valuation 0 Expiration Date 9/22/07 Qty Unit Charge Per Extension BASE FEE. .15.00 ..2464.00 .0350 ELEC NEW RES - 1 OR .2 FAMILY 86.24 478.00 0200 - ELEC GARAGE OR NON-RESIDENTIAL 9.56 -LQPERMIT _ - . Application Number 07-00000892 INCLUDES 290 SF GUEST SUITE, BOX BAY @ Permit= MBR -26 SF & NOOK -26 SF. PERMIT DOES NOT PLUMBING INCLUDE BLOCK WALLS, POOL, SPA OR DRIVE Additional desc.. CEC, 2005 ENERGY'CODES Other Fees ART IN PUBLIC PLACES -RES Permit Fee ' DIF COMMUNITY CENTERS -RES 165.00' Plan'Check Fee 41.25 Issue Date . . . . DIF FIRE PROTECTION -RES Valuation . . . 0 Expiration, Date .9/22/07. DIF PARK MAINT FAC - RES 22.00 Qty Unit Charge Per 21..08 Extension 67.00 DIF TRANSPORTATION - RES BASE FEE 15.00 16.00 6..0000 EA- PLB FIXTURE. 96.00 . 1.00 15.00.00 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 9/22/07 . SFD -.LOT 121, PLAN 5515A, 2464 SF INCLUDES 290 SF GUEST SUITE, BOX BAY @ MBR -26 SF & NOOK -26 SF. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVE WAY APPROACH. 2001: CBC, CMC, CPC, 2004 CEC, 2005 ENERGY'CODES Other Fees ART IN PUBLIC PLACES -RES 27.07 ' DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER'- RES 995.0 -0. - ENERGY REVIEW FEE 66.82 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 21..08 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1930.00 . LQPERMIT 4 Application Number 07=00000892 Fee summary Charged Paid Credited Due -�- _- - Permit Fee Total 1395.80= .00 .00• 1395.80 Plan Check -Total .756.40 .00 .00 756.40 .! Other Fee Total 4589.97 .00 .00 4589.97 Grand Total 6742.17 1.00 .00 6742.17 LQPERMIT