04-5039 (SFD)o� .�tQr�ra
P.O. Box 1504
.78-495 CALLE TAMPICO
e I;A' QU-INT�Ap CALIFORNaA ;92253
BUILDING & SAFETY DEPARTMENT.
(760).717-7012
FAX (760) 777-7011
ACTION=REQUESTS (760) 777-7153
BUILDING IPE�RMIT� 2 4 2004
Application Number . . .
Property'Address
APN :
Application description
Property Zoning . . . .
Application valuation
Owner
SHEA LA QUINTA
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE AZ 85258
cera OF AQUI T
'0'0=0-:�j 5039 Date 6/18/04
81271 STONE CROP LN
764 -270 -999 -69 -300233 -
DWELLING - SINGLE FAMILY DETACHED
MEDIUM HIGH DENSITY RES
2.02505
Contractor `
SHEA HOMES, INC.
81260 AVENUE 62
LA QUINTA - CA 92253
(760) .777-6005
I
WCC: NTL UNION INS
WC: 7165833
08/01/04
CSLB: 672285
06/30/05
CCC: B
------ Structure Information.
PLAN -5515C
-----
Construction Type . .
. . . TYPE V - NON RATED
Occupancy Type. . . .
. . . DWELLG/LODGING/CONG <=10
Flood Zone .. . . . .
. . . NON -AO FLOOD ZONE
Other struct info . .
. . .. CODE EDITION
2001
# BEDROOMS
3.00
FIRE SPRINKLERS
NO,
GARAGE ,SQ FTG
,:.' ,478:`00
'�
PATIO 'SQ- FTG
"` 178.`00
NUMBER`OF UNITS
1.00
FIRST FLOOR -SQ FTG
23611,.00
-
Permit . . . .
BUILDING PERMIT
y
Additional desc
Permit Fee
1000.00 Plan Check Fee
650.00
Issue Date
Valuation
202505
Qty Unit Charge
Per
Extension
BASE FEE
639.50
103.00 3.5000
THOU BLDG 100,001-500,000
360.50
--------------------------------------------------------------------------
Permit . . . . . .
MECHANICAL
Additional desc.. .
Permit Fee . . . .
59.00 Plan Check Fee
14.75
Issue Date . . .
Valuation . .
. . 0
Qty Unit Charge
Per
Extension
I
P.O. BOX 1504 • VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
Pate: C2 -U
E
Architect or Engineer's Address:
ni
I—Lic. No.: J CQ j 4?A119`� 1
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DEC RATION
I hereby affirm der penalty of perjury that I am licensed under provisionspf Ct�with Section 7000) of Division 3 of the Business and Professionals
Code, and my Li is in full force and eff ct.
16
cense C lass icfnse No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Contractors' State 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 any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars ($500).):
U 1, 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 Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work
himself or herself or through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is
sold within 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.).
U I.
as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec. , BA P.C. for this reason
Date Owner.
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
I h1'p an 11 aintain wLecopensation insurance, as required b Section 3700 of the Labor Code, for the performance of the work for which this permit is
/ .,M , y ers'cction irl5urance carne c
Carrier .v' V i>rolicy Number
I certify that, in the per -Or -mance of the work for whit his permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, ano agree that, should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
1 forthvtith comply with those ygiKon
WARNING: FAILURE TO SECURE WZIRKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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
Lenders Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application, the owner, and the applicant, each agree o, 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 bei performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if wo i not commenced within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit to canc11 lion.
I certify that I have read this application and state that the above info a is correct. gree to comply with all city and county ordinances and state laws relating to building
construc' nn. and reby authorize representatives of this county t er u on a ab -mentioned property for inspection purposes.
_ V ignature (Applicant or Agent):
J
f,
S
��J Yf, �P kfuSl�G IC•.' f S � )'1 cN
Page
2
Application
Number .
. . .
. 04-00005039 Date
',6/18/04
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
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
. . .'
107.20 Plan Check Fee
26.80
Issue Date
. . . .
Valuation
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
.2361..00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
82.64
478.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
9.56
---------------
Permit .
-----------
. . . . .
---------------------------------------
PLUMBING
-----------
Additional
desc . .
Permit Fee
141.00 Plan Check Fee
35.25
Issue Date
. . . .
Valuation
0.
Qty -
Unit Charge
Per
Extension
BASE FEE
15.00
12.00
6.0000
EA
PLB'FIXTURE
72.00
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
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes
and Comments
SFD - Plan
5515C.w/Exercise
Rm (191sf)
i
0
1
Page 3
Application Number
04-00005039 Date
6/18/04
-------------------- --------------------------------------------------------
Special Notes and
Comments
Box Bay @ MBR (26sf
) & Nook (22sf)
'.
----------------------------------------------------------------------------
Other Fees . . .
. . . . ....
ART IN PUBLIC PLACES -RES
20.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
65.00
DIF FIRE PROTECTION -RES
97.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC'_- RES
5.00
DIF PARKS/REC - RES
502.00
STRONG MOTION (SMI) - RES
20.25
DIF.STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION- RES
1098.00
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
1322.20
.00 .00
1322.20
Plan Check Total
726.80
.00 .00
726.80
Other Fee Total
2510.25
.00 .00
2510.25
Grand Total
455.9.25
.00 .00
4559.25
1