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04-5012 (SFD)P.O. Box 1504 78-495 CALLE TAMPICO 9. LA QUINTA,-C.AL.IFORNIA 92253 BUILDING PERMIT Application Number . . . Property Address APN: Application description Property Zoning . . . . . Application valuation BUILDING & SAFETY DEPARTMENT --(760).777-7012 FAX) 760 777-7011 N:SPECTION REQUESTS (760) 777-7153 JU41 2 2224 CITY OF LA QUIX A FG,1A'L,-'n DEPT 04-00:00.5.0.12_ Date 6/21/04 81290 STONE CROP LN 764-270-999-81 -300233- DWELLING - SINGLE FAMILY DETACHED MEDIUM HIGH DENSITY RES 170396 Owner Contractor SHEA LA QUINTA SHEA HOMES, INC. C/O JEFF MCQUEEN 81260 AVENUE 62 8800 N GAINEY CENTER 350 LA QUINTA CA 92253 SCOTTSDALE AZ 8.5258 (760) 777-6005 WCC: NTL UNION INS WC: 7165833 08/01/04 CSLB: 672285 06/30/05 CCC: B -------------------------- Structure Information --------------==--------- Construction Type . . . . . TYPE'V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Flood Zone .'.. . . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001CBC FIRE SPRINKLERS NO GARAGE SQ FTG576..00 PATIO. SQ.. FTG c 17`7j.;O0 NUMBER OF UNITS .. e a.. 1j. 00 FIRST FLOOR SQ.FTG 1940.00 .Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 888.00 Plan Check Fee 144.30 Issue Date . . . Valuation . . . . 170396 'Qty Unit Charge Per Extension BASE FEE 639.50 71.00 3.5000 THOU BLDG 100,001-500,000 i', 248.50 - ------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 88.50 Plan Check Fee 5.53 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per a Extension 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: Date: "04 Applicant: Archit or n er (bAmo Applicant's Mailing Address: Arch itec or Engineer's Address: ic. No.: ka 9_C. qQ BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisi ns of C pter 9 omrn�ncing with Section 7000) of Division 3 of the Business and Professionals dGode, and my se is in full force and effect. �� License,Cllaass ��%, ense No. Date ( �T 4z Contract ry OWNER -BUILDER DECLARATION 1 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 violafion 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 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 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 1, 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. , B.& 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. /--Carrier 1 av ,and ill aintain wo rs' compensation insuranc� squired b S ion 00 of the Labor Code, for the performance of the work for which this permit is ued. orkers' co ensatio rance carrier and rI/� 1 Carrier Policy Number _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, an agree that, if I s ould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisiW. Jt6 late plicant WARNING: FAILURE TO SECURE WORKERS' 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 Lender's 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 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. 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 permit to canc tion. I certify that I have read this application and state that the above info atiocorrect. I agree to comply with all city and county ordinances and state laws relating to building construction and here authorize representatives of this count p n the above-mentioned property for inspection purposes. 'tal) /15-ate4__nature (Applicant or Age Page 2 - Application Number . . . . . 04-00005012 Date - 6/21/04 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 3.00 9.0000 EA MECH B/C <=3HP/100K BTU 27.00 2.00 6.:5.000 EA MECH VENT FAN 13.00 1.00.6.5000 EA MECH EXHAUST HOOD 6.50 Permit ELEC-NEW RESIDENTIAL Additional desc Permit Fee 33.17 Plan Check Fee 8.29 Issue. Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 190.00 .0350 ELEC NEW RES-- 1 OR .2 FAMILY' 6.65 576.00 .0200. ELEC GARAGE OR NON-RESIDENTIAL 11.52 ---------------------- Permi.t . . ------------------------------------------- PLUMBING ----------- Additional desc . Permit -Fee- - 152.25 Plan Check Fee 9.52 Issue Date . . . Valuation . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 14.00' 6.0000 EA PLB FIXTURE 84.00 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 5.00 .7500 EA PLB GAS PIPE.>=5 3.75 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 - LOT 81,.PLAN 4520B/CASITA/23 - SF. t M 1 Page 3 Application Number 04-00005012 Date 6/21/04 ---------------------------------------------------------------------------- Special Notes and Comments BAY @ MBR/88 SF. GARAGE EXTENSION. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH, 75% REDUCTION TO PLAN CHECK FEE DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY.CENTERS-RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 14.43 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 17.03 DIF STREET MAINT FAC -RES 15.00' DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Permit Fee Total 1176.92 Plan Check Total 167.64 Other Fee Total 2436.46 Grand Total- 3781.02 Paid Credited Due .00 .00 1176.92 .0.0 .00 167.64 .00 .00 .2436.46 .00 .00 3781.02