04-7220 (SFD)�`�o �I urlUriV
BUILDING & SAFETY DEPARTMENT
P.O. Box,1504 (760),777-7012
- -495 LE TAMPICo"FAX.(760) 777-7011
e'
CALIFORNIA 92253_ INSPECTION REQUESTS (760) 777-7153
DEG -2 0'. 2004 BUILDING -PERMIT
A C OF. LA QUINTA
�0 4�O O:O Oi7�2 2 0 '}, --- D a.t e 11/A6/04
Property "Address 160�53�STA�GHO NR _ DR
.APN: ' '764-270=999-92 -300233-
Application description -DWELLING,,- SINGLE FAMILY DETACHED
Property Zoning MEDIUM HIGH DENSITY RES
Application valuation.. 162115
Owner Contractor
SHEA LA QUINTA SHEA HOMES, INC. -
C/O JEFF MCQUEEN 8.1260 AVENUE 62
8800 N GAINEY CENTER 350 LA QUINTA CA 92253
SCOTTSDALE AZ 8.5258 (760) 777-6005
WCC: NTL UNION INS
WC: 6436568 08/01/05
CSLB: 672285 06/30/05
CCC: B
-------------------------- Structure Information. -.--------------7---------
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 520.00
• PATIO SQ FTG • 457 .I)0 ,.
NUMBER -OF UNITS 1.,00
- FIRST FLOOR SQ .FTG`, 180.5.00
Permit BUILDING PERMIT
Additional 'desc
Permit Fee 860.00 Plan Check Fee 559.00
Issue Date- Valuation 162115
Qty Unit Charge Per Extension
BASE FEE 639.50.
63.00 3:5000 THOU BLDG 100,001-500,000 220.50
- - - - - - -
----------------------------------------------- r. r
Permit . . . . . MECHANICAL
Additional desc
Permit Fee 83.50 Plan.Check Fee'. 20.88
Issue Date Valuation 0
4 Y
Qty Unit Charge Per Extension
BASE FEE 15.00
2.00 9.0000 EA MECH FURNACE <=1,100K ! 18.00
2.00 9.0000 EA ,,MECH B/iC <-j3HP/100K BTU r 18.00.
4.00 6.5000 EA' MECH' VENT FAN 26.00
P.O. Box 1504 • �I� I VOICE (760) 777-7012
78-495 CALLE TAMPICO �v FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 04- 702 te: /2 -/7 -OV
Applicant: ct r ila
Applicant's Mailing Address: Architect or Engineer's Address:
/�y —4- L LgR
. No.�- �✓1i2� V
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm u0g" Walty of perjury that I am licensed under provisi s o I tef (7rr3ing with Section 7000) of Division 3 of the Business and Professionals
Fede, and my Li
cen lam. fsJJnpn full force and effect. colI �j Ivy
License Class Z _` icense No. Ve/ Zj
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 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 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
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 wo for which this permit is issued.
ve a w I maintain w ers' compensation insnnd d by SectjQQ 3700 of the Labor Code, for the performance of the work for which this permit is
sued. ers' c pensation insy,ance carner-P6ficy NumbeI certify that, in the performance of the work for whssued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Calif mia, and agree thate subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
fort with comply with those ov' ' S.
/-'Date� pplica t \ `
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 A
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 Quinta, 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 perNaboinformati
tion.
1 certify that I have read this application and state that the on is ct. I agree to comply with all city and county ordinances and state laws relating to building
construcction, and h eby authorize representatives of thiser above-mentioned property for inspection purposes.
to Y ignature (Applicant or Agen
4�
Application Number 04-00007220
Page 2
Date 11/16/04
Qty Unit
Charge .Per
Extension
1.00
6.5000 EA MECH EXHAUST HOOD
6.50
Permit . . . .
. . ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee .
. . 88.58 Plan Check Fee
22.15
Issue Date . .
. . Valuation
0
Qty Unit
Charge Per.
Extension
BASE FEE
15.00
1805.00
.0350 ELEC NEW RES - 1 OR 2 FAMILY
63.18
520.00
.0200 ELEC GARAGE OR NON-RESIDENTIAL
10.40
----------------------------------------------------------------------------
Permit . .
. . PLUMBING
Additional desc
Permit Fee . .
. . 147.00 .Plan Check Fee
36.75
Issue Date . .
. . Valuation
0
Qty Unit
Charge Per
Extension
BASE FEE
15.00
13.00
6.0000 EA PLB FIXTURE
78.00
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 - LOT92, PLAN 4210A, 249 SF CASITA,
BOX BAY @MBR -26
SF, 120 SF. PATIO EXT.
PERMIT DOES NOT'INCLUDE
POOL, SPA, BLOCK
WALLS.OR DRIVEWAY
APPROACH.
Other Fees
. . . . . . . ART IN PUBLIC PLACES -RES
:00
DIF COMMUNITY CENTERS -RES
97.00
DIF'CIVIC CENTER - RES
366.00
Page
3
Application Number
04-00007220 Date
11/16-/04
----------------------------------------------------------------------------
Other Fees.,. . .
. . ... . .
ENERGY REVIEW FEE
55.90
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
16.21
DIF STREET MAINT FAC -RES
15.00
DIF•TRANSPORTATION - RES
1098.00
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
1194.08
,00 .00'
1194.08
Plan Check Total
638.78
.00 .00
638.78
Other Fee: Total`
2477..11
.00 _. .00
2477.11
Grand Total
14309.97
.00 .00
4309.97
F