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05-3617 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: . APN: Application description Property Zoning: Application valuation: Applicant: uplil_" (05-00003617 81 0 1 7-ULRICH DR 764-270-999-76 -300234- DWELLING - SINGLE FAMILY MEDIUM HIGH DENSITY RES 186889 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: SHEA'LA QUINTA C/O JEFF MCQUEEN DETACHED 8800 N GAINEY CENTER 350 SCOTTSDALE, AZ' 85258 �chitect or Engineer: Y�sr� C�5LU-IJ -------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Pr fiZlsCode, and my License is in full force and effect. L�icen C ss: B e No.: 672285 ' �ua�_ ntractor. OWNER -BUILDER DECLARATION I hereby affirm•under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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).: (_ 1 .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 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.). (_ 1 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.). ' ( 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: 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: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 12/05 t.S►° 13 2505 CITY OF LA QUINTA Contractor: SHEA HOMES, -INC. 81260 AVENUE 62 LA QUINTA, CA 92253 (760)77.7-6005 Lic. No.: 672285 WORKER'S 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 is sued. 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 insurance carrier and policy number are: Carrier NTL UNION INS Policy Number 6436568 I certify that, in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to be a subject to the workers' compensation laws of California, and agree that, if I houl becom biect to the the compensation provisions of Section X3700 of the La r shall f with comply with those provisions. 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. 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 permit to cancellation. I certify that I have read this application and state that the above informa is correct. I agree to comply with all city and ounty ordinances ands to laws relating t b ' ing construct and hereby authorize representatives O fenter upoabove-mentioned pr rt for in oses. ature (Applicant or Application Number . . . 05-00003617 ------ Structure Information SFD PLAN 5505 W/CASITA MBR GAR & PAT EXT ----- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . DWELLG/LODGING/CONG <=10 Other struct info . . . . . CODE EDITION 2001 # BEDROOMS 4..00 FIRE SPRINKLERS NO GARAGE SQ FTG 539.00 PATIO SQ FTG 536.00 NUMBER OF UNITS 1 1.00 1ST FLOOR SQUARE FOOTAGE 2094.00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 944.00 Plan Check Fee 613.60 Issue Date Valuation . . . . 186889 Expiration Date 2/08/06 Qty Unit Charge Per Extension BASE FEE 639.50 87.00 3..5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 304.50 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 83.50 Plan Check Fee 20.88 Issue Date . . . . Valuation . . . 0 Expiration Date 2/08/06 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 9.0000 EA MECH.B/C <=3HP/100K BTU 18:00 4.00 6.5000 EA MECH VENT FAN 26.00 1.00 6.5000 --------------- ------------------------------------------------------------ EA MECH EXHAUST HOOD 6.50 Permit . . . Additional desc . . Permit Fee . . . . Issue.Date . . . . Expiration Date . Qty Unit Charge 2094.00 .0350 539.00 .0200 LQPERMIT ELEC-NEW RESIDENTIAL 99.07 Plan Check Fee . Valuation 2/08/06 Per BASE FEE ELEC NEW RES 1 OR 2 FAMILY ELEC GARAGE OR NON-RESIDENTIAL 24.77 0 Extension 15.00 73.29 10.78 Application Number . . . . . 05-00003617 Permit PLUMBING Additional desc . Permit Fee . . . . 133.50 Plan Check Fee 33.38 Issue -Date. Valuation . . . . 0 Expiration Date . . 2/08/06 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 Permit GRADING PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee .: .00 Issue Date . . . . Valuation . . 0. Expiration Date 2/08/06 Qty Unit Charge Per Extension BASE FEE 15.00 --------------------------------=------------------------------------------- Special Notes and Comments SFD - Plan 5505C Lot 76 w/casita (247 sqft), MBR box bay (26 sqft), ext.garage (83 sgftj,'ext patio (315 sqft), 2094 SF. Permit does not include block wall, pool or driveway approach. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 61.36 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 18.68 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 109.8.00 Fee summary Charged Paid Credited Due LQPERMrr Application Number 05-00003617 Permit Fee Total 1275.07 .00 Plan Check Total 692.63 .00 Other Fee Total 2485.04 .00 Grand Total 4452.74 .00 J LQPERMIT .00 1275.07 .00 692.63 .00 2485.04 .00 4452.74