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05-0569 (SFD)P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number . . Property'Address . . . APN: Application description Property Zoning Application valuation Owner BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 y - FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 05000.00.569 Date 2/14/05 60168 KATIE CIR 764-270-999-164 -300233- . . . DWELLING - SINGLE FAMILY DETACHED . . . MEDIUM HIGH DENSITY RES . . 182411 SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER 350 SCOTTSDALE AZ 85258 Contractor---Itc L SHEA HOMES81260 AVENUEJM2005LA QUINTA 92253 (760) 777-6005 �n,OF�''4QUINTA WCC: NTL UNION INS WC: 6436568 08/01/05 CSLB: 672285 06/30/05 - CCC: B ------ Structure Information SFD PLAN 53200 W/MBR & NOOK BAY EXT GAR ----- Construction Type . . . . . TYPE V - NON RATED Occupancy Type DWELLG/LODGING/CONG <=10 Other struct info . . . . . CODE EDITION 2001 # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 541.00 PATIO SQ FTG 245.00 ' NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 2086.00 --------------------------------------------------------------- Permit BUILDING PERMIT ------------- Additional desc Permit Fee . . . . 930.00 Plan Check Fee 604.50 Issue Date . . . . Valuation . . . . 182411 Qty Unit Charge Per Extension BASE FEE 639.50 83.00 3.5000 -------------------------------------------------------- THOU BLDG 100,001-500,000 290.50 Permit 4. --------------------- MECHANICAL Additional desc Permit Fee . . . . 77.00 Plan Check Fee 19.25 Issue Date . . . . Valuation . . . . 0 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 BIC <=3HP/100K BTU 18.00 3.00 6.5000 EA MECH VENT FAN 19.50 P.O. BOX 1504 • VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: LQ 5 • 5C� a 3 • .v Applicant: n n4e Applicant's Mailing Address: r hitect r Engineer's A dress: Lic. Nolecc, L HO BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirmr penalty of perjury that I am licensed under pr w ions.o h"r Ging with Section 7000) of Division 3 of the Business and Professionals rdede, and my f- force is in full force and effect. 61, el, lass icense o ,,--Dat S Q.M�ractor 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 cr 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 gompletion, 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.). (_) I am exempt under Sec. , BA P.C. for this reason Date 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 work for which this permit is issued.)1�of.ethe an wil maintain rs'compensationinsur ce,aq req d by 370 the Labor Code, for the performance of the work for which this permit is ed. My orkers' co ensation i ance care c a e: icamer olicy Number _ I certify that, in the performance o 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 and a forthwith comply with those ( gree that 'f I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall I / V it! I U1 6� s 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 Lenders Address f^ 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 t cancellation. I certify that I have read this application and state that the abo e'nfor tion is ct. I agree to comply with all city and county ordinances and state laws relating to building construct (n, and h(/er�e�by authorize representatives of this coun ent r upon ove-mentioned property for inspection purposes. at S' ignature (Applicant or Ag g, Win. . r 1Y l� 'T. � •, rt Page 2 Application Number . . . . . 05-00000569 Date 2/14/05 Qty Unit Charge Per Extension 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 -----------=---------------------------------------------------------------- Permit ELEC-NEW RESIDENTIAL Additional desc.. Permit Fee . . . . 98.83 Plan Check Fee 24.71 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 2086.00. 0350 ELEC NEW RES - 1 OR 2 FAMILY 73.01 541.00 ---------------------------------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 10.82 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 15.00.00 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 Qty Unit Charge Per Extension ---------------------------------------------------------------------------- BASE FEE 15.00 Special Notes and Comments SFD - Plan 5320C Lot 164 w/box bay MBR 26 (sqft), box bay nook (26 sqft) & ext garage (83 sqft). Permit does not include block wall, pool or driveway approach. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00 Page 3 Application Number . . 05-00000569 Date 2/14/05 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 60.45 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 18.24 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Permit Fee Total 1267.83 Plan Check Total 685.21 Other Fee Total 2483.69 Grand Total 4436.73 Paid Credited Due ---------- ---------- ---------- .00 .00 1267.83 .00 .00 685.21 .00 .00 2483.69 .00 .00 4436.73