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04-4548 (SFD)Tihf 4 4 Q" ).Box 1504 ' -495 CALLE TAMPICO QUINTA,• CA-LIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 77777011 INSPECTION REQUESTS (760) 777-7153 amber . . .OC 4—_0.0004548 Date 5/26/04 PropertytAddre_s_s _`'T. . . . 60612 LACE LEAF CT APN: 764-270-999-117 -300231- Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . MEDIUM HIGH DENSITY RES Application valuation 208404 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 85258 (760) 777-6005 WCC: NTL UNION INS WC 7165833 08/01/04 CSLB: 672285 06/30/05 CCC: B ------ Structure Information PLAN 5515B W/GST SUITE 290SF & NOOK 22SF----- 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 2434.00 ---------------------------------------------------------------------------- Permit . . . . . BUILDING PERMIT ` Additional desc Permit Fee . . . . 1021.00 Plan Check Fee 663.65 Issue Date Valuation 208404 Qty Unit Charge Per Extension BASE FEE 639.50 109.00 3.5000 THOU BLDG 100,001-500,000 381.50 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 66.50 Plan Check Fee 16.63 Issue Date Valuation . . . . 0 Qty Unit Charge Per ..a ,Extension l P.O. Box 1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: J, VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: Architect or Engineer's Address: No.:Q.c-t -2-6 %A b I BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm t{rWa enin f 11 perjury that I am licensed under prove ions of Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my Li in full force and effect. / �+1 License Class /License No. ! /` J OWNER43UILDER 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. . B.8 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. IF I have and will maintain orkers' compensate insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is is AAq rkers' o ensatio rance poli�+►� h Policy Number. ��0� p _ I certify that, in the performance of the work t ich 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 agref I, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / Dateu 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. 1 herebyaffirm under CONSTRUCTION LENDING AGENCY 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 IMPORTANT APPLICANT ACKNOWLEDGEMENT 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, indemnity 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 wo is not commenced within 180 day! 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 information is co I agree to comply with all city and county ordinances and state laws rotating to building constructio and ereby authorize repre ntatives of this county o ent upon the a ntioned property for inspection purposes. Dat O Signature (Applicant or Agent) Application Number . . . . . 04-00004548 Page 2 Date 5/26/04 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 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 . . . . 109.75 Plan Check Fee 27.44 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 2434.00 .0350 ELEC NEW RES- 1 OR.2 FAMILY 85.19 478.00 ---------------------------------------------------------------------------- .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 5515B LOT 117 2434 SQFT r pl� Page .3 Application Number ---------------------------------------------------------------------------- . . . .. . 04-00004548 Date 5/26/04 Special Notes and Comments W/GUEST SUITE 290SF & NOOK 22SF. PERMIT .DOES NOT INCLUDE BLOCK WALL, POOL OR DRIVEWAY APPROACH. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 21.01 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 66.37 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 20.84 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged Paid Credited Due Permi�t Fee Total ---------- 1353.25 ------------------------------ .00 .00 1353.25 Plan Check Total 742.97 .00 .00 742.97 Other Fee Total 2513.22 .00 .00 2513.22 Grand Total 4609.44 .00 .00 4609.44 r pl�