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04-4683 (SFD)r P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFE T T (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Application Number . . . . . C04-0,000.4683-__ j Date 6/01/04 Property Address . . . . 60590 LACE LEAF CT - APN: 764-270-999-118 -300231- Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . MEDIUM HIGH DENSITY RES Application valuation . . . . .200727 , Owner SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER 350 SCOTTSDALE AZ 85258 Contractor SHEA HOMES, INC. 81260 AVENUE 62 LA QUINTA CA 92253 (760) 777-6005 Qty Unit Charge Per Extension WCC: NTL UNION INS WC: 7165833 08/01/04 CSLB: 672285 06/30/05 CCC: B ------ Structure Information PLAN 5515B W/EXER RM 191SF & MBR 26SF ----- Construction Type . . . . .. TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10. Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struct info . . . . CODE EDITION 2001 4 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 2339.00 Permit . . . . . . BUILDING PERMIT ------------- Additional desc Permit Fee . . . . 993.00 Plan Check Fee 645.45 Issue Date Valuation 200727 Qty Unit Charge Per Extension BASE FEE 639.50 101.00 3.5000 ----------------------------------------------------7----------------------- THOU BLDG 100,001-500,000 353.50 Permit . . . . . MECHANICAL Additional desc Permit Fee . . . . 66.50 Plan Check Fee 16.63 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension ! v P.O. Box 1504 �/,/�G� 78-495 CALLE TAMPICO qY VOICE (760) 777-7012 LA QUINTA, CALIFORNIA 92253 44FAX (760) 777-7011 INSPECTIONS (760) 7 77 -7 15 3 // BUILDING & SAFETY DEPARTMENT Application Number: �o Date: �O- 7-D VApplicant: Ar t t E " - Applicant's Mailing Address: ec or r� (neer. CIS / ' .vnc Architect ddr � s � n_ Mlkp J—Lic. No.: 1JC& Z-io (4` 1 BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (coma ting with Section 7000) of Division 3 of the Business and Professionals Code, and Licen in full force and effect. /��-� License Class ss '— �( License No. _ -Date' 7 b 1 Con 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.). (--) 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 1 am exempt under Sec. BA P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION 1 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. I have and will maintain wo ers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issu y w rkers' co sati nsrnce rp rmq�rag /Carrs .10 Policy NumberT_�� I certify a , in the performance of the work for which his permit is issued, I shall not employ any person in any manner so as to beco compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Sme subject to the workers' ection 3700 of the Labor Code, I shall forthwith comply with those provisions. n Date 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. I herebyaffirm under CONSTRUCTION LENDING AGENCY penalty of perjury that there is a construction lending agency for the perfoman ce 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 Buildingand Safety A 1. Each person upon whose behalf this application is made, each person at whose reqpermit uest st a d for whose benefit works rk ct to the conditions and restrictions 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 Le Quints, 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 g i from date s 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 ce agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this countyto nter upon the �/�� ve-mentioned property for inspection purposes. Date �L7" ignature (Applicant or Agent): �' f 1 Page 2 Application Number . . . . . 04-00004683 Date 6/01/04 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 . . . . 106.43 Plan Check Fee 26.61 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 ` 2339.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 81.87 478.00 ---------------------------------------------------------------------------- .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 1.0.0 _ 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 5515C LOT 118 W/EXER RM 191SF Page 3 Application Number . . . . . 04-00004683 Date 6/01/04 -----------------------=---------------------------------------------------- Special Notes and Comments '& 26SF BOX BAY @ MBR. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL,SPA OR DRIVEWAY APPROACH. ---------------------------------------------------------------------------- Other Fees . . ART IN PUBLIC PLACES -RES 20.00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 64.55 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 20.07 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION -RES 1098.00 Fee summary Charged ----------------- Paid Credited Due ---------- Permit Fee Total 1321.93 ------------------------------ .00 .00 1321.93 Plan Check Total 723.94 .00 .00 723.94 Other Fee Total 2509.62 .00 .00 2509.62 Grand Total 4555.49 .00 .00 4555.49