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04-4572 (SFD)BUILDING & SAFETY DEPARTMENT 1.0. Box 1504 (760).777-7012 18-495 CALLS TAMPICO FAX (760) 777-7011 YA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 'l BUILDING PERMIT Number 04=00004572 Date 5/25/04 ress 60546 LACE LEAF CT I.Iv k,--..-- II description Property Zoning . . . . Application valuation . Owner SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER 350 SCOTTSDALE AZ 85258 764-270-999-120 -300231- DWELLING - SINGLE FAMILY DETACHED MEDIUM HIGH DENSITY RES _166621 Contractor r -------------------- j - - - - - - SHEA HOMES, INC. 81260'AVENUE 62 LA QUINTA CA 92253 (760) 777-6005 WCC: NTL UNION INS WC: 7165833 08/01/04 CSLB: 672285 06/30/05 CCC: B -------------------------- Structure Information --------------------- - --- 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 539.00 ,PATIO ,SQ FTG 537.00. NUMBER OF UNITS 1.00 -------------------- FIRST FLOOR SQ FTG 1843.00 -------------------------=--------------------------- Permit .. BUILDING PERMIT --- ,° Additional desc Permit Fee 874.00 Plan Check Fee 568.10 ,Issue Date Valuation . . . . 166621 Qty Unit Charge Per Extension BASE FEE 639.50 67.00 3.5000 ---------------------------------------------- THOU BLDG 100,001-500,000 234.50 Permit . . . . . . ------------------------------ MECHANICAL Additional desc Permit Fee 77.00 Plan Check Fee 19.25 Issue Date Valuation . . 0 Qty Unit Charge Per Extension r P.O. 1504 7$-4955 CALLE TAMPICO VOICE (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Z1574;? Date: 6-1-04/ Applicant: E i Applicant's Mailing Address: Architect or Engineer's Address: Ic. No-k,5 BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm r natty of perjury that I am licensed un r provisions of Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my i nse m in full force and effect. � �s License Cl ss License No. 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 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 wjr� scompensat" ' urance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is rriem �uedy'�dffs' calio urance ca ►►ll (7\ oticy Number 1 l�3nno _ 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 become subject to the workers' compensation laws of California, and agree that, ' should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pr` vision . 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 performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address IMPORTANT Application is hereby made to the Director of Buildingand Safety ACKNOWLEDGEMENT 1. Each tY permit subject to the conditions and restrictions set forth on this application. 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 actor omission related to the work being performed under or following issuance ofthis 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 information is correct I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to en upon ve mentioned property for inspection purposes. ate L `V mgna� tUfe (Applicant or Agent): Page 2 Application Number 04-00004572 Date 5/25/04 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 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 90.29 Plan Check Fee 22.57 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1843.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 64.51 539.00 ---------------------------------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 10.78 Permit . . . . . . PLUMBING Additional desc . . Permit Fee . . . . 129.00 Plan.Check Fee 32.25 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 10.00 6.0000 EA PLB FIXTURE 60.00 1.00 k 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 i. . . . 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 - LOT 120, PLAN 5505A/22 SF BAY @ R Fee summary . Charged Permit Fee Total 1185.29 Plan Check Total 642.17 Other,Fee Total 2478.47 Grand Total 4305.93 11 Paid Credited Due ---------- ---------- ---------- .00 .00 1185.29 ..00 .00 642.17 .00 .00 2478.47 .00 .00 4305.93 Page 3 Application Number ---------------------------------------------------------------------------- 04-00004572 Date 5/25/04 Special Notes and Comments MBR/83 SF GARAGE EXT./315 SF EXT. PATIO PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA 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 56.81 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 16.66 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary . Charged Permit Fee Total 1185.29 Plan Check Total 642.17 Other,Fee Total 2478.47 Grand Total 4305.93 11 Paid Credited Due ---------- ---------- ---------- .00 .00 1185.29 ..00 .00 642.17 .00 .00 2478.47 .00 .00 4305.93