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04-4571 (SFD)BUILDING & SAFETY DEPARTMENT 1504 (760).777-7012 ALLE TAMPICO FAX (760) 77777011 'A, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT 04-000-045"71-j Date 5/25/04 Property Address , �. . . . . 60502 LACE LEAF CT APN: 764-270-999-121 -300231- Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . ... . . MEDIUM HIGH DENSITY RES Application valuation 206626 Owner Contractor ----------------- SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER 350 SCOTTSDALE AZ 85258 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 ------------------------- Construction Type . . . . .. TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CBC FIRE.SPRINKLERS NO GARAGE SQ FTG 478.00 _ PATIO.. SQ FTG 178.00 -NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 2412.00 -------------------------- Permit . . . . . ----------------------------------- BUILDING PERMIT - --------------- Additional desc Permit Fee . . . . 1014.00 Plan Check Fee 659.10 Issue Date . . Valuation . . . . 206626 Qty Unit Charge Per Extension BASE FEE 639.50 107.00 3.5000 THOU BLDG 100,001-500,000 374.50 ----------------------------------------------7----------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee 77.00 Plan Check Fee 19.25 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number:- 45 71 Applicant: Applicant's Mailing Address: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6 ' Q Architec En n fir: % . ,tS �Lj� le, �11( Architect or Engineer's Address: No. t/ t -� ��¢ LIa BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm and enaltyinf 11 perjury that I am licensed under provisiggqfft��s of Chapter 9 ( mmencing with Section 7000) of Division 3 of the Business and Professionals Code, and my Li in full force and effect. License Class ✓ 1celns,1Noo.. Date l,0 l 1 Contractor 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 fora 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: 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) liThe Contractors' censed 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: _ 1 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 w ers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this �ss� ♦d•1 MY vtro ers' c nsation i once �Rf� permit is �\.... t.( Ifs ` r Cartier rNumber _ I certify that, in the performance 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 agree that, should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith 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. 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 01 Lender's Address IMPORTANT Application is hereby made to the Director of BuildingAPPLICANT CKNOWLEDGEMENT Safety Ato the 1. Each penton upon whose behalf this application is made, each person atwhos-e request and for hose benefit work s Performed under or pustrictions set forth on this rsuant to an 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 pernit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the abT ation is correct. I gree to comply with all city and county ordinances and state laws rotating to building construction, an hereby authorize representatives of this cn a ntioned property for inspection purposes. ate t.p ignature (Applicant or Agent) t Application Number 04-00004571 Page 2 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 108.98 Plan Check Fee 27.25 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 2412.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 84.42 478.00 ----------------------------------7----------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.56 Permit . . . . . . PLUMBING Additional desc . . Permit Fee 165.00 Plan Check Fee 41.25 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 16.00 6.0000 EA PLB FIXTURE 96.00 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 - LOT 121, PLAN 5515C/290 SF.GUEST Page 3 Application Number = . . . . . 04-00004571 Date 5/25/04 --------------------------------------------------------------------------- Special Notes and Comments SUITE. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH -------------------7-------------------------------------------------------- Other Fees . . . . . . . ... ART IN PUBLIC PLACES -RES 20.00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 •ENERGY REVIEW FEE 65.91 DIF FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK FEE 00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC - RES 5.00 DI.F PARKS/REC - RES 502.00 STRONG.MOTION (SMI) - RES 20.66 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged Paid Credited Due Permit Fee Total ---------- 1379.98 ------------------------------ .00 .00 1379.98 Plan Check Total 746.85 .00 .00 746.85 Other Fee Total 2511.57 .00 .00 2511.57 'Grand Total 4638.40 .00 .00 4638.40