04-5750 (SFD)T,Vf °F 4 Q"
�9�
v`P.O. BOX 1504
'Tit "i78-495 Cie1LLE TAMPICO
U LAQUIN, CALIFORNIA 92253
9„
') _":1a-1 1 BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760) .777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
Application Number -0400005750 Date 7/29/04
Property Address .. . . . . 60100 DESERT ROSE DR
APN: 764-270-999-19 -300233-
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning MEDIUM HIGH DENSITY RES
Application valuation . . . . 183194
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 --------------
------------
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
478.00
PATIO SQ FTG
178.00
NUMBER OF UNITS
1.00
FIRST FLOOR SQ FTG
2122.00
-------------------------
Permit . . . . . .
---------------------------------------------------
BUILDING PERMIT
Additional desc
Permit Fee . . . .
933.50 Plan Check Fee
606.78
Issue Date
Valuation . . .
. 183194
Qty Unit Charge
Per
Extension
BASE FEE
639.50
84.00 3.5000
THOU BLDG 100,001.-500,000
294.00
----------------------------------------------------------------------------
Permit . . . . . .
MECHANICAL
Additional desc
Permit Fee . . . .
59.00 Plan Check Fee
14.75
Issue Date . . . .
Valuation . . .
. 0
Qty Unit Charge Per
Extension
P.O. BOX 1504ICE VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
�! BUILDING & SAFETY DEPARTMENT
Application Number: �� / .��0 ,Date:
Applicant:
Applicant's Mailing Address:
or Engineer's Address:
tic. No.: `�3--Ly
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm ugdpr penalty of perjury that I am licensed under provisio)is of Chapt9( mpG�yiith Section 7000) of Division 3 of the Business and Professionals
Cie, and my Lf;phsis in full force and effect.
/Lice� 1
nse Clpss _ _ - cepse No.
I
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.).
( j 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
I 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 e a II maintain orkers' compensation insure
3700 of the Labor Code, for the performance of the work for which this permit is
su orkers' mpensation�psarance Car�rmer Policy NumberI certify that, in the performance of the work for whicd, I shall not employ any person in any manner so as to become subject to the workers'
com nsabon laws of California, and agree that, ibject to the workers' compensafion provisions of Section 3700 of the Labor Code, I shall
forttAh co%m� ply with those prowsi s�
X U 11 " 1_/ l ro\I
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
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 rel d to the work being p ormed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes 1 and void if work is n commenced within 160 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit nenupo
I certify th t 1 haveread this application and state that the aborrect. I a to comply with all city and county ordinances and state laws relating to building
constructi , and ereby authorize representatives of this cothe ab ntioned property for inspection purposes.
t
ate q L� &/� ' nature (Applicant or Agent):
11
Application Number
Page 2
. . . . 04-00005750 Date 7/29/04
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
1.00
9.0000
EA
MECH
FURNACE <=100K
9.00
1.00
9.0000
EA
MECH
B/C <=3HP/100K BTU
9.00
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 .
. . .
98.83
Plan Check Fee
24.71
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
2122.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
74.27
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
15.001
----------------------------------------------------------------------------
Special Notes
and Comments
SFD - LOT 19,
PLAN 55,15C,
2122 SF.
Page 3
Application Number
. . . . .
04-00005750 Date
7/29/04
-----------------------------------------------------------------------------
Special Notes and
Comments
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
60.68
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
18.31
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Charged
Paid Credited
Due
Permit Fee Total
----------
1247.33
------------------------------
.00 .00
1247.33
Plan Check Total
681.49
.00 .00
681.49
Other Fee Total
2483.99
.00 .00
2483.99
Grand Total
4412.81
.00 .00
4412.81