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04-4897 (SFD),J W1 P.O. Box 1504. 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT Application Number . . . Property Address APN: Application description Property Zoning Application valuation Owner ------------------------- SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER 350 SCOT.TSDALE AZ 85258 BUILDIN4' &ISAFETY DEPARTMENT A 7.7=7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 04-00004897 Date 6/14/04 60455 DESERT SHADOWS.DR 764 -270 -999 -84 -300231 - DWELLING - SINGLE FAMILY DETACHED MEDIUM HIGH DENSITY RES 123975 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/LONG <=10 Flood Zone NON -AO FLOOD ZONE Other struct info. . . . . CODE EDITION 2001 # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE.SQ FTG 47.4.00 PATIO SQ'FTG 391.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ.FTG 1355.00 -----------------------------------------7---------------------------------- Permit * . . . . ... BUILDING PERMIT Additional desc Permit Fee. 723..50 Plan.Check Fee 470.28 'Issue Date . . . . Valuation 123975 Qty Unit Charge Per Extension ..BASE FEE 639.50 24.00 3-.5000 THOU BLDG 100,001-500,000 84.00 Permit . . . . . . MECHANICAL Additional desc . ..Permit Fee 65.50 Plan Check Fee 16.38 ,Issue Date Valuation 0 Qty Unit Charge'' Per Extension P.O. Box 1504I4 CE VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Date: Applicant:--ArcJ�j�jeFt�r Eryeg�_ /J/ Applicant's Mailing Address: Architect or Engineer's Addltss: Lic. No.: "C�. 44Q(0qbf BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under p natty of perjury that I am licensed under provisiops hapteL9�mm�ng with Section 7000) of Division 3 of the Business and Professionals ode, and in full force and effect. my Licen s t/O S �icense Class^ 1--iricense No. Date `' 1 I _ + --�Cont.ctor 5k414— Oq 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 contractors) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , BA P.C. for this reason 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 emtit is issued. iJ I have anf vyill maintain w ers' compensation insurance, s required by Section 3700 of the Labor Code, for the performance of the work for which this permit is ue workers' c nsation i nce _ 1 certify that, in the performance of 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 'f I 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. 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 Lender's 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 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 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 . I agree to comply with all city and county ordinances and state laws relating to building constru ion, and he by authorize representatives of this county nt upon above-mentioned property for inspection purposes. / // c ate �Si Signature (Applicant or Agent)- n M Page 2 Application Number . . . . . 04-00004897 Date 6/14/04 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 4.00 6.5000 EA MECH VENT FAN 26.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ----------------------------------------------=----------------------------- Permit . . . . . . ELEC-NEW RESIDENTIAL Additional desc . . Permit Fee 71.91 Plan Check Fee 17.98 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1355.00 .0350 ELEC NEW RES - 1 OR -2 FAMILY 47.43 474.00 .0200• ELEC GARAGE OR NON-RESIDENTIAL 9.48 ---------------------------------------------------------------------------- -Permit . . . . . . PLUMBING Additional desc Permit Fee 122.25 Plan Check Fee 30.56 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 9.001 6.0000 EA PLB FIXTURE 54.00 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 5.00 .7500 EA PLB GAS PIPE >=5 3.75 1.00 15.0000 EA PLB GAS METER 15.00 ----------------------------------------------------------------------------- Permit . . . . . . GRADING PERMIT Additional desc J 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 4210A w/Ext. Patio (177sf) Page 3 Application Number . . . . . 04-00004897 Date 6/14/04 -------------------------- Other Fees . . . . -------------------------------------------------- . . ., ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW.FEE 47.03 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 12.39 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ------------=---- Charged Paid Credited Due Permit Fee Total ---------- 998.16 ---------=-------------------- .00 .00 998.16 Plan Check Total 535.20 .00 .00 535.20 Other Fee Total 2464.42 .00 .00 2464.42 Grand Total 3997.78 .00 .00 3997.78