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04-4863 (SFD)P.O. Box 1504. 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING &-S.A,FETY_'DEPARTMENT (760),777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Application Number . . . . . --04-000-04863_ Date 6/14/04 Property Address . . . ... . 60477 DESERT SHADOWS.DR APN:. 764-270-999-85 -300231- Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning MEDIUM HIGH DENSITY RES Application valuation .149793 Owner Contractor SHEA LA QUINTA SHEA HOMES, INC. C/0 JEFF MCQUEEN 81260 AVENUE 62 8800 N GAINEY CENTER 350 LA QUINTA .CA 92253 SCOTTSDALE AZ 85258 (760) 777-6005 WCC: NTL UNION INS WC:- 7165833 08/01/04 CSLB: 672285. 06/30/05 CCC: B =------=--------=--------- Structure Information -------------- ---------- Constructi�on 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 576.00 PATIO SQ FTG 177.00. NUMBER OF UNITS 1.00 ------------------=------------------------------ FIRST FLOOR SQ FTG" 1685.00 Permit ---------------------------- BUILDING PERMIT Additional desc Permit Fee. 814.50 Plan Check Fee 529.43 Issue Date. Valuation 149793 Qty Unit Charge Per Extension BASE FEE 639.50 50.00 3.5000 THOU. BLDG 100,001-500,000 175.00 ------------------.---=------------------------------------------------------ Permit . . . . . MECHANICAL Additional desc Permit Fee 73.50 Plan Check Fee 18.38 .Issue Date Valuation 0 Qty Unit Charge Per Extension 1 P.O. Box .1504• �� VOICE (760) 777-7012 78-495 CALLE TAMFICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: o4-486-3 Date: Applicant: Applicant's Mailing Address: Ar I Engi eIG 4 5 a, - /, Architect or Engineer's Address: er- Lic. No.Zct 2,& lo/ BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm un a nalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Cede, and Lice in full force and effect. cense Class -,License No. OWNER -BUILDER DECLARATION 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 1, 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 Owner 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 thi permit is issued. t19v `an I maintain ers' compensation insurance, s required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issue orkers' ensation i r9nce ca .rri ,,Policy Number _ I certify that, in the performance of the work for which this perm ss 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, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with thosep isions. Date46 cant C� 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.). Lenders Name Lender's Address A 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 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. 1 certify that I have read this application and state that the above information Is correct. I e to comply with all city and county ordinances and state laws relating to building construction, d hereb authorize representatives of this county toe p n the abo mentioned property for inspection purposes. e Signature (Applicant or Agent): r AI Application Number . . . . . 04-00004863 Page 2 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 11.0000 EA MECH FURNACE >100K 11.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 1.00 6.5000 EA MECH VENT FAN 6.50 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 85.50 Plari,Check Fee 154.07 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 1685.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY .58.98 576.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 11.52 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit.Fee . . . . 128.25 Plan Check Fee 32.06 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 10.00 6.0000 EA PLB FIXTURE 60.00 1.00 15.0000 EA PLB BUILDING SEWER _1S.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 Permit Fee 15.00 Plan Check Fee .00 Issue Date Valuation . . . . 0 Qty Unit Charge Per BASE' FEE' ' ' Extension 15.00 wf Page 3 Application Number . . . . . 04-00004863 Date 6/14/04 ------------------7--------------------------------------------------------- Special Notes and Comments SFD - LOT 85 PLAN 4520B, PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS, 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 52.94 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 14.97 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged ---------- Paid Credited Due Permit Fee Total 1116.75 ------------------------------ .00 00 1116.75 Plan Check Total 733.94 .00 .00 733.94 Other Fee Total. 2472.91 .00 .00 2472.91 Grand Total 4323.60 .00 .00 4323.60