04-4828 (SFD),
41 \ 11
BUILDING &'SAFETY -DEPARTMENT__
P.O. Box 1504. (760) 777-7012
78-495, CALLS TAMPICO FAX (760) 777-7011
LA QUINTA., CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number 0-4-000__04828 Date 6/14/04
Property Address 60543 DESERT SHADOWS. DR
APN:. 764 -270 -999 -88 -300231 -
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning . . . MEDIUM HIGH DENSITY RES
Application valuation 160640
Owner Contractor
SHEA LA QUINTA SHEA HOMES, INC.
C/O 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/G4
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 539.00
PATIO SQ FTG 221.00'.
NUMBER OF UNITS 1.00
FIRST FLOOR S.Q FTG\ 1821.00
----------------------------.------------------------------------------------
Permit BUILDING PERMIT.
Additional desc
Permit Fee 853.00 Plan Check Fee 554.45
Issue Date. Valuation . . 160640
Qty Unit Charge Per Extension
BASE FEE 639.50
61.00 3.5000 THOU BLDG 100,001-500,000 213.50
---------------------'=------------------------------------------------------
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 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
B�UIILDING & SAFETY DEPARTMENT
Application Number: 64- Date:
Applicant:
Applicant's Mailing Address:
or
Architect or
Lic. No.: Lt0 7
BUILDING PERMIT DECLARATIONS \
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm un er penalty of perjury that I am licensed under provisigns of Cha ter ( mencing with Section 7000) of Division 3 of the Business and Professionals
Code, and my Wipe is in full force and effect.
License Clasnse No.
Date ��• �lQ `
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 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 1 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:
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.
�e aV�d Oil maintain erscompensation insurance, s quired Section 3700 of the Labor Code, for the performance of the work for which this permit is
fitJ,,s.uft%r,J,ers' ensation in rance ca
,--Came ,-Policy Number
_ 1 certify that, in the performance of the work for whi 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 th f I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
(//D /forthwith comply with those provis' s.
Date K ( • v ip
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
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, indemnity 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 an4eabove-mentioned
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 info onagree to comply with all city and county ordinances and state laws relating to building
construction, d he y authorize representatives of this county to upproperty for inspection purposes.
C0 1e�i
Date Signature (Applicant or Agent):
v
Page
2
Application
Number .
. . .
. 04-00004828 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
.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
89.52 Plan Check Fee
22.38
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per.
Extension
BASE FEE
15.00
1821.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
63.74
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
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
88, PLAN 5505A/83
SF GARAGE
Page 3
Application Number
. . . . .
04-00004828 Date
6/14/04
-----------------------------------------------------------------------------
Special Notes and
Comments
EXT. 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
55.45
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
16.06
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-------------
Charged
Paid Credited
Due
- ---
Permit Fee Total
----------
1145.52
---------- ---------- ----------
.00 .00
1145.52
Plan Check Total
623.83
.00 .00
623.83
Other Fee Total
2476.51
.00 .00
2476.51
Grand Total
4245.86
.00 .00
4245.86