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06-1155 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: ep, 06-00001155 81835 EAGLE CLAW DR 764-28.0-99.9-119 -300235- DWELLING - SINGLE FAMILY MEDIUM HIGH DENSITY RES 200727 c&i1t 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: SHEA LA QUINTA C/O JEFF MCQUEEN DETACHED D 8800 N GAINEY CENTER 350 SCOTTSDALE, AZ 85258 Arch' ect.orEngineer: )VAR 4.9Ca ontractor: a/ THEA HOMES, INC... 81260 AVENUE 62 LA QUINTA, CA 92253 (760)777'-6005 Lic. No.: 612285 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/23/06 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby.affirm under penalty oPperjury that 1 am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section ) of ivision 3 of the Busit and Profession Is Cade, and my License is in full force and effect. I have and will maintain a aertificeterof consent to self-insure:for workers' compensation, as;provided a cense No.:. 672285 _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is ontr. issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of,the Labor Code; for the performance ofthe work forwhi this permit is issued: My workers' compensation OWNER -BUILDER DECLARATION insurance. carrier and.policy number.are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Cartier :AMERICAN HOME Policy Number 1247619 following reason (Sec. 7031.5,. Business and,Professions Code: Any city or county that requires a q permit to ' _ I certifythat, in the perfor ante of the work for ichahis permit is issued, I shell not employ any construct, after, 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 Isdlcensed pursuant to the.provisions offheContrector's State perfon in any manse : asme sub' to the, workers' compensation laws of California 1 and 9grs;!e that, if I shou a sub a workers`compensation provisions;of Section 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 applicamto•a civil penalty of not more than five hundred dollars: ($500).: as owner of1he property, or my employeeswith 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 applyto an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees; providecLthat the improvements are not intendedor offered for sale. If, however; the building or improvement is sol&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.). 1 _ 1 I,: as.owner,af'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 whocontracts forthe..projects with acontractor(s) licensed pursuant:to the Contractors' State License.Law.). 1 1 I,am exempt under Sec. B.&P.C. for this reason Date: Owner: 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: 14 Date: WARNING: FAILURETO SECURE,WORKERS' COMPENSATION COVERAGE.IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL, PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS.(s100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby'made to the Director of Building and Safety for a permit subject to the conditions and restrictionsset 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 resultofthis application, the owner, arta the applicant, each agrees to, and shall defend, indemnify and hold harmless, the City of La Quints, 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 suc emit, or cessati of work for 180 days will subject permit to cancellation. I certi that I h ve read this application and state that the a ormation i c eat. I agree to comply with all a county r ;ponolhe nd state laws relating to bull ' const ion, re horize representatives o t _ _ t e er ovo-mentioned props -f 'spaSre (Applicant or Agent): Application Number . . . . . 06-00001155 .Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 993.00 Plan Check Fee'. 645.45 Issue Date . . . . Valuation 200727 Expiration Date 9/18/06 Qty Unit Charge Per Extension BASE FEE 639.50 1.01.00 3.5000 THOU BLDG 100,001-500;000 353.50 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 5-9.00 Plan Check Fee 14.75 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 9/18/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.0.0 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/10.0K BTU 9.00 3.00 6.500.0 EA MECH VENT FAN 19.50 1.00 ---------------------------------------------------------------------------- 6.5000 EA MECH EXHAUST HOOD 6.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . . Permit Fee 106.43 Plan Check Fee 26.61 Issue Date Valuation . . . . 0 Expiration Date 9/18/06 Qty Unit Charge Per Extension BASE FEE 15.00 2339.00 .0350 ELEC NEW RES = 1 OR 2 FAMILY 81.87 478.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.56 Permit PLUMBING Additional desc . Permit Fee. 141.00 Issue Date Expiration Date 9/18/06 Plan Check Fee . . Valuation . . . . Qty Unit Charge Per BASE .FEE 12.00 6.0000 EA PLB FIXTURE 1•.00 15.0000 EA PLB BUILDING SEWER LQPE DW 35.25 0 Extension 15.00 72.00 15.00 Application Number . . . . . 06-000.0.1155 Permit . . . . . . PLUMBING Qty Unit Charge Per BASE FEE 15.00 Extension 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 Issue Date . . . . Expiration Date . . 9/18/06 Plan Check Fee . . .00 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 --------------------- ------------------------- Special Notes and Comments ------- SFD - Plan 55150 Lot 119 w./Box Bay MBR ('26sfY & Exercise RM .(191sf). Permit does not include block wall, pool or driveway approach. 2001 CBC, CMC, CPC, 2004 CEC, 2005 ENERGY CODES -----------------.------------------------ Other Fees . . . . . . ---- -. ART IN PUBLIC PLACES -RES 20.00 DIF COMMUNITY CENTERS -.RES 74.00 DIF CIVIC CENTER - RES 480.00 ENERGY REVIEW FEE 64.55 DIF FIRE PROTECTION -RES 140.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES - RES 355.00 DIF PARK MAINT FAC - RES 22.00 bIF PARKS/REC - RES 8.92.00 STRONG MOTION (SMI) -.RES 20.07 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1666.0.0 Fee summary Charged Paid Credited Due Permit Fee Total 1314.43 .00 .00 1314.43 Plan Check Total 722.06 .00. .00 722.06 Other Fee Total 3800.62 .00 .00 3800,.62 Grand Total 5831.11 .00 .00 5837.11 LRS