04-4873 (SFD). (^
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BUILDING 8L SAFETY'DE`PARTM-FINT N
P.O. Box 1504. (760),777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA; CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number . . . . . -04-00004873 Date 6/14/04
Property Address . . . . . . 60375 WHITE SAGE DR
APN: 764-270-999-81 -300231-
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning MEDIUM HIGH DENSITY RES
Application valuation .148309
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: N'I'L 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 CBC
FIRE SPRINKLERS
NO
GARAGE SQ FTG
488.00
PATIO SQ FTG
177.00
NUMBER OF UNITS
1.00
FIRST FLOOR SQ FTG,
1688.00
--------------------------
Permit
-----------------------------------
BUILDING PERMIT
---------------
Additional desc .
Permit Fee . . . .
811.00 Plan Check Fee
527.15
Issue Date.
Valuation
148309
Qty Unit Charge
Per
Extension
BASE FEE
639.50
49.00 3.5000
THOU. BLDG 100,001-500,000
171.50
Permit . . .
MECHANICAL
Additional desc
Permit Fee
64.00 Plan Check Fee
16.00
Issue Date . . . .
Valuation . . .
. 0
Qty Unit Charge Per Extension
P.O. Box 1504
u�l'�tt6v
78-495 CALLE TAMPICO 4
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760)"777-7153
Application Number: 4S7J� I Date:
Applicant:
Applicant's Mailing Address:
Architect or Engineer's
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirmand f enalty of perjury that I am licensed under provisio of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Code, and Lic� in full force and effect. ���
�icense Class
/License No.y p J
r
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 I am exempt under Sec. BA P.C. for this reason
Date
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.
I v and ill aintain wo rs' compensation insuran as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
�� p%u'ed. ers ensation in nce cam
a re
�er/oS./1. v olicyNumber
_ I certify that, in the performance of the work for which Ihis perms is issued, shall not employ any person In any manner so as to become subject to the workers'
compensation laws of California, and agree that, i hould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
^� forthwith comply with those provisions
Y .
Date cant
/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 If
Lender's Address JA
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.
I certify that I have read this application and state that the above information is correct. agree to comply with all city and county ordinances and state laws relating to building
construction, nd her7by authorize representatives of this county to enter thea ve mentioned property for inspection purposes.
—Date G Signature (Applicant or Agent):
�w
Page
2
Application Number
.
. . .
. 04-00004873
Date
6/14/04
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
2.00
9.0000
EA
MECH
FURNACE <=100K
18.00
2.00
9.0000
EA
MECH
B/C <=3HP/100K BTU
18.00
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 .
. . .
83.84
Plan Check Fee
20.96
Issue Date .
. . .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
1688.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
59.08
488.00
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
9.76
----------------------------------------------------------------------------
Permit . .
. . .
PLUMBING
Additional desc
. .
Permit Fee .
. . .
128.25
Plan Check =ee ..
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
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
. .
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 - LOT81, PLAN
4520C/BOX
BAY
Q MBR
Fee summary Charged
Permit Fee Total 1102.09
Plan Check Total 596.17
Other Fee Total 2472.55
Grand Total 4170.81
Paid Credited Due
---------- ---------- ----------
.00 D0 1102.09
.00 .D0 596.17
.00 D0 2472.55
.00 D0 4170.81
Page
3
Application Number . . . .
. 04-00004873 Date
6/14/04
----------------------------------------------------------------------------
Special Notes and Comments
-26 SF. 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
52.72
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
14.83
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary Charged
Permit Fee Total 1102.09
Plan Check Total 596.17
Other Fee Total 2472.55
Grand Total 4170.81
Paid Credited Due
---------- ---------- ----------
.00 D0 1102.09
.00 .D0 596.17
.00 D0 2472.55
.00 D0 4170.81