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04-4568 (SFD)4 . u�l�ticv BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 18-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 a BUILDING PERMIT \,.Ap-p- i cation Number0 4=-0-0-0-0 4 5-6-8 Date 5/25/04 Property Address . . . . 60494 WHITE SAGE DR APN: 764-270-999-112 -300231- Application description . . . DWELLING - SI=NGLE FAMILY DETACHED Property Zoning . . . . . . . MEDIUM HIGH DENSITY RES Application valuation . . . . 149793 Owner SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER 350 SCOTTSDALE AZ 85258 Contractor SHEA HOMES, INC. 81260 AVENUE 62 LA QUIRTA 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 RA' -ED 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 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Applicant: Applicant's Mailing Address: BUILDING & SAFETY DEPARTMENT itect or VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: G — / - OZA No. Ylcf- 2—�, 40 BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm undenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my Licen full force and effect. License Class License No. OWNER -BUILDER DECLARATION 1 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 fora 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 Profde State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects w : The Contractors' ith f coessions lons o Code 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. ��I have and will maintain w ers' compens tion insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is mss rkers' c gnsa� nsurance cam p4na golifiSU ref ' '� Policy Number _ Il p a _ I 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 th , '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. I herebyaffirm under y p 4 ry CONSTRUCTION LENDING AGENCY penalty of a 'u 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 IMPORTANTAPPLICANT ACKNOWLEDGEMENT Appliption 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 and void if work is not commenced within 180 day& 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 inf rmation is co agree to comply with all city and county ordinances and state laws rotating to building construction, and hereby authorize representatives of this county tUn& upon a ntioned property for inspection purposes. ate 1 Signature (Applicant or Agent): Application Number . . . . . 04-00004568 Page 2 Date 5/25/04 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 Plan 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 NCN-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 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 Page 3 Application Number -------- : . . . . . 04-00004568 Date 5/25/04 Notes and Comments SFD - LOT 112 PLAN 4520A,1685 S.F.,23 S.F.BAY @ MBR PERMIT DOES NOT INCLUDE BLOCK WALL, 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 52.94 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 MA=NT 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