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08-0334 (SFD)�I P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA;_CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter.9 (commencing with Section 7000) of Division 3 of the Business nd Professi nals Code, and my License is in full force and effect. Lice lass: L4 Code No.: 672285 /ate: I L13y actor: OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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).: (_) 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 sate (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 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 sate.). (_ 1 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.). (_ 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: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/22/08 WORKER'S 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 V,,// issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier AMERICAN HOME Policy Number CA 1593364 _ 1 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 that, if I should become 11bject to the workers' compensation provisions of Section ��— 3 00 of the L or Code, I shall for h vith comply with those provisions. at0 e: "�licant: WARNING: FAILURE TO SECURE W RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000). 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 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. I agree to comply with all �De': nd cc my ordinances and state laws relating to building constr tion, and hereby authorize representatives y to ent ' on the above-mentioned property for inspe ion purposes. il§yture (Applicant or Agent): BUILDING PERMIT Application Number: 0-870_0-0-0__Q3314;7 Owner: Property Address: 61620 FIRE -BARREL DR SHEA LA QUINTA APN: 764-280-999-2 -300235- C/O JEFF MCQUEEN Application description: DWELLING - SINGLE FAMILY DETACHED 8800 N GAINEY CENTER Property Zoning: MEDIUM HIGH DENSITY RES SCOTTSDALE, AZ 85258 Application valuation: 166943 Contractor: Applicant: Architect or Engineer: SHEA HOMES, INC. 81260 AVENUE 62 LA QUINTA,.CA 92253 (760)777-6005 Lic. No.: 672285 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter.9 (commencing with Section 7000) of Division 3 of the Business nd Professi nals Code, and my License is in full force and effect. Lice lass: L4 Code No.: 672285 /ate: I L13y actor: OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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).: (_) 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 sate (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 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 sate.). (_ 1 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.). (_ 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: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/22/08 WORKER'S 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 V,,// issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier AMERICAN HOME Policy Number CA 1593364 _ 1 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 that, if I should become 11bject to the workers' compensation provisions of Section ��— 3 00 of the L or Code, I shall for h vith comply with those provisions. at0 e: "�licant: WARNING: FAILURE TO SECURE W RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000). 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 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. I agree to comply with all �De': nd cc my ordinances and state laws relating to building constr tion, and hereby authorize representatives y to ent ' on the above-mentioned property for inspe ion purposes. il§yture (Applicant or Agent): Application Number . . . . . 08-.00000334 Structure Information Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG <=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 537.00 NUMBER OF UNITS 1.00 ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 1847.00 Permit . . . . . . BUILDING PERMIT Additional desc . Permit Fee . . . .. 856.50 Plan Check Fee 556.73 Issue Date Valuation . . . . 161587 Expiration Date 8/20/08 Qty Unit Charge Per Extension BASE FEE 639.50 62.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 217.00 Permit . . .. MECHANICAL Additional desc . Permit Fee . . . . 86.50 Plan Check Fee 21.63 Issue Date Valuation . . . . 0 Expiration Date 8/20/08 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 16.500.0 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 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 . . . . 81.19 Plan Check Fee 3.76 Issue Date . . . . Valuation . . . . 0 Expiration Date 8/20/08 Qty Unit Charge Per Extension BASE FEE 15..00 LQPER\IIT Application Number . . . . . 08-00000334 Extension Permit . . . . . . ELEC-NEW RESIDENTIAL Qty • Unit Charge Per Extension 1847.00 .0300 ELEC NEW RES - MULTI FAMILY 55.41 539.00 ---------------------------------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 10.7.8 Permit . . . . . PLUMBING Additional.desc ... ENERGY CODES Permit.Fee . . . 120.00 Plan Check Fee 16.50 Issue Date ART IN PUBLIC PLACES -RES Valuation . . . . 0 Expiration Date 8/20/08 DIF CIVIC CENTER - RES Qty Unit Charge Per Extension 55.67 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 6.00 .7500 EA PLB GAS PIPE >=5 4.50 1.00 -----------------------------"----------------------------------------------- 15.0000 EA PLB GAS METER 15.00 Permit . . . Additional desc . Permit Fee . . . . Issue Date . . . . Expiration Date.. . GRADING PERMIT 15.00 8/20/08 Plan Check Fee . .00 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 Special Notes"and.Comments SFD - LOT 2, PLAN 5505A, 1847 sf 26 SF BOX BAY @ MBR, 83 SF. GAR." EXT.,315 SF PATIO EXT. PERMIT DOES NOT INCLUDE BLOCK WALL, POOL, SPA OR DRIVEWAY APPROACH. 2007 CBC, CMC, CPC, 2004 CEC, 2007 ENERGY CODES --------------------------------------------------------------------- ------ Other Fees . . . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 55.67 DIF FIRE PROTECTION -RES 140.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES -'RES 355.00 LQPERA4IT Application -Number . . . . . 08-00000334 ---------'------------------------------------------------------------------- Other Fees . . . . . . . DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION (SMI) - RES 16:15 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES" 1930.00 Fee summary . Charged Paid Credited Due Permit Fee Total 1159.19 .00 .00 1159.19 Plan Check Total 598.62 .00 .00 598.62 Other Fee Total 4546.82 .0'0 .00 4546.82 Grand Total 6304.63 .00 .00 6304.63 LQPERAI IT