08-0021 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/03/08
Application Number: 08-00000021 Owner:
Property Address: 81394 GOLDEN POPPY WY SHEA LA QUINTA
APN: 764-280-999-94 -300236- C/O JEFF MCQUEEN
Application description: DWELLING - SINGLE FAMILY DETACHED 8800 N GAINEY CENTER 350
Property Zoning: MEDIUM HIGH DENSITY RES SCOTTSDALE, AZ 85258
Application valuation: 170639
Contractor: "JAN
'Applicant: Architect or Engineer: SHEA HOMES,.INC.23
81260 AVENUE 62
LA QUINTA, CA 92253
(760) 777-6005 CITY OF LA QUINTA
LiC. No.: 672285 FINANCE DEPT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm and r penalty of perjury that" am license u der provisions of Chapter 9 (commencing with
Sectio 000! of D vision 3 of the Busis nd Professi ns Code, and my License is in full force and effect.
Licen I - B. ?IIense No.: 672285
te. tractor: .
OWNER -BUILDER DECLARATION
I 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).:
(_ 1 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 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.). '
(_ 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.).
I ) 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
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
'/► issued.
C I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
T� 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
pe on in any manner so as to become subject to the workers' compensation laws of California,
a gree that, if I should becomes ect to the workers' compensation provisions of Section
I the L bIWRS'
shall for ith comply with those provisions.
ate: plicant:
WARNING: FAILURE TO SECURCOMPENSATION 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.
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 cernnA���ttttify at I hav read this application and state that the above information is correct. I agree to comply with all
cit�nd county or inances and state laws relating to building constr tion, and hereby authorize representatives
of tis o �er upon the above-mentioned pr rty f r in a purposes.
e: re the,
or Agent).
Application Number . . . . . 08-00000021
Permit . . .
Additional desc .
Permit Fee . .
Issue Date
Expiration Date .
Qty Unit Charge
1943.00 ..0350
576.00 .0200
LOPER.MIT
ELEC-NEW RESIDENTIAL
94.53 Plan Check Fee .
Valuation . . .
7/01/08
Per
BASE FEE
ELEC NEW RES - 1 OR 2 FAMILY
ELEC GARAGE OR NON-RESIDENTIAL
5.91
0
Extension
15.00
68.01
11.52
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
576.00
PATIO SQ FTG
177.00
NUMBER OF UNITS
1.00
'
----------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
1943.00
Permit . . . . .
BUILDING PERMIT
Additional desc .
Permit,Fee . . . .
888.00 Plan Check Fee
144.30
Issue Date . . . .
Valuation . .
. . 170639
Expiration Date
7/01/08
Qty Unit Charge
Per
Extension
BASE FEE
639.50
71.00 3.5000
----------------------------------------------------------------------------
THOU BLDG 100,001-500,000
248:50
Permit . . .
MECHANICAL
Additional desc . .
Permit Fee
70.50 Plan Check Fee
4.41
Issue Date . . . .
Valuation . .
. . 0
Expiration Date
7/01/08
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
2.00 6.5000
EA MECH VENT FAN
13.00
1.00 6.5000
----------------------------------------------------------------------------
EA MECH EXHAUST HOOD
6.50
Permit . . .
Additional desc .
Permit Fee . .
Issue Date
Expiration Date .
Qty Unit Charge
1943.00 ..0350
576.00 .0200
LOPER.MIT
ELEC-NEW RESIDENTIAL
94.53 Plan Check Fee .
Valuation . . .
7/01/08
Per
BASE FEE
ELEC NEW RES - 1 OR 2 FAMILY
ELEC GARAGE OR NON-RESIDENTIAL
5.91
0
Extension
15.00
68.01
11.52
Application Number .
. . . . 08-00000021
--------------------------------
Permit . . .
--------------------------------------------
PLUMBING
Additional desc .
Permit Fee . . . .
152.25 Plan Check Fee
8.95
Issue Date . . . .
Valuation . . . .
0
Expiration Date
7/01/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
14.00 6.0000
EA PLB FIXTURE
84.00
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•
Expiration Date
7/01/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
SFD - LOT 94, PLAN 4520B,
1943 SF/ 255
SF CASITA,BOX BAY @ MBR -26 SF 4- GARAGE
EXT - 88 SF.PERMIT DOES
NOT INCLUDE
BLOCK WALLS,POOL, SPA
OR DRIVEWAY
APPROACH. 75% REDUCTION
TO PLAN CHECK
FEE DUE TO MULTLIPLE
ISSUANCE OF SAME
PLAN TYPE. 2001 CBC,
CMC, CPC, 2004 CEC,
2005 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
14.43
DIF FIRE PROTECTION -RES.
140.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
355.00
-
DIF PARK MAINT FAC - RES
22.00
DIF PARKS/REC -RES
892.00
STRONG MOTION (SMI) - RES
17.06
LQPERAIIT L
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Application Number•
. . . . .
08700000021
---------------------------
Other Fees . . . .
------------------------------------------------
. . . . .
DIF STREET MAINT FAC -RES.
67.00
DIF TRANSPORTATION - RES
1930.00
Fee summary
-----------------
Charged
----------
Paid Credited
--------------------
Due-
Permit Fee Total
1220.28
----------
.00 .00
1220.28
Plan Check Total
163.57
.00 .00
163.57
Other Fee Total
4506.49
.00 .00
4506.49
Grand Total
5890.34
.00 .00'
5890.34
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