08-0020 (SFD)P.a. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
081-00000020
81401 GOLDEN POPPY WY
764-280-999-110 -300236-
DWELLING - SINGLE FAMILY
MEDIUM HIGH DENSITY RES
127702
Tiht 4 - XP Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHEA LA QUINTA
C/O JEFF MCQUEEN
DETACHED 8800 N GAINEY CENTER
SCOTTSDALE, AZ 85258
/rD
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
I hereby ffirm and, penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 001 of D isiye of the Bus(s a �,aCode, License is in full force and effect.
Licen e I s72285
ate: mractor:
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):
(_) 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 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:
LQPER111T
Contractor:
SHEA HOMES, INC.
81260 AVENUE 62
LA QUINTA, CA 92253
(760)777-6005
Lic. No.: 672285
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/04/08
JAN 231008 19)
OFLq
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.
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
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
pers n in any manner so as to become sub* ct to the workers' compensation laws of California,
$N
and ree that, if I should become subject the workers' compensation provisions of Section
37 f e Labor Code, I ally orth ntply with those provisions.
Date: plicant:
WARNING: FAILURE TO SECURE WORKR COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL P ALTIES 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
P1
it
to cancellation.
I�a*e:
h ve read this application and state that the above informatio is correct. I agree to comply with all
y gkdinances and state laws relating to building construction d hereby authorize representatives
ter upon the above-mentioned property f sp ti n r ses.
Signature (Applicant or Agentl:
M
LQPERNIIT r M
i
Application Number•
08-00000020
• i ------ Structure Information
SFD 4210A W/BOX BAY,- EXT GAR,
EXT PAT -----
Construction Type . .
. . . TYPE V *- NON RATED
Occupancy Type . .
. . . DWELLG/LODGING/CONG <=10
Other struct info . .
. . . CODE EDITION
2001
## BEDROOMS
3.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG
-557.00
PATIO SQ FTG
391.00
NUMBER OF UNITS
1.00
----------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
1381.00
Permit . . . . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
737.50 Plan.Check Fee
119.85
Issue Date
Valuation
127702
Expiration Date .
7/02/08
Qty Unit Charge
Per
Extension
BASE FEE
639.50
28.00 3:5000
-----------------------------------------------------------------------------
THOU BLDG 100,001-500,000
98.00
Permit . . .
MECHANICAL
j Additional desc .
Permit Fee . . . .
65.50 Plan Check Fee
4.10
Issue Date . . . .
Valuation
0
Expiration Date
7/02/08
Qty Unit Charge
Per
Extension
-
BASE FEE
15.00
1.00 9.0000
EA MECH FURNACE <=100K
9.00
1.00 9.0000
EA MECH B/C <=3HP/100K BTU
9.00
4.00 6.5000
EA MECH VENT FAN
26.00-
6.001.00
1.006.5000
----------------------------------------------------------------------------
EA MECH EXHAUST HOOD
6.50
Permit . . .
ELEC-NEW RESIDENTIAL
- Additional desc .
Permit Fee . . . .
74.48 Plan Check Fee
.4.66
Issue Date . . . .
Valuation
0
Expiration Date
7/02/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
-1381.00 .0350
ELEC.NEW RES - 1 OR 2 FAMILY
48.34
557.00 .0200
ELEC GARAGE OR NON-RESIDENTIAL
11.14
M
LQPERNIIT r M
i
Application Number . . . 08-00000020
Permit . . . PLUMBING
Additional desc . .
Permit Fee . . . . 122.25
Issue Date . . . .
Expiration Date . . 7/02/08
Plan Check Fee . . 7.64
Valuation . . 0
Qty Unit
Charge Per
Extension
BASE FEE
15.00
9.00
6.0000 EA PLB FIXTURE
54.00
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
7/02/08
Qty Unit
Charge Per
Extension
BASE FEE
15.00
----------------------------
Special Notes
------------------------------------------------
and Comments
SFD - LOT 110,
Plan 4210A,(1381
sft)
w�box bay (26
sqft), ext. garage (83 .
sqft) & patio
ext. (177 sqft) Permit
does not include block wall, pool or
driveway approach. 75% REDUCTION TO PLAN
CHECK FEES DUE
TO MULTIPLE 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
11.99
DIF FIRE PROTECTION -RES
140.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
355.00
DIF PARK MAINT FAC - RES
22.00
LQPERAIIT
iApplication Number . . . . 08-00000020
----------------------------------------------------------------------------
Other Fees . . . . . . . . . DIF PARKS/REC - RES 892.00
STRONG MOTION (SMI) - RES 12.77
DI•F STREET MAINT FAC -RES 67.00
DIF TRANSPORTATION - RES 1930.00
Fee summary Charged Paid 'Credited Due
---------------------------------------------------------
Permit Fee Total 1014.73 .00 .00 1014.73'
Plan Check Total 136.25 .00 .00 136.25
` Other Fee Total 4499.76 .00 .00 4499.76
Grand Total 5650.74 .00 .00 5650.74-
a
0
LQPERAIIT