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08-0026 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 08-00000026 ; 81413—GOLDEN POPPY WY 764-280-999-112 -300236- DWELLING - SINGLE-FAMILY MEDIUM HIGH DENSITY RES 225179 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: SHEA LA QUINTA C/O JEFF MCQUEEN DETACHED 8800 N GAINEY CENTER 350r SCOTTSDALE, AZ 85258 ��►U► Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION I hereby affirm under enalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 70 0) of Divi 'on 3 of the Business, nd Professionals Code, and my License is in full force and effect. License] I - Bcense No.: 672285 te: ractor: 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, 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: LQPER111IT 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: JAN 2 3 2000 1/03/08 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 issued. 111 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 erson in any manner so as to be a subject to the workers' compensation laws of California, nd ag ee that, if 1 should become bje�gtt to the workers' compensation provisions of Section oI the Labor Code, I shall f withl comply with those provisions. ate: icant: v WARNING: FAILURE TO SECURE WO K S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINA ENALTIES 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 per it to cancellation. I certify t at I ha a read this ap lication and state that the above infor tion is correct. I agree to comply with all city tyQ o in es state laws relating to building construc n, and hereby authorize representatives of t co �d�/�/ t r the above-mentioneb proper for spec ' urposes. ate: ignature (Applicant or Agent): I• Application Number . . . . . 08-00000026 Permit . . . . . BUILDING PERMIT Additional desc Permit Fee . . .1080.50 Plan Check Fee 175.58 Issue Date . . . . Valuation 225179 Expiration Date 7/01/08 Qty Unit Charge Per Extension BASE FEE 639.50 126.00 ------------------------------- 3.5000 THOU BLDG --------------------------------------------- 100,001-500,000 441.00 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 74.50 Plan Check Fee 4.66 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 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 4.00 6.5000 EA MECH VENT FAN 26.00 1.00 ---------------------------------------------------------------------------- 6.5000 EA MECH EXHAUST HOOD 6.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee 117.85 Plan Check Fee 7.37 Issue Date . . . . Valuation . . . . 0 Expiration Date 7/01/08 Qty Unit Charge Per Extension BASE FEE 15.00, 2599.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 90.97 594.00 ---------------------------------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 11.88 Permit . . . PLUMBING Additional desc . Permit Fee 160.50 Plan Check Fee 10.03 Issue Date Valuation . . . . 0 Expiration Date 7/01/08. Qty Unit Charge Per Extension BASE FEE 15.00 15.00 6.0000 EA PLB FIXTURE 90.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 LQPERn1IT Application Number . . ... 08-00000026 Permit . . . . . . PLUMBING Qty Unit Charge Per BASE FEE 15.00 Extension 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 8.00 .7500 EA PLB GAS PIPE >=5 6.00 1.00 -------------------------------- 15.0000 EA PLB -------------------------------------------- GAS METER 15.00 Permit . . GRADING PERMIT Additional desc . ENERGY REVIEW FEE 17.56 Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . DIF PARK MAINT FAC - RES Valuation . . . . 0 Expiration Date . . 7/01/08 Qty Unit Charge Per Extension BASE FEE 15.00 --------------------------------7------------------------------------------- Special Notes and Comments SFD - LOT 112, PLAN 5500A, 2599 SF. (149 SF. EXERCISE ROOM, 63 SF,BB, 83 SF. GARAGE.EXTENSION)'. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS 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 62.94 DIF COMMUNITY CENTERS -RES 74:00 DIF CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 17.56 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 22.51 DIF STREET MAINT FAC -RES_ 67.00 DIF TRANSPORTATION - RES 1930.00 Fee summary ----------------- Charged Paid Credited. ---------------------------------------- Due Permit Fee Total 1448.35 .00 ..00 1448.35 Plan Check Total 197.64 .00 .00 197.64 Other Fee Total 4578.01 .00 .00 4578.01 LQPERA11T LQPERA1IT Application Number . . . . . 08-00000026 Grand Total 6224.00 .00 .00 6224.00