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06-2276 (SFD)jr P.O. BOX 1504 , 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Tity/ 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 06-00002276 ---� Owner: Property Address: 81975—GOLDEN STAR WY SHEA LA QUINTA APN: 764-280-999-95 -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: 220693 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/06/06 Contractor: N "'I Applicant: Architect or Engineer: SHEA HOMES, INC. JUN 12 2006 U 81260 AVENUE 62 �C� V✓ 1'� LA QUINTA CA 92253 CITY ()F AQIJ �� (760)777-6005 INAN�� d�pyt -J - _J Lic. No.: 672285 CIO -----------------------------------------------------------------------L------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: - Section 7000) of Division 3 of the Bus' and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Ias�B License No.: 672285 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is I _ �/ issued. at ontractor. `�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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that 1 am exempt from the Contractor's State License Law for the Carrier AMERICAN HOME Policy Number 1247619 following reason (Sec. 703.1.5, Business and Professions Code: Any city or county that requires a permit to_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I houId become subject to a workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 700 of the Lab sh fort,th co ly with thoseprovisions. 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).: Dat App' (_ 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 WARNING: FAILURf TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). (_) - 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.I. Lender's Name: Lender's Address: oil LQPERMIT 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 th the above information is correct. I agree to comply with all city and county ordinances and state laws relating to ildi construction, ad he y authorize representatives of is .ount to enter upo he above-mentioned f r in ectio pur o� ate:_ 6 ignature (Applicant or A 1 Application Number . . . . . 06-00002276 Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 1063.00 Plan Check Fee 690.95 Issue Date . . . . Valuation . . . . 220693 Expiration Date-. . 12/03/06 Qty Unit Charge Per Extension BASE FEE 639.50 121.00 ----------------------------=-------=--------------------------------------- 3.5000 THOU BLDG 100,001-500,000 423.50 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 83.50 Plan Check Fee 20.88 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/03/06 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 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 . . . . 115.82 Plan Check Fee 28.96 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/03/06 Qty Unit Charge Per Extension BASE FEE 15.00 2529.00 0350 ELEC NEW RES - 1 OR 2 FAMILY 88.52 615.00 -----=-----------------------------------------=---------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 12.30 LQPERMIT Permit . . . PLUMBING Additional desc . . Permit Fee . . . . 151.50 Issue Date . . . . Expiration Date . . 12/03/06 Qty" Unit Charge Per Plan Check Fee . . 37.88 Valuation . . . . 0 BASE FEE 14.00 6.0000 EA PLB FIXTURE 1.00 15.0000 EA PLB BUILDING SEWER Extension ..15.00 84.00 15.00 Application Number . . . . . 06-00002276 Permit . . . . . . PLUMBING Qty Unit Charge Per 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 6.00 3.0000 ------------------------------------------ EA PLB GAS PIPE 1-4 OUTLETS ------------------------- 18.00 --------- Permit . . . GRADING PERMIT Additional desc . . Permit Fee 15.00 Plan Check Fee .00 Issue Date . . . . Valuation 0 Expiration Date 12/03/06 Qty Unit Charge Per Extension BASE FEE 15:00 ---------------------------------------------------------------------------- Other Fees . . . . . . . ART IN PUBLIC PLACES -RES 51.73 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 480.00 ENERGY REVIEW FEE 69.10 DIF FIRE PROTECTION -RES 140.00 DIF LIBRARIES - RES 355.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION (SMI) - RES 22.06 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1666.00 Fee summary Charged --------------------------- Paid Credited Due Permit Fee Total ------------------------------ 1428.82 .00 .00' 1428.82 Plan Check Total 778.67 .00 .00 778.67 Other Fee Total 3838.89 .00 .00 3838.89 Grand Total 6046.38 .00 .00 6046.38 LQPERMIT