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10-1119 (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: 10-00001119 81151 LAGUNA CT 764-280-004-15 -35996 - DWELLING - SINGLE FAMILY LOW DENSITY RESIDENTIAL 155988 Tity/ 4 - 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: SHEA LA QUINTA 60800 TRILOGY.PARKWAY DETACHED LA QUINTA, CA 92253 Architect or Engineer: Contractor: SHEA HOMES, INC. VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 D° 60800 TRILOGY PAxtcw nCr Q LA QUINTA, CA 92253 (760) 777-6032 CITY' OF LA QUINTA �^ Lic. No.: 672285 UEPL ------------------------------------------------------------------------------------------------- Date: 10/28/10 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0) of Division 3 of the Busines and Profession) Is Code, and my License is in full force and effect. Lice J a/s icense No.: 672285 ateV`' t ntractor: 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, 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: Q Lender's Address: r ` 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. 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 LIBERTY MUTUAL Policy Number WA-266DO66115030 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 subject to the workers' compensation provisions of Section / k ft a Labor Code, I shall forthwith comply with those provisions. Date: pplicant: WARNING: FAIO SECURE WORK S' COMPENSATION 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 certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives o Ahis c unt to ter upo 'e above-mentioned property for inspection purposes. Date: gnature (Applicant or Agent): Application.Number . . . . . 10-00001119 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 835.50 Plan Check Fee 543.08 Issue Date . . . . Valuation . . . . 155988 Expiration Date 4/25/11 Qty Unit Charge Per Extension BASE FEE 639.50 56.00 ---------------------------------------------------------------------------- 3.5000 THOU BLDG 100,001-500,000 196.00 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 79.50 Plan Check Fee 19.88 Issue Date . . . . Valuation . . . . 0 Expiration Date 4/25/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 5.00 6.5000 EA MECH VENT FAN 32.50 1.00 ---------------------------------------------------------------------------- 6.5000 EA MECH EXHAUST HOOD 6.50 Permit ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 86.94 Plan Check Fee 21.73 Issue Date• . . . . Valuation 0 Expiration Date 4/25/11, Qty Unit Charge Per Extension BASE FEE 15.00 1749.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 61.22 536.00 ---------------------------------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 10.72 Permit . . . PLUMBING Additional desc . . Permit Fee 123.75 Plan Check Fee 30.94 Issue Date . . . Valuation 0 Expiration Date 4/25/11 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 LQPERMIT -3, Application Number . . . . . 10-00001119 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 7.00 .7500 EA PLB GAS PIPE >=5 5.25 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 4/25/11 Qty Unit Charge Per. Extension - BASE FEE 15.00 --------------------------------------------------------------------------- Special Notes and Comments SFD LOT 15, PLAN 4515C, 1749 SF. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2007/2008 CODES. 2010 PLAN UPDATE. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 7.00 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 54.31 DIF FIRE PROTECTION -RES 140.00 . GRADING PLAN CHECK FEE .00_ DIF LIBRARIES - RES 355.00 MULTI -SPECIES (MSHCP) FEE 1284.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION_(SMI) - RES. 15.60 .DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1930.00 Fee summary Charged - - - - Paid Credited --------- - - - - - - - - - - - - - - - - - - - - - - - - ---------- Due ----------------- Permit Permit Fee Total - - - 1140.69 .00 .00 1140.69 Plan Check Total 615.63 .00 .00 615.63 . Other Fee Total 5835.91 .00 .00 5835.91 Grand Total 7592.23 .00 .00 .7592.23 LQPERMIT