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10-1117 (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: c&i4t 4 4 " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 10-00001117 • 81172 LAGUNA CT 764-280-004-9 -35996 - DWELLING - SINGLE FAMILY DETACHED LOW DENSITY RESIDENTIAL 159946 Architect or Engineer: pip LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with - Section 7000) of Division 3 of the Business jnd Professionals Code, and my License is in full force and effect. Lice Cla : icense No.: 672285 Date: DAontractor: 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 13500).:. (_ 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.). (_ 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.). Lender's Name: Lender's Address: PIP LQPERMIT Owner: SHEA LA QUINTA 60800 TRILOGY PAR LA QUINTA, CA 922 Contractor: SHEA HOMES, INC. 60800 TRILOGY PARK Y LA QUINTA, CA 92253 (760)777-6032 Lic. No.: 672285 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/28/10 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 WA266D066115030 I 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 Date3700 of t e s II Labor Codforthwith c ply with those provisions. pplicant- WARNING: FAILURE TO SECURE WORK ' 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 co my rdma/earndtate laws relating to building construction, and hereby authorize representatives of th' y to enterabove-mentioned property for inspection purposes. Dae: �pplicant or Agent): Application Number . . . . . 10-00001117 Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 849.50 Plan Check Fee 552.18 Issue Date . . . . Valuation . . . . 159946 Expiration Date 4/25/11 Qty Unit Charge Per Extension BASE FEE 639.50 60.00 ---------------------------------------------------------------------------- 3.5000 THOU BLDG 100,001-500,000 210.00 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 89.84 Plan Check Fee 22.46 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 4/25/11 Qty Unit Charge Per Extension BASE FEE 15.00 1773.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 62.06 639.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 12'.78' Permit PLUMBING Additional desc . Permit Fee 123.75 Issue Date . . . . Expiration. Date . . 4/25/11 Qty Unit Charge Per Plan Check Fee . . Valuation . . . . BASE FEE• 9.00 6.0000 EA PLB FIXTURE 1.00 15.0000 EA PLB BUILDING SEWER LQPERMIT 30.94 0 Extension 15.00 54.00 15.00 Application Number Permit . . . . . . . . 10-00001117 PLUMBING Qty Unit Charge Per BASE FEE 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 Issue Date . . . . Expiration Date . . 4/25/11 Plan Check Fee . . .00 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 --------------------- ------------------------------------------------------ Special Notes and Comments SFD LOT 9, PLAN 4515C, 1773 SF. INCLUDES 24 SF. BAY @ NOOK & 103 SF. GARAGE EXTENSION. 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 55.22 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_ 15.99 DIF STREET MAINT FAC -RES 67.00, DIF TRANSPORTATION - RES 1930.00 Fee summary Charged Permit Fee Total 1157.59 Plan Check Total 625.46 Other Fee Total 5837.21 Grand Total 7620.26 LQPERMIT Paid Credited Due .00 .00 1157.59 .00 .00 625.46 .00 .00 5837.21 .00 .00 7620.26