10-1165 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4t!t 4 4t Qu &
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: r_ 10-00 00 1165_ -
Property Address: 81199 LAGUNA CT
APN: 764-280-004-19 -35996 -
Application description: DWELLING - SINGLE FAMILY DETACHED
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 180549
Applicant:
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION .
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Sectio 700 1 o Division 3 of th usi ss and Professions Code, and my License is in full force and effect.
Licens s : L ense No.: 672285
at ontracto .
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 awn 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.).
(_) 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 ISec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
SHEA LA QUINTA
60800 TRILOGY PARKWAY
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/03/10
Contractor:
SHEA HOMES, INC.
60800 TRILOGY PARKWAY
LA QUINTA, CA 92253
(760)777-6032
Lic. No.: 672285
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 WA266DO66115030
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
3700 of the Labor CA I shall forthwith comply with those provisions.
date cant:
WARNING: FAILURE TO SECURE WORKERS' 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 cou ty prdinances and state laws relating to building construction, and hereby authorize representatives
of thi un t enter upon he above-mentioned property for inspection purposes.
ate: ignature (Applicant or Agent):
Application Number . . . . 10-00001165
Permit .
. .
BUILDING PERMIT
Additional desc
.
Permit Fee . .
...
923.00
Plan Check Fee
149.98
Issue Date
Valuation . . . .
180549
Expiration Date
5/02./11
Qty Unit
Charge
Per
Extension
BASE
FEE
639.50
81.00
---------------------------------------------------------------------=------
3.5000
THOU BLDG
100,001-500,000
283.50
Permit .
. .
MECHANICAL
Additional desc..
Permit Fee . .
. .
110.50
Plan Check Fee
6.90
Issue Date . .
. .
Valuation . . . .
0
Expiration Date
5/02/11
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
1.00 16.5000
EA MECH
B/C >3-15HP/>100K-500K3TU
16.50
6.00
6.5000
EA MECH
VENT FAN
39.00
2.00
--------------------------------------------7-------------------------------
6.5000
EA MECH
EXHAUST HOOD
13.00
Permit .
. .
ELEC-NEW RESIDENTIAL
Additional desc
.
Permit Fee
. .
98.76
Plan Check Fee
6.17
Issue Date . .
. .
Valuation . . . .
0
Expiration Date
5/02/11
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
2028.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
70.98
639.00
----------------------------------7-----------------------------------------
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
12.78
Permit .
. .
PLUMBING
Additional desc
. .
Permit Fee . .
. .
147.75
Plan Check Fee
9.23
Issue Date . .
. .
Valuation
0
Expiration Date
5/02/11
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
13.00
6.0000
EA PLB FIXTURE
78.00
LQPERMIT
Application Number 10-00001165
Permit . . . . . . PLUMBING
Qty Unit Charge Per
Extension
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
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 5/02/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
--------------------------------------- ------------------------------------
Special Notes and Comments
SFD - LOT 19, PLAN 4515C,.2028 SF.
INCLUDES 255 SF. DETACHED CASITA,24 SF
.BAY Q NOOK & 103 SF. GARAGE EXTENSION.
PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK
WALLS OR DRIVEWAY APPROACH. 755.1-
5$REDUCTION
REDUCTIONTO PLAN CHECK FEES DUE TO
MULTIPLE ISSUANCE OF SAME PLAN TYPE.
2007/2008 CODES. 2010 PLAN UPDATE.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
8.00
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
15.00
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
18.05
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1930.00
Fee summary Charged Paid Credited
--------------------------------------------------------=
Due
Permit Fee Total 1295.01 .00 .00
1295.01
Plan Check Total 172.28 .00 .00
172.28
LQPERMIT
Application Number 10-00001165
Other Fee Total 5800.05 ..00 .00 5800.05
Grand Total 7267.34 .00 .00 7267.34
LQPERMIT ..
Bin #
City of La Quinta
Building 8T Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: \ ^ (�
Owner's Name:
A. P. Number: "r 35� (p
Address:10 / -
Legal Description:
City, ST, Zip:
Contractor: ���. `ll^ec�>
Telephone:
>3-r:::>•>::<::«:::::::>:>:<;::z::>;>:<:>::>:>.<;::>;.:
<>.<:r:rr:;:>:;:;::>::;::»:<;:;:>r:<>.•;:»:
Address:
�, O �� &�. &L,
Project Description:
City, ST, Zip: 1
Telephon
State Lic. # :
City Lie. #;
Arch., Engr., Designer:
cV
Address:
City, ST, Zip:
Telephone: �`��>`><v> ��>a`:�:::;:<:»:::;.;:;::s<
€.:ti.:;:<.;:.�;•,.:,.,::;:::. •.a:
State Lic. #:<<;;:sy.;::>.:<<:».<.<:«..;;
Name of Contact Person: Q � C)
6A4X�
Construction Ty e: Occupancy:
project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: #Units:
Telephone # of Contact Person-'] �"� �—{p v3Z
Estimated value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Pian Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
PL ` ➢ �-
-NI
t
—�I F -------- BAY '7306
I I
,a I I
PL
5,1 LOT 6 15' I
11 6,509 SF
PL I 4515B "', I
PRODUCT 1 I
n FF=475.37
PE -474.7 I I
_I
I I
. I ✓ �I
I
4' GARAGE 7606_
e.
GF=474.77
f a
� � o
C-4 S
R/W BC S/W
—s — —s— —
LAGUNA COURT
CITY OF LA QUINTA
BUILDING & SAFETY DEPT,
APPROVED"
FOR CONSTRUCTION
DATE!- �' i I BYJ (�
TOP
—j
TOE —
00
N
—
t
—�I F -------- BAY '7306
I I
,a I I
PL
5,1 LOT 6 15' I
11 6,509 SF
PL I 4515B "', I
PRODUCT 1 I
n FF=475.37
PE -474.7 I I
_I
I I
. I ✓ �I
I
4' GARAGE 7606_
e.
GF=474.77
f a
� � o
C-4 S
R/W BC S/W
—s — —s— —
LAGUNA COURT
CITY OF LA QUINTA
BUILDING & SAFETY DEPT,
APPROVED"
FOR CONSTRUCTION
DATE!- �' i I BYJ (�