10-1147 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 10-00001147 ) Owner:
Property Address: 81208'LAGUNA CT 'SHEA LA QUINTA
APN: 764-280-004-6 -35996 - 60800 TRILOGY PARKWAY
Application description: DWELLING - SINGLE FAMILY DETACHED LA QUINTA, CA 92253
Property Zoning:, LOW DENSITY RESIDENTIAL
Application valuation: 159946
So
Applicant:
Architect or Engineer:
Contractor:
SHEA HOMES, INC.
0 TRILOGY PARKWAY
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/02/10
�G^ G 12010
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:
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 as 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 hav read this application and state that the above information is correct. I agree to comply with all
city and cou y o inances and state laws relating to building construction, and hereby authorize representatives
of thi n /to /nte—r upon the above-mentioned grope y for inspection purposes.
te. V L . ure (Applicant or Agent):
6080
LA QUINTA, CA.92253 GtTYAFtA UI TA
FtyH;�a�PT.
(760) 777-6032
(
Lic. No.: 672285
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 70 0) Division 3 of the Business anf Professionals C de, nd 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
Lice- se CI s: Lice e N .: 672285
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
ate .I ontractor:
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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier LIBERTY MUTUAL Policy Number WA-266DO66115030
following reason (Sec. 7031.5, 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
a4d agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
300 of the Labor Code, I shall forthwith comply with those provisions.
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).:
ate A cant:
(_ 1 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
WARNING: FAIL E TO SECURE WOR E S' 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.):
(_ 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:
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 as 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 hav read this application and state that the above information is correct. I agree to comply with all
city and cou y o inances and state laws relating to building construction, and hereby authorize representatives
of thi n /to /nte—r upon the above-mentioned grope y for inspection purposes.
te. V L . ure (Applicant or Agent):
Application Number . . . . . 10-00001147
Permit
. .•.
BUILDING PERMIT
Additional
desc .
Permit Fee
. . . .
849.50
Plan Check Fee
138.04
Issue Date
. . . .
Valuation . . . .
159946
Expiration
Date
5/01/11
,
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
4.'97
Issue Date
Valuation
0
Expiration
Date
5/01/11
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
5.61
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
5/01/11
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
.00
.0300
ELEC
NEW RES - MULTI FAMILY
.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
Plan Check Fee
7.73
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
5/01/11
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
9.00
6.0000
EA PLB FIXTURE
54.00
LQPERMIT
LQPERMIT
Application Number 10-00001147
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 5/01/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
-------------------------------------------------------------7--------------
Special Notes and Comments
SFD LOT 6, PLAN 45158, 1773 SF. -
INCLUDES 24 SF. BAY @ NOOK & 103 SF.
GARAGE EXTENSION.'PERMIT DOES NOT
INCLUDE POOL, SPA, BLOCK WALLS OR
DRIVEWAY APPROACH. 759. REDUCTION TO PLAN
CHECK FEES DUE TO MULTIPLE ISSUANCE OF
SAME PLAN TYPE. 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
13.80
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 Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total 1157.59 .00 .00
1157.59
Plan Check Total 156.35 .00 •.00
156.35
LQPERMIT
N
LQPERMIT
Application Number 10-00001147
Other Fee Total 5795.79 .00 .00 5795.79
Grand Total 7109.73 ..00 .00 7109.73