05-2191 (SFD)P.O. BOX 1504,.:'VOICE (760)'777-7012
781495, CALLE TAMPICO t FAX (760) 777-7011',
LA QUINTA, CALIFORNIA 92253. BUILDING & SAFETY DEPARTMENT. - INSPECTIONS- (760) 777-7153
BUILDING PERMIT
Date: 6/07/05,
Application Number: 05-0000219.1 Owner w
4 Property Address: 8.1232`VICTORIA 'LN SHEA LA 'QUINTA
APN- j 764.-27,0-999-138 -30.0234='<-' ''' C. /O JEFF`MCQUEEN
Application'description: DWELLING SINGLE FAMILY •DETACHED 8800 N. GAINEY CENTER• 350
Property Zoning: MEDIUM HIGH DENSITY RES,. D SCOTTSDALE, AZ 85258 t
Application.valuation: 237751
Contractor: ,-
Applicant: hitect or Engineer: JUN 2 3.2005 SHEA HOMES, INC.
Arc
81260 AVENUE 62
M1/l 1 CITY®F1.AQUI ^LA" QUINTA, CA 9.2253
L/! 1
F1W"CeJ)E ,. (360)777-6005 I
-Lic: No 672285
• LICENSED CONTRACTOR'S DECLARATION _ WORKER'S COMPENSATION DECLARATION
hereby affirm under penaltyi6f 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 Business 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 1
• License ass: B . . License No.: 672285 - ..for by Section 3700�of the Labor Code, for the performance of the work for which this permit is .
�j� /�f�yJ r'•– _
issued.
/ate"" ontractor: - / r t/�/! t e ', - •" .I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
.P ` - Code, for the performance of the work for which this pwmit,is issued. My workers' compensation
y 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 NTL UNION. INS Policy Number 6436568, - -
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 and agree that, if I should become subject to.the workers' compensation provisions of Section
License Law (Chapter 9 (commencin`g with Section 7000) of Division 3 of the BusinessandProfessions Code) or0,0 of the L borCode all forthwith co pt�wh ' 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 aperm it subjects the applicant to a _civil penalty of not more than fivehundred dollars ($500).5 3 Date: _ (( pplicant:'
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 offeredfor sale (Sec. 7044, Business and Professions Code: The WARNING:, FAILURE TOSECURE WORK AISTION COVERAGE 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 thework 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.). • - APPLICANT ACKNOWLEDGEMENT
1 —1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for permit subject to the
..
7044, Business and Professions Code: The Contractors' State. License,Law does not apply to an owner of conditions and restrictions set forth on this application. -
property who builds or improves thereon, and who contracts for the•projects,with a contractor(s) licensed, 1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.)_ whose benefit work is performed under or pursuant to any permit issued as a result of this application,• ,
1 1 I am exempt under Sec. , B.&P.C. for this reason 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 tothe•workbeing
performed under or following issuance of this permit.:.
"- Date: Owner:' 2. • Any permit issuedas a resultofthis application becomes null and void if work is not commenced
° _ s r_ - 'within" 180 -days from date of issuance of such permit, orcessation 'of work for 180 days will subject -
- . - CONSTRUCTION LENDING AGENCY; -permit to cancellation. -
' Ihereby affirm under penalty of. perjury that there. is a construction lending agency for the -performance of'the I certify that I have read this application and state that the above information is correct. I agree to comply with all-
• - work for which this permit is issued (Sec. 3097, Civ. C.)., - - - - - -city and county ordinances. and state lawi relating to building construction, and r y authorize representatives,-
• • of this co nty.t enter u - the above-mentioned property f inspection p i"
_ Lender's'Name: ° •"c -' _ '
r -t' i ' .. ` `.. D e (A pPlicantor'Agentl'
ate tur
_ Lender's Address:.
LQPERMIT - - - , . • v r • , .. - .. if,.
Application'Number "_.
05700002191
:St ructure Information
Construction Type
TYPE V - NON RATED
—.:Occupancy Type:
: . . DWELLG/LODGING/CONG <=10
Flood Zone
.NON -AO FLOOD ZONE
. Other struct info .- ..
CODE EDITION 2001 CBC .
FIRE SPRINKLERS NO
GARAGE-SQ.FTG
755.00
•
PATIO SQ.FTG
488':.00
.,NUMBER OF UNITS1.00
:..1ST FLOOR` SQUARE_ FOOTAGE
2679`.00
'Permit
BUILDING PERMIT
Additional desc .
Permit -Fee
1122.50 Plan Check. Fee..
729.63
Issue'Date
Valuation
237751
Expiration.Date
12/04/05
Qty Unit Charge
Per.
Extension
BASE FEE
-. 639.50
- 138.00- 3.-5000
THOU BLDG -100,001-500,000
483.00"
Permi.t.' MECHANICAL
Additional-desc .
Permit Fee
99.50- Plan Check Fee
6.00
Issue Date
Valuation
0
Expiration Date
12/04/05
.' Qty -- Unit Charge,
Per.
Extension
.. BA$E -FEE
15.00.
1.00 9.0000
EA MECH FURNACE <=100K
.9. 00
1.00 11.'0000
EA MECH FURNACE >100K
'11.00
1.00 9.0000
EA MECH B/C.<=3HP/100K BTU
~9::0.0
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
_
i Permit Fee.
15.'06 -Plan Check Fee
3.77
,Issue- Date'. . .
- Valuation
0
Expiration Date,,
a
12/04/05 .
Qty Unit Charge
Per
Extension
.BASE -FEE "
15.00'. .' =..
.. „ LQPERMIT
Application Number•'.
05-000-02191
- Permit
ELEC-NEW RESIDENTIAL;
Qty Unit' Charge
Per
Extonsion-
- 1.00 _ :'0350
ELEC' NEW RES'L 1 OR 2 FAMILY
04
- 1.00., _ :.0200
ELEC�GARAGE OR NON-RESIDENTIAL
,.
02
Permit
PLUMBING ~
Additional desc .
Permit Fee
177:00 Plan Check Fee
44.25
Issue Date
Valuation
01"
Expiration Date
12/04/05
Qty, Unit Charge'
Per
Extension
BASE FEE'
15.00
18.0,0 6.0000
EA PLB FIXTURE
108.00
.1.0'0 15.0000
.EA PLB BUILDING•SEWER_
15.0.0•--
1.00 7.SO,00
EA PLB`WATER,HEATER/VENT
7.50
1.00 3.0000
EA PLBWATER INST/AI1T/REP
3.00
1.00 9.0000
EA PLB LAWN SPRINKLER SYSTEM
9.00"
6.00 .7500
EA PLB GAS-PIPE.>=5
4.50"
_ 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'.
1.2/04•/05
r Qty Unit Charge
Per
Extension
BASE FEE
-15.00
-----------------------------------
---------------
-----------------------
SpecialNotes and Comments
--------Special
SFD LOT 138: PLAN 6505B,.2679 SF.INCLUDES
255 SF CASITA, 26 SF BOX BAY @ MBR. '
- .,PERMIT'DOES NOT INCLUDE BLOCK WALL, '
` ,POOL, SPA OR.*DRIVEWAY
APPROACH:
Other Fees. :.:
--------------------
ART IN PUBLIC PLACES -RES
94.37
,.-
DIF COMMUNITY CENTERS RES
.:97.00
DIF CIVIC CENTER -,RES
366.00
ENERGY REVIEW FEE
145.92
- DIF FIRE' PROTECTION RES..
97.00 ,
GRADING PLAN CHECK FEE
00
/
DIF LIBRARIES = RES
`225.0.0
DIF PARK MAINT FAC. -.,RES
5.00
DIF PARKS/REC;- RES
502.00:
. -_ LQPERMIT - - ,- r` ,: .. `.- _. ._ . ,...
. • .. - - _
': -
Application'Number
:'
05=00002191
Other Fees
'-•..STRONG
- - ------------------------
MOTION (SMI) - RES
23..77"
DIF STREET 'MAINT FAC RES
15.00 "
—DIF,TRANSPORTATION TRANSPORTATION RES,
1098.00.:;'
Fee summary
Charged
Paid Credited
Due
-------------------
Permit Fee, Total
----
1429:06:
---------- ---------- --------
:00 .00
1429.06
Plan Check Total
"''`
783.65
.00 .00
783.65
-, Other•Fee Total
2669.06
.00 ., .00
2669..06.
:- Grand Total
4881.77
.00 .00
4$81.77
. LQPERAIIT