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SFD (05-3323)51365 Marbella Ct 05-3323 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: 05-00003323 51365--MARBELLA 772-250-998-63 DWELLING - SINGLE FAMILY LOW DENSITY RESIDENTIAL 333037 DETACHED ,,"Architect or Engineer: ,FETY DEPARTMENT NG PERMIT ? e S _:>;::> Owner: TOLL CA V C/O KEVIN D DUERMIT 8901 E MOUNTAIN VIEW 200 SCOTTSDALE, AZ 85258' Contractor: TOLL BROS, INC. 73121FRED WARING DRIVE, #100 PALM DESERT, CA 92260 (760)'674-9699 Lic. No.: 777699 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/01/05 -------------------------------------------------------------=---------=------------------------- 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 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 License Class: B cense No : 7 7699 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is Date: onuactor: issued. 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor of Code, for the performance of the work for which this permit is issued. My workers' compensation OWNER- L D_RATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier LIBERTY MUTUAL Policy Number WA762DO04723014 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 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forthwit comply wi h 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).: plicant: 1 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and te: the structure is notintended or offered for sale (Sec. 7044, Business and Professions Code: The WARM AILURE TO SECURE WOR S' COM SATI N COVER 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 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 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 permii 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 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 au honze representatives of this count to enter upon th above-mentioned property for inspectio rposes. $afte: gnature (Applicant or Agen . I LQPERMIT Application Number . . . . . 05-00003323 Structure Information Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONE <=10 Flood Zone . . . . . NON -AO FLOOD ZONE Other struct info CODE EDITION 2001 CBC FIRE SPRINKLERS NO GARAGE SQ FTG 752.00 . PATIO SQ FTG 561.00 NUMBER OF UNITS 1.00 ---------------------------------------------- 1ST FLOOR SQUARE FOOTAGE ------------------ 3847.00 ------------ Permit . . . BUILDING PERMIT Additional desc . Permit Fee 1458.50 Plan Check Fee 237.01 Issue Date . . . Valuation . . . . 333037 Expiration Date 1/28/06 Qty Unit Charge Per Extension BASE FEE 639.50 234.00 3.5000 ------------------------------------ THOU BLDG 100,001-500,000 ---------------------------------------- 819.00 Permit . . . MECHANICAL Additional desc . Permit Fee 127.50 Plan Check Fee 9.38 Issue Date Valuation . . . . 0 Expiration Date 1/28/06 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 3.00 9.0000 EA MECH B/C <=3HP/100K BTU 27.00 .00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 1 .00 8.00 6.5000 EA MECH VENT FAN 52.00 1:00 6.5000 ----------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 Permit . . . Additional desc . Permit Fee . . . Issue Date . . . . Expiration Date . . Qty Unit Charge 3847.00 .0350 ELEC-NEW RESIDENTIAL 164.69 Plan Check'Fee . Valuation . . . 1/28/66 Per BASE FEE ELEC NEW RES - 1 OR 2 FAMILY 10.29 0 Extension 15.00 134.65 Application Number . . . . . 05-00003323 Permit ELEC-NEW RESIDENTIAL Qty Unit Charge Per Extension 752.00 .0200 --------------7-------------'-------------------------------------7---------- ELEC GARAGE OR NON-RESIDENTIAL 15.04 Permit PLUMBING Additional desc . Permit Fee . . . . 195.00 Plan Check Fee 12.19 Issue Date . . . . Valuation 0 Expiration Date.. 1/28/06 Qty Unit Charge Per Extension BASE FEE 15.00 21.00 6..0000 EA PLB FIXTURE 126.00 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 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 1/28/06 Qty Unit Charge Per Extension -------------=-------------------------------------------------------------- BASE FEE 15.00 Special Notes and Comments SFD - LOT 63, MIRAMONTE-A, 3847 SF. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH.. 75% REDUCTION TO PLAN CHECK FEE DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE ---------------------------=------------------- Other Fees . . . . . ------------------------------ . . ART IN PUBLIC PLACES -RES 332.59 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 23.10 DIF FIRE PROTECTION -RES 97:00 GRADING PLAN CHECK FEE- .00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC - RES 502.00 LQPERMIT Application Number . . . . 05-00003323 ----------------------------------------------------------------------------- Other Fees . . . . . . . . . STRONG MOTION (SMI) - RES 33.30 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION- RES 1098.00 Fee summary Charged Paid Credited Due -- Permit Fee Total ---------- 19.60.69 ---------- --------------------- .00 .00 1960.69 Plan Check Total. 268.87 .00 .00 268.87 Other Fee Total 2794.59 .00 .00 2794.59 Grand Total 5024.15 .00 .00 5024.15 LQPERMIT