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SFD (04-8100)51493 Marbella Ct 04-8100 c{ .i' T-Vf 4 4 Q" BUILDING & SAFETY DEPARTMENT P.O. BOX 1504 J (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number Property Address APN: Application description Property Zoning . . . . Application valuation . `_0_400008.10.0 - Date 1/25/05 . . . 51493 MARBELLA CT - 772 -250-998-59 -31349 - . . . DWELLING - SINGLE FAMILY DETACHED . . . LOW DENSITY RESIDENTIAL . . . 321400 Owner Contractor TOLL CA V TOLL BROS, INC. C/O KEVIN D DUERMIT 73121 FRED WARING DRIVE, #100 8901 E MOUNTAIN VIEW 200 PALM DESERT, CA 92260 SCOTTSDALE AZ 85258 (760) 674-9699 WCC: MARSH USA INC. WC: WA762DO04723014 09/01/05 CSLB: 777699 04/30/06 CCC: B -------------------------- Structure Information ------------------------- Construction Type . . . . TYPE V - NON RATED Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CBC FIRE SPRINKLERS NO GARAGE SQ FTG 756.00 PATIO SQ FTG 324.00 NUMBER OF.UNITS 1.00 ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 3741.00 Permit . . . . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 1416.50 Plan Check Fee-. 920.73 Issue Date . . . . 10T 321400 D LJ Qty Unit Charge Per Extension 222.00 3.5000 BASE FEE FEB 15 2005 THOU 639..50 --------------- BLDG 100,0 1 500,000 777.00 Permit - - - --er1YYQF►flED - - - ------------- MECHANICAL FINANCE DEPT Additional desc Permit Fee . . . . 118.00 Plan Check Fee 29.50 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 33.00\. 7.00 6.5000 EA MECH VENT FAN 45.50 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: C/ L. -- ML3y f Applicant: Applicant's Mailing Address: ^•- VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: d /4, o5- Archit or Engineer: (MOUVIS ,.1 rchltect or Engineer's Address: Lic. No.: tsUILUINU PhKMIT DECLARATIONS 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 and Professionals C and my License++m,e iin full force and effect. /,'license Class t- 'icense No. / (o iti 2 / 4- o — ate_ ontrector OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Tor the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' 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).): U 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 or 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 sate.). U 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.). U I am exempt under Sec. , B.& P.C. for this reason Date WORKERS' 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' compensatio 'nsurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is ued. My orkers' compensation ins ce carrier and olic number are - artier ///A?t / (.zS icv Number (,yy 76 Z 0047 3fg 1 certify that, in the performance 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 Code, 1 shall forthwith comply with those provisions. 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. 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 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 Ouinta, 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, andherebyauthorize representatives of this county to enter upon the above-mentioned property for inspection purposes. Sure (Applicant or Agent): A J' Page 2 Application ---------------------------------------------------------------------------- Number . . . . . 04-00008100 Date 1/25/05 Permit . . . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee 161.06 Plan Check Fee 40.27 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge `Per Extension BASE FEE 15.00 3741.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 130.94 756.00 ---------------------------------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 15.12 Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 192.75 Plan Check Fee 46.13 Issue Date Valuation . . . . 0 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 .00 1.5000 EA PLB VACUUM BRKR >5 .00 3.00 .7500 EA PLB GAS PIPE ->=5 2.25 1.00 ---------------------------------------7------------------------------------- 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 Qty Unit Charge Per Extension ---------------------------------------------------------------------------- BASE FEE 15.00 Special Notes and Comments SFD - LOT 59, SANTA ROSA-A, 3741 S.F. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH --------------------------------------------------=------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 303.50 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 92.07 DIF FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK FEE .00 4 Page 3 Application Number . . . . 04-00008100 Date 1/25/05 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC -'RES 502.00 STRONG MOTION (SMI) - RES 32.14 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid ----------------- ---------- ---------- Permit Fee Total 1903.31 .00 Plan Check Total 1036.63 .00 Other Fee Total 2832.71 .00 Grand Total 5772.65 .00 Credited Due .00 1903.31 .00 1036.63 .00 2832.71 .00 5772.65