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SFD (06-3505)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: . Application description: Property Zoning: A lication valuation' BUILDING & SAFETY DEPARTMENT BUILDING PERMIT _06-00003505 d R,CAM , T1f PE owner: 80053 MIRAMONTE LN TOLL CA V 772-250-018-23 -31349 - C/O KEVIN D DUERMIT-. DWELLING - SINGLE FAMILY DETACHED 8901 E MOUNTAIN -VIEW 0 LOW,DENSITY RESIDENTIAL SCOTTSDALE, AZ 85258 241854 ' VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153. Date: 10/02/06 PP GST 1 S 2006 j Contractor: Applicant: Architect or Engineer: TOLL-BROS, INC. 1, C 73121 FRED WARING DRIVE, OF LA QUINTA NCE DEPT.--------- EPT(760)674-9699 PALM DESERT, CA 9226`0 (760)674-9699 Lic. No.: 777699 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION 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 Li ens No.: 777699 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: �1� ntractor:% - d- 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 ECLARATION insurance carrier and policy number are: hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier ZURICH AMERICAN Policy Number WC387821301 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 70001 of Division 3 of the Business and Professions Code) or 3700 of the or Cod Ishall forthwith mply 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).: .te:& pplicant: . 1 _ 1 I, as owner of the property, or my employees with wages as their sale compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATIO 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.). 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 a 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 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 to the work being • performed under or following'issuance of this permit. Date: Owner: - 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 ' CONSTRUCTION LENDING AGENCY permit to cancellation. I hereby 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.1- city and unty ordinances and state laws relating to building construction, and hereby authorize representatives - - oft ' county to enter upo he above-mentioned property fir inspection pur oses. , - Lender's Name: / �� - - ) Date: / ignatura (Applicant or Agent): Lender's Address: LQPERMIT - Application Number . . . . 06-00003505 Structure Information ., Construction Type . . . . . TYPE V - NON RATED Occupancy Type DWELLG/LODGING/CONG <=10 Flood Zorje . . . .. NON -AO FLOOD ZONE Other struct info CODE EDITION 2001 CBC # BEDROOMS 13.00 FIRE SPRINKLERS NO GARAGE SQ FTG 610.00 PATIO SQ FTG 275.00 a' ' NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE.. 2800.00 -. Permit BUILDING PERMIT Additional desc . Permit Fee 1136.50 Plan Check Fee 738.72 Issue Date + Valuation 241854 Expiration Date-'. 3/31/07 Qty Unit.Charge Per Extension: BASE FEE 639.50 r 142.00 3.5000 THOU BLDG 100,001-500,000 497.00 -------------------------------- -------------------"------------------------. Permit MECHANICAL Additional desc . r. Permit Fee 96.50 Plan -Check Fee 24.13 Issue Date Valuation . . . . 0 Expiration Date 3/31/07 Qty Unit Charge Per Extension BASE -FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 9.0000 EA MECH B/C <=3HP/100K BTU 18.00 6-.00 6.5000 EA MECH VENT FAN 39.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 Permit ELEC-NEW RESIDENTIAL Additional desc . Permit Fee 125.20 Plan Check Fee 28.25 Issue Date Valuation 0 - Expiration Date 3/31/07 - Qty Unit Charge Per. Extension BASE FEE 15.00 2800.00 .0350 ELEC•NEW RES - 1 OR 2 FAMILY 98.00 1 r LQPERMIT i LQPERAIIT Application Number 06-00003505 Permit . . . . . ELEC-NEW RESIDENTIAL Qty Unit Charge Per Extension 610.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL. 12.20 Permit . . . PLUMBING Additional desc . Permit Fee . . 189.00 Plan Check Fee 47.25 Issue Date Valuation 0 Expiration Date 3/31/07 Qty Unit Charge Per Extension_ BASE FEE 15.00 20.00 6.0000 EA PLB FIXTURE 120.00 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 3/31/07, Qty Unit Charge Per Extension BASE FEE 15.00 " Special Notes and Comments . SFD - LOT 23. 2800 SF, SEDONA-CONTEMP..PERMIT DOES'NOT INCLUDE BLOCK WALLS, POOL/SPA, OR DRIVEWAY APPROACH. 2001 CBC, CMC, CPC, 2004 CEC; 2005 ENERGY CODES Other Fees . . . . . . . 'ART IN PUBLIC PLACES -RES 104.63 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 73.87 DIF FIRE PROTECTION -RES 140.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES - RES 355.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 LQPERAIIT Application Number . . . . 06-00003505 -----------------_-_----------------- -------_----- - Other Fees STRONG MOTION (SMI) RES 24.18 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1930.00 Fee summary Charged Paid Credited Due Permit Fee Total 1562.20 .00 .00 1562.20 Plan Check Total 838.36 .00 .00 838.36 Other Fee Total 4677.68 .00 .00 4677.68 Grand Total 7078.24 .00 00 7078.24 LQPE%NIIT