SFD (07-0525)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number.
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
4 4.0"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
s
-07-00000525 A -PLA" _ry?r= Owner: d
`80071 MIRAMONTE LN TOLL CA V
772-250-018-22 -31349 - C/O KEVIN D DUERMIT
DWELLING - SINGLE FAMILY DETACHED 8901 E MOUNTAIN VIEW 200
LOW DENSITY RESIDENTIAL SCOTTSDALE,- AZ 85258
230142
rchitect or Engineer:
R , . Ar
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 Code, and my License is in full force and effect.
Licensee Class: B License No.: 777699
Date:J A /..tractor.
OWNER -BUILDER DECLARATION,
I hereby affirm under penalty of perjury that,l am exempt from the Contractor's 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'for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's 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).:
(_ 1 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 through his or her own employees, provided that the
improvements are not intended or offered for sale.' If, however, the building or improvement is soldwithin
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.).
1 _ 1 I am exempt under Sec. B.&P.C. for this reason
Data: 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
Contractor: O
TOLL BROS, INC.
14350 NORTH 87TH ST, ST
SCOTTSDALE, AZ 85260. d'
(760)674-9699 JJj
Lic. No.: 777699
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/20/07
MAR 221007 O.
WORKER'S 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
.J1 issued. '
R 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
insurance carrier and policy number are: '
Carrier ZURICH AMERICAN Policy Number WC387821301
_ 1 certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to theworkers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section"
3700 of the Lab:j4)Q'wi"
comply with those provisions.
Pete: SZ D, cant: tyj7V*
s
04
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.
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 authorize representatives
of this county to enter upon t e above-mentioned property for inspection purposes.
pte: ature (Applicant or Agent):
LQPERMYr _
Application Number,
07..-00000525
Permit . . . . .
BUILDING PERMIT.'
Additional 'desc
Permit Fee . . . .
1098.00
Plan Check Fee
713.70'
Issue Date
Valuation
230142
Expiration Date
8/19/07
Qty Unit Charge
Per
-
Extension'
BASE
FEE
639.50
131.00 3.5.000
THOU BLDG
100,001-500,000
458_.50
Permit . . . .
MECHANICAL
Additional desc .
Permit Fee
105.00
Plan Check Fee26.25
Issue Date
Valuation
0
Expiration Date
8/19/07
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
5.00 6.5000
EA MECH
VENT FAN
32.50
1.0,0 6.5000
EA MECH
EXHAUST HOOD
6..50
Permit ELEC-NEW RESIDENTIAL
Additional desc .
Permit.Fee
119.59
Plan Check Fee
30.90,
..
Issue Date
Valuation
0
Expiration Date
8/19/07
Qty Unit Charge
Per
Extension
-BASE
FEE
15.00
' 2631.00 .0350
ELEC
NEW RES - 1' OR 2:FAMILY'
92.09;
.625.0.0 .0200
ELEC
;GARAGE OR NON-RESIDENTIAL
12.50:
Permit . .. PLUMBING
-Additional desc .
Permit Fee.
177.75
Plan Check Fee
44.44
Issue Date
Valuation
0
Expiration Date
8/19/07
Qty, Unit Charge
Per
Extension
BASE
,FEE
15.00
18:00 -6.0000
EA PLB.FIXTURE
108.00
1.00 15.0000
EA PLB BUILDING SEWER-
15.00
LQPERMYr _
. Application Number .
. . . 07=00000525
Permit
PLUMBING
Qty :.Unit Charge
Per
Extension
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
Expiration Date'.
8%19/07 .`.
Qty Unit Charge
Per
Extension
BASE FEE
15.00
-----------
Special Notes and.Comments
---- - - - - -- -
SFD - LOT.22, CAMINA-SB,
2631 -SF.
PERMIT DOES NOT
INCLUDE POOL, SPA, BLOCK WALLS OR
DRIVEWAY APPROACH.2001 CBC,.CMC, CPC,
2004 CEC, 2005 ENERGY
CODES_
Other Fees
------------------
ART IN PUBLIC PLACES -RES
94.26
DIF COMMUNITY CENTERS -RES
74..00
DIF CIVIC CENTER _ RES
995:00
ENERGY REVIEW FEE
71.37
DIF FIRE 'PROTECT ION -RES
140.00
DIF LIBRARIES - RES
355.00'
DIF PARK MAINT FAC - RES-
22:00
.
DIF PARKS/REC - RES
892..00
STRONG MOTION. (SMI) - RES
� 23.77 '
.'
DIF STREET MAINT:FAC-RES
67.00
DIF TRANSPORTATION -,RES
1930.00
Fee.summary` Charged _ Paid Credited
Due
Permit 'Fee Total
1515.34_ .00 .00
1515.34
Plan Check Total
815..29 .00 .00
815.29
Other Fee Total.
4664.40 .00_ .00
4664.40
Grand Total,-
6995.03 00 .00
6995.03-
LQPERMIT
... .. -