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SFD (05-3190)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT 1 BUILDING PERMIT Application Number: 05-00003190 1 Owner: Property Address: 80143 MIRAMONTE LN !i% TOLL CA V APN: 772-250-018-18 -31349 - C/O KEVIN D DUERMIT Application description: DWELLING - SINGLE FAMILY DETACHED n 8901 E MOUNTAIN VIEW 200 Property Zoning: LOW DENSITY RESIDENTIAL /?� /� SCOTTSDALE, AZ 85258 Application valuation: 227594 0 y 2�0f Contractor: Applicant: �chitect or Engineer: TOLL BROS, INC. 73121 FRED WARING DRIVE, #100 PALM DESERT,,,CA 92260 T,l� (760)674-9699 1� C�,��f7f Lic. No.: 777699 ------------------------------------------ - ------- 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. 'License Class: B LicenseNo.: 777699 te: JJ % ontraaor: CFL L r/ A— OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I 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 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 sale.). (_) 1, 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 am exempt under Sec. , BAP.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY J. 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 ISec. 3097, Civ. C.).' Lender's Name: Imo, Lender's Address: IOA LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/26/05 ----------------------------------------------- WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: - _ 1 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. —V -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 LIBERTY MUTUAL IPolicy Number WA762DO04723014 _ I 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 the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the L r Code, I shall forthwith comply /with, those provisions. A ate: 1 , PPlicant: �� yMrAw Ott •.IOM)+ / �[�< (- WARNING: 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 the above-mentioned property for inspection purposes. i Date: T J 7 gnature (Applicant or Agent): (y Q b&AV.. Application Number 05-00003190 Structure Information•. Construction Type . . . . TYPE V - NON RATED ''Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 F1ood,.Zone. . . . NON -AO FLOOD ZONE -_Other struct info . . . . . CODE EDITION 2001 CBC # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 495.00 PATIO SQ FTG, 399.00 NUMBER OF UNITS 1.00 .1ST FLOOR SQUARE FOOTAGE 2631.00 ._Permit" BUILDING PERMIT Additional desc . Permit Fee 1087.50 Plan Check Fee 706.88 Issue Date Valuation . . . . 227594 Expiration Date 1/22/06 Qty Unit Charge Per Extension BASE FEE 639.50 128.00 3.5000 ----------------------------------------------------------------------------- THOU BLDG 100,001-500,000 448.00 PermitMECHANICAL Additional desc . Permit Fee . . . . 109.50 Plan Check.Fee 27.38 Issue Date . . . . Valuation . . . . 0. Expiration Date 1/22/06 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 8.00 6.5000 EA MECH VENT FAN 52.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 Permit ELEC-NEW RESIDENTIAL Additional.desc . Permit Fee 116.99 Plan Check Fee 29.25 Issue Date Valuation . . . . 0 Expiration Date 1/22/06 Qty Unit Charge Per Extension ' BASE FEE 15.00 2631.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 92.09 LQPERMIT _ . Application Number . . . 05-00003190 Permit . . . .. ELEC-NEW RESIDENTIAL Qty Unit Charge ---'Per Extension ,4.95.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.90 Permit PLUMBING • Additional desc . Permit - Fee 189.00 ;' Plan*Check Fee 47.25 Issue Date . . . . •, Valuation . . . . 0 Expiration Date 1/22/06 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 1/22/06 Qty Unit Charge, Per Extension - BASE FEE 15.00. ---------------------------------------------------------------------------- ' Special Notes and Comments. SFD - LOT 18. 2631 S.F. CAMINA/SB. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL/SPA, OR DRIVEWAY APPROACH. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 68.98 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES* 366.00 ENERGY REVIEW FEE 70.69 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_ STRONG MOTION (SMI) - RES 22.75 DIF STREET MAINT FAC -RES 15.00 LQPEPAI[T Application Number 05-00003.190 Other Fees DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due Permit Fee Total 1517.99 .00 .00 1517.99 Plan Check Total 810.76 .00 .00 810.76' Other Fee Total 2567.42 .00 .00 2567.42 Grand Total' 4896.17 .00 00 4896.17 LQPERAIIT ... .