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SFD (04-5083)44 BUILDING & SAFETY DEPARTMENT yrc `�'ID4 rQP-O: B'ox 15041 y (760).777-7012 OF " i=8'-495 CALL ►AMPICO FAX. (760) 777-7011 JULLA2Q3U,2N A FORNIA 92253 INSPECTION REQUESTS (760) 777-71.53 clT�r.oF �,cauiNT�+ . BUILDING PERMIT FINANCE DEPT I Application Number 00005083 bate— 6/25/04 Property Address 56405 MOUNTAIN VIEW APN: 762-410-041- - - Application description DWELLING - SINGLE FAMILY DETACHED Property Zoning LOW DENSITY RESIDENTIAL Application valuation-. 376373 Owner Contractor SRHI TOLL BROS, INC. C/O RIELLY HOMES INC .73121 FRED WARING DRIVE, #100. 3 CORPORATE PLAZA DR 210 PALM DESERT CA 92260'' NEWPORT BEACH Ck 92660 WCC: LIBERTY MUTUAL WC WA26DO04723013 0,9/01/.0'4. CSLB;: 777699 04/30/06 CCC: B =------------------------- .Structure Information ------------------------- Construction Type TYPE V - NON RATED Occupancy Type . . . . . .. DWELLG/LODGING/CONG <=10 - Flood Zone NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CRC FIRE SPRINKLERS ..NO GARAGE,SQ FTG 730.00 PATIO SQ FTG 650.00 'NUMBER -OF UNITS 1°.00 FIRST FLOOR SQ FTG .4374.00 Permit . . .BUILDING PERMIT Additional desc Permit Fee 1609.00 Plan Check Fee 261.46 Issue Date . . Valuation . . . 376373 Qty Unit Charge Per.- Extension BASE FEE- 639.50 277.00 3.5000 THOU BLDG 100,001-500,000 969.50 Permit . . . . . . MECHANICAL Additional desc Permit Fee 134:00 Plan Check Fee 8.38 Issue Date Valuation 0 Qty Unit Charge Per Extension_ P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 0q—OS 3 Date: Applicant: Applicant's Mailing Address: 43A L t Architect or Engineer: IArchitect or Engineer's Address: Lic. No.: BUILDING PERMIT 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 e, and my License is in full force and effect. nse Class cense No. —% 9� 9 Date`V D 4}- ctor 0-/-, 117 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 for 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 sale.). 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. , BA P.C. for this reason Date Owner. 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' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issu : My y(or�kers' porn bon insurance carrier and policy number ale ,errier i �/n? .191 1 A�. A l Number Lys�-c6/, Om �t723D 1- _ 1 certify tKat, 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 Labor Code, I 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 Lenders 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, and hereby authorize representatives of this county to enter upon the above -menti ned property for inspection purposes. ate mature (Applicant or Agent): t Page Page 2 Application Number 04-00005083 Date 6/25/04 _ 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 9.00 6.500.0 EA MECH VENT FAN 58'.50 1.00 6:..5000 EA MECH EXHAUST HOOD 6.50 Permit ELEC-NEW RESIDENTIAL Additional desc . • Permit Fee 182•.69 Plan Check Fee 11.42 Issue Date . . . . `Valuation . . . . 0' Qty Unit Charge Per Extension. BASE FEE 15.00 4374.00 .035.0 ELEC'-NEW RES - 1 OR 2 FAMILY 153.09 •730.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 14.60 Permit PLUMBING Additional desc Permit Fee . . . . 216.00 Plan Check Fee 13.50 Issue Date Valuation 0 Qty Unit•Charge Per - Extension BASE FEE 15.00 .24.00 6.0000 EA PLB FIXTURE 144.00 1.00. 15.0000 EA PLB BUILDING SEWER 15.00 1.0.0 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 10.00 .7500 EA PLB GAS PIPE >=5 7.50 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 Qty Unit -Charge Per. Extension ' BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 41 PLAN VENTANA SB W/CASITA & Page .'3 r . . . . . .04-00005083 Date ' 6/2.5/04 ------------------------------------ Special. Notes and Comments -------------------------- Page .'3 Application Number . . . . . .04-00005083 Date ' 6/2.5/04 ------------------------------------ Special. Notes and Comments -------------------------- -------------- EXT PATIO 4374 S.F. PERMIT DOES NOT " - INCLUDE BLOCK WALL, POOL, SPA OR DRIVEWAY APPROACH. 75% PLAN CHECK FEE REDUCTION APPLIED FOR MULTIPLE ISSUANCE OF SAME PLAN TYPE. Other Fees. . . . . . . . . . ART IN PUBLIC PLACES -RES 440.93 DIF COMMUNITY CENTERS -RES 97.00 DIF -CIVIC CENTER - RES 366.00. ENERGY REVIEW FEE .. 26.15 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 37.63" DIF STREET MAINT.FAC-RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited .Due Permit Fee -Total 2156.69 .,00 .00' 2156. 69 Plan Check Total 294.76 .00 .00 2,.94.76. Other Fee Total 2909.71 .00_ .00 2909.71 Grand Total 5361.16 .00 -.00 5361.16