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05-3408 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: CXPX T4ht 4 4 Q" BUILDING& SAFETY DEPARTMENT BUILDING PERMIT 05'00003408 81888 CONTENTO 767-200-011-17 -318741- DWELLING - SINGLE FAMILY DETACHED LOW DENSITY RESIDENTIAL 175002 rchitect or Engineer: v�G-� fid 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: Bic nse No.: 352047 ontractor. J z OWN -BUILDER DECLARATION I hereby affirm under penalty of perjury hat I am exempt from the Contractor's St License Law for the following reason (Sec. 7031 .5, Business and Professions Code: Any city or cou y 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).: . (_) 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 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 Qf 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. , B.&P.C. for this reason Date: 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: ,1 Lender's Address: N LQPERMIT Owner: TAYLOR WOODROW HOMES, INC. 15 CUSHING IRVINE IRVINE, CA 92618 ED Contractor: TAYLOR WOODROW HOMES INC 15 CUSHING IRVINE, CA 92618 (760)275-0598 Lic. No.: 352047 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/03/05 w U AUG 0 8 2005 CITY OF LA AUINTA 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. N 0(1 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 Policy Number WA76SD283614055 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 Labor Code, I shall forthwith oo ply with t5S. s. WARNING: FAILURE TO SECURE W KERS' CO NSATION COVEWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI L PENALTIES AND CIVIL FINES UNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATIS AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S 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 constru ' nd hereby authorize representatives of this county to enter upon a above-mentioned property for ecti p p es. 9nature (Applicant or Agent) _ 01 1 Application Number . . . . . 05-00003408 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 905.50 Plan Check Fee 147.15 Issue Date . . . . Valuation . . . . 175002 Expiration Date 1/30/06 Qty Unit -Charge Per Extension BASE FEE 639.50 76.00 ---------------------------------------------------------------------------- 3.5000 THOU BLDG 100,001-500,000 266.00 Permit MECHANICAL Additional desc . Permit Fee . . . . 83.50 Plan Check Fee 5.22 Issue Date . . . . Valuation . . 0 Expiration Date 1%30/06 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 5.00 ---------------------------------------------------------------------------- 6.5000 EA MECH VENT FAN 32.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . . Permit Fee . . . . 121.92 Plan Check Fee 7.62 Issue Date Valuation . . . . 0 Expiration Date 1/30%06 Qty Unit Charge Per Extension BASE FEE 15.00 2685.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 93.98 647.00 ---------------------------------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 12.94 Permit PLUMBING Additional desc . Permit Fee 161.25 Plan Check Fee 10.08 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/30/06 Qty Unit Charge. Per Extension BASE FEE 15.00 15.00 6.0000 EA PLB FIXTURE 90.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 LQPERMIT Application_ Number . . . 05-00003408 Permit . . . . . . PLUMBING Qty Unit Charge Per Extension 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 9.00 .750'0 EA PLB GAS PIPE >=5 6.75 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 1/30/06 Qty Unit Charge Per e Extension BASE FEE : 15.00 ---------------------------------- Notes and Comments SFD - LOT 17, PLAN lA 2685 SF. 2001 CODES. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH.75% REDUCTION TO PLAN CHECK FEES DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE ---------------------------------------------------- Other Fees . . . . . . . ----------------------- . . DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 14.72 DIF FIRE PROTECTION -RES 97.00 DIF LIBRARIES•- RES 225.00 DIF'PARK MAINT FAC - RES 5.00 DIF PARKS/REC - RES - 502.00 STRONG MOTION (SMI) - RES 17.50 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION'- RES 1098.00 Fee summary Charged Permit Fee Total 1287.17 Plan Check Total 170.07 Other Fee Total 2437.22 Grand Total 3894.46 LQPEPAIITP Paid Credited Due .00 .00 1287.17 .00 .00 .170.07 .00 .00 2437.22 .00 .00 3894.46