05-5054 (SFD)r� P.O. BOX 1504 "`&tr4:
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
(- BUILDING PERMIT
Application Number: 05-00005054 I� Owner: `
Property Address: 80383 OLD RANCH TR -•S TOLL BROTHERS, INC.
APN: 762-240-999-37 -30834 - 73121 FRED WARING DRIVE
Application description: DWELLING - :SINGLE FAMILY DETACHED PALM DESERT, CA 92260
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 233717
Contractor:
Applicant: Architect or Engineer: TOLL BROS, INC.
r%N� 14350 NORTH 87TH ST, STE
!� SCOTTSDALE, AZ 85260
C �S/`S�_ (760) 674-9699
1 e _ Lic. No.: 777699
r
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: . 2/28/06
EAPR4 2006
C; ir' op,'&AOWNTA
#310
-------------------------------------------------------7------------------------------------------
' LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION -
I 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 License No.: 777699
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
ntractor: di' 1.. R 7/t7'�L me -s
/ -
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 issued. My workers' compensation
OWNER -BUILDER DECLARATION -.
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier ZURICH INS Policy Number WC387821300
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 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code, I shall forthwith comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
,/ Q '
A7-I&I TCJ// R3,J" ��
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
te: licant: �4LJ-_S
( 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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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.).
(_ 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.). .
( ) 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: a '
Lender's Address: 14
'
LQPERMIT
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 prop rt for inspection rposes.
te:�1/ � ignature (Applicant or Agent):
rl.. Application Number .
. . . . 05-00005054
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee
1108.50. Plan Check Fee
720.53
Issue Date
Valuation . . . .
233717
Expiration Date
8/27/06
Qty Unit Charge
Per
Extension
-
BASE FEE
639.50
134.00 3.5000
THOU BLDG 100,001-500,000
469.00
Permit . . .
MECHANICAL
Additional desc .
Permit Fee
114.50 Plan Check Fee
28.63
Issue Date . . . .
Valuation . . . .
0
- ' Expiration Date . , .
8/27/06.
..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
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 . . . .
161.43 Plan Check Fee ..
40.36
Issue Date . . . .
Valuation . . . .
0
Expiration Date
8/27/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
3774.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
132.09
717.00 -.0200
ELEC GARAGE OR NON-RESIDENTIAL
14.34
Permit
PLUMBING
Additional desc .
Permit Fee . .
173.25 Plan Check Fee
43.31
Issue Date
Valuation . . . .
0
Expiration Date..
8/27/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
17.00 6.0000
EA PLB FIXTURE
102.00
1.00 15.0000.EA
PLB BUILDING SEWER
15.00
LQPE"IT -
-
r61
i` Application Number . . . . . 05-00005054
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
9.00. .7500 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 8/27/06
_- Qty Unit. Charge. -i -Per
Extenzion
BASE FEE
15.00
--- - -- --- -- ---------------------------------------------
Special Notes and Comments
SFD - LOT 37, 3, MONTANA -TUSCAN,
.PLAN
3774 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
--- ---------
84.29
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
480.00
ENERGY REVIEW FEE
72.05"
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
STRONG MOTION (SMI) - RES-
23.37
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1666.00
Fee.summary Charged Paid Credited
Due
___
Permit Fee Total 1572.68 .00 .00
1572.68
Plan Check Total 832.83 300.00 .00
532.83
Other Fee Total 3875.71 .00 .00
3875.71
Grand Total 6281:22 300.00 .00
5981.22
LQPERMIT - - -
