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06-0822 (SFD)P.O. BOX 1504 787495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING &SAFETY DEPARTMENT BUILDING PERMIT Applicant: C . �Ie �ect or Engineer: TO<< �rc�ia i•C„� . LL'BROTHERS, INC. 121 FRED WARING DRIVE, 4100 LM DESERT, CA 92260 Contractor: TOLL BROS, INC. 14350 NORTH:87TH ST, STE #310 SCnTTSDALE, AZ 85260 (760)674-9699 Lic. No.,: 777699 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/28/06 -------------------------------— ' LICENSED CONTRACTOR'S DECLARATION Application Number: 06-00000822 D Property Address: 80481 -OLD -RANCH TR S _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided APN: 762-240-999-30 -30834 - APR f� Q 2006 Application description: DWELLING - SINGLE FAMILY DETACHED Property Zoning: LOW DENSITY RESIDENTIAL Code, for the performance of the work for which this permit is issued. My workers' compensation A,ppligatign valuotionl 026022 I CIYY- FLA QUIN'rA - I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Applicant: C . �Ie �ect or Engineer: TO<< �rc�ia i•C„� . LL'BROTHERS, INC. 121 FRED WARING DRIVE, 4100 LM DESERT, CA 92260 Contractor: TOLL BROS, INC. 14350 NORTH:87TH ST, STE #310 SCnTTSDALE, AZ 85260 (760)674-9699 Lic. No.,: 777699 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/28/06 LQPERMIT . -------------------------------— ' 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 Licens ass:. B License No.: 777699 - -for by Section 3700 of the Labor Code, for the performance of the work for which this permit is `7 ��/`f' - issued. rector: I haveand will maintain woikers' 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 th 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 �//y/� ' any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: �7��+� pplicant: .--s :..(_ ) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and 10- - - 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 'SF EES. 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.). APPLICANT ACKNOWLEDGEMENT (_) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. - -property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for - pursuant to the Contractors' State License Law.). whose benefit work is performed under or.pursuant to any permit issued as a result of this application, ( ) I am exempt under Sec. , B.&P.C. for this reason 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. , Date: - Owner: 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 CONSTRUCTION LENDING AGENCY permit to cancellation. hereby affirm under.penalty of perjury that there is a construction lending agency for.the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all . work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building construction, and hereby authorize representatives - Lender's Name: of thi ounty to enter upo eabove-mentioned prop y for inspection p Poses. L/ ' {(1r ate�� ignature (Applicant or Agent): Lender's Address �q LQPERMIT . Application Number. . . . . . ' 06-00000822 Permit . . . BUILDING PERMIT' Additional desc Permit Fee . . 1084.00 Plan Check Fee 176.15 Issue Date Valuation . . . 226022 Expiration Date . 8/27/06 Qty Unit Charge Per Extension BASE FEE 639.50 127.00 3.5000 THOU BLDG 100,001-500,000 444.50 ------------------------------------ Qty Unit Charge Per .r Application Number. . . . . . ' 06-00000822 Permit . . . BUILDING PERMIT' Additional desc Permit Fee . . 1084.00 Plan Check Fee 176.15 Issue Date Valuation . . . 226022 Expiration Date . 8/27/06 Qty Unit Charge Per Extension BASE FEE 639.50 127.00 3.5000 THOU BLDG 100,001-500,000 444.50 ------------------------------------ Qty Unit Charge Per Extension BASE FEE 15.00 4.00 9.0000 EA MECH FURNACE <=100K 36.00 4.00 9.0000 EA MECH B/C <=3HP/100K BTU 36.00- 5.00 6.5000 EA MECH VENT FAN 32.50 1.00 6.5000 EA MECH EXHAUST HOOD .6.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . 155.45 Plan Check Fee 9.72 Issue Date . . . . Valuation 0 Expiration Date 8/27/06 Qty Unit Charge Per Extension BASE FEE 15.00 3607.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 126.25 710.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 14.20 Permit PLUMBING Additional desc . Permit Fee . . . 186.75 Plan Check Fee 11.67 Issue Date . . . . Valuation . . . . 0 Expiration Date 8/27/06 Qty, Unit Charge Per Extension BASE FEE 15.00 19.00 6.0000 EA PLB FIXTURE 114.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 .LQPERMIT . Application Number . . . . . 06=00000822 APPROACH.75% REDUCTION TO PLAN Permit . . . . . . PLUMBING FEES -DUE TO MULTIPLE ISSUANCE OF SAME 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 11.00 .7500 EA PLB GAS PIPE >=5 8.25 1.00 15.0000 EA PLB GAS METER 15.00 Permit . . . ORADING PERMIT GRADING PLAN CHECK FEE Additional desc - 355.00 Permit Fee . . . 15.00 Plan Check Fee .00 Issue Date . . . . 892.00 Valuation . . 0 Expiration Date 8/27/06 DIF STREET MAINT FAC -RES 67:00 Otv Unit G` -arae Per. 1666.00 -J-xtension SPA, BLOCK WALLS OR DRIVEWAY APPROACH.75% REDUCTION TO PLAN CHECK FEES -DUE TO MULTIPLE ISSUANCE OF SAME PLAN CHECK 2001 CBC, CMC, CPC, 2004.CEC, 2005 ENERGY CODES - Other Fees ... . . . . . . . ------------------------------- ART IN PUBLIC PLACES -RES 65.05 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 480.00 - ENERGY REVIEW FEE 17.62 ..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 22.60 DIF STREET MAINT FAC -RES 67:00 DIF TRANSPORTATION - RES 1666.00 Fee summary Charged Paid Credited Due Permit Fee Total 1567.20 ---------------- .00 .00 1567.20 Plan Check Total 205.42 .00 .00 205.42 Other Fee Total 3801.27 .00 .00 3801.27 LQkRMIT