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07-0790 (SFD)P.O. BOX 1504 73-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 . Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: 07-00000790 . 50665 VERANO DR 772-250-999-76 -30357 - DWELLING - SINGLE FAMILY .LOW DENSITY RESIDENTIAL 262610 T44t 4 44umrw BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: D TOLL CA V C/O KEVIN D DUERMIT DETACHED 8901 E MOUNTAIN VIEW 209q SCOTTSDALE, AZ 85258 .1 /Architect or Engineer: G1� 141 Qc� u,V is 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: License No.: B ate: 15/-) actoAgawe4&*Azl&2�� " OWNER -BUILDER DECLARATION 1 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 1, 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.). (_ 11, 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 Seca , 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: Vr Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 --9/07 U MAY 0 7 2001 CITY OF LA QUINTA Contractor: TOLL BROS, INC. 73121 FRED WARING DRIVE, #100 PALM DESERT, CA 92260 WCC: ZURICH AMERICAN Lic. No.: B. ------------------ WORKER'S COMPENSATION DECLARATION 1 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 issued. My workers' compensation insurance carrier and policy number are: Carrier ld(;387821301 09/O1/OF7olicyNumber 777699 gar: ;l certify that, in the performance of the work for which this permit is issued, 1 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. /lwppli/cant: /WARNING: FAIL REU 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 oI is county to enter upon the above-mentioned property for inspection purposes. /Date: p 'nature (Applicant or Agent): Application Number .. . . . . 07-00000790 J LQPERMIT Structure Information Construction Type . . . TYPE V - NON RATED Occupancy Type ... . . . . DWELLG/LODGING/LONG <=10 Flood Zone . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CBC # BEDROOMS 3 A 0 FIRE SPRINKLERS NO GARAGE SQ FTG 625.00 PATIO SQ FTG 233.00 NUMBER OF UNITS 1.00 ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 3047.00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee 1210.'00 Plan Check Fee 786.50 Issue Date. . . . . Valuation 262610 Expiration Date 9/15/07 Qty- Unit Charge Per Extension BASE•FEE 639.50 163.00 3.5000•THOU BLDG 100,001-500,000 570.50 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 127.50 Plan Check Fee.. 31.88 Issue Date . . . . Valuation 0 Expiration Date a 9/15/07 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 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 . . . . 134.15 Plan Check Fee 33.54 Issue Date Valuation 0 Expiration Date 9/15/07 Qty Unit Charge Per Extension BASE FEE 15.00 3047.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 106.65 J LQPERMIT Application Number . . . . . 07-00000790 Permit . . . . . . ELEC-NEW RESIDENTIAL Qty Unit Charge Per• Extension 625.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL -----------------------------------------------------=-- - - - - --- 12.50 ------ - - - - - - Permit . . . PLUMBING Additional desc . Permit Fee . . . . 207.75 Plan Check Fee 51.94 Issue Date Valuation . . . . 0 Expiration Date 9/15/07 Qty Unit Charge Per Extension BASE FEE 15.00 23.00 6.0000 EA PLB FIXTURE 138.00 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 7.00 .7500 EA PLB GAS PIPE >=5 5.25 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 9/15/07 Qty Unit Charge Per Extension BASE FEE 15.00 -----------------=---------------------------------------------------------- .Special Notes and Comments SFD - LOT 76. 3047 S.F. BELIZE -SC PERMIT DOES NOT.INCLUDE BLOCKWALLS,POOL/SPA,OR DRIVEWAY APPROACH.2001 CBC, CMC, CPC, 2004 CEC, 2005 ENERGY CODES --------------------------------------- -------------------------------------- Other Fees . . . . . . . . ART IN PUBLIC PLACES -RES 153.86 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 78.65 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 LQPERMIT Application Number . . . . . 07-00000790 - ---------------------------------------------------------------------------- Other Fees . . . . . . . STRONG MOTION (SMI) - RES 26.15 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1930..00 Fee summary Charged Paid Credited -------------------- Due ----------------- Permit Fee Total ---------- 1694.40 ---------- .00 .00 1694.40 Plan Check Total 903.86 .00 .00 903.86 Other Fee Total 4733.66 .00 .00 4733.66 Grand Total 7331.92 .00 .00 7331.92 LQPERMIT