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04-3967 (SFD)0 TA BUILDING & SAFETY DEPARTMENT =O: Box 104. _ 760 777-7012 4 ( ) OF9." pp��y 78-495� OALLE, AMPICO FAX (760) 777-7011 .1L7 LA QUINTA, � A IFORNIA 92253 INSPECTION REQUESTS. (760),777-7153 BUILDING PERMIT Application Number X10-4 0-0-0-03'9-6-7 Date. 5/10/04 Property Address . . . . 8_0_TTU0 TOR REON WY APN: 772-250=997-100 -31349 - Application description DWELLING.- SINGLE FAMILY DETACHED Property Zoning LOW DENSITY RESIDENTIAL. Application valuation 261546 Owner Contractor TOLL CA V TOLL BROS, ' INC.' C/O KEVIN_D DUERMIT 73121 FRED WARING DRIVE, #100 `8901 E MOUNTAIN VIEW 200 PALM DESERT CA.92260 SCOTTSDALE AZ 85258 WCC: ROGAL- .& HAMILTO WC:WA26D004723013 09/01/04 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 CBC # BEDROOMS 3.00. FIRE SPRINKLERS NO. GARAGE SQ FTG 625.00. PATIO. SQ FTG 233.00 NUMBER'OF UNITS .. 1.00 FIRST FLOOR SQ FTG 3047.00 Permit. . . . BUILDING PERMIT Additionaldesc Permit Fee 1206.50. Plan Check Fee 784 23 Issue .Date Valuation 261546 Qty Unit Charge Per' Extens=on BASE FEE 639 50 162.00 5.5000 THOU BLDG 10.0,001-500,000 567 00 Permit. .. . . . MECHANICAL Additional desc Permit Fee 127.50 Plan Check Fee 31.88 Issue'Date Valuation . . ' 0 Qty Unit Charge' Per Extens=on P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 CQ LA QUINTA, CALIFORNIA 92253 4. INSPECTIONS (760)'777-7153 BUILDING & SAFETY DEPARTMENT Application Number: (O Date: % • 6 04 Applicant: Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: JIic. No.: G°c"3 2.2'7 BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 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 de, and my License ' in full force and effect. 9 7 7 Iff License Class cense No. Date ctor/& / /Co OWNER43UILDER 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 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 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. V-1 have and will maintain workers' compensation insu ce, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is / issued. My workers' mpensation insu carier an olicy nu t! are: amer 47/'6 At z y Number I.v �O�06,13 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 comply with those provisions. Bate oplicant WARNING: FAILURE TO SECURE WORKERS' COM NSATION 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 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 s to 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 repre atives of this county to enter upon the above-mentioned property for inspection purposes. ate d Signature (Applicant or Agent),nt. tw. Page 2 Page 2 Application Number . . . . . 04-00003967 Date 5/10/04 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 127.00 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 . . k - . Permit Fee 134.15 Plan Check Fee 33.54 Issue Date Valuation 0 Qty Unit Charge Per Extens-on BASE FEE, 15..00 3047.00 .0350 ELEC NEW RES - 1 OR 2 -FAMILY 106.65 625.00 .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 Qty Unit Charge Per Extens-on BASE FEE 15 0.0 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 Qty Unit Charge Per Extension BASE FEE 15.00 ------------------------------------------------------------------------------- Special Notes and Comments LOT 100. 3047 S.F. SFD. BELIZE SB. Page 3 Application Number 04-00003967 Date 5/10/04 ---.--------------------- Special Notes and.Comments' ----------------- -------------- ------------- PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL/SPA,OR DRIVEWAY -APPROACH. ------------------------------------------------------------------------------- Other Fees . . . . . . . . ART IN PUBLIC PLACES=RES. 153.86 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC .CENTER - RES 366.00 ENERGY REVIEW FEE 78.42 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 26.15 DIF STREET MAINT.FAC-RES 15.00 DIF TRANSPORTATION - RES 1098.00. Fee summary,. ----------------- Charged Paid Credited Due Permit Fee Total ---------- 1690.90 ------------------------------ .00 .00 1690.90 Plan Check Total 901..59 .00 .00 901.59 Other Fee Total .2663.43 .00 _.00 2663.43 Grand Total 5255.92 00 .:00 5255.92