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04-3984 (SFD)BUILDING & SAFETY DEPARTMENT P + . Bo +1�504. (760),777-7012 �`�QF�1f19 78-495 0IH1. E TAMPICO FAX (760) 777-7011 JUL 1 A?�,��JINTA,% CALIFORNIA 92253 INSPECTION REQUESTS (760).777-71.53 CjTv0F AQU1N1rA BUILDING PERMIT (FINANCE EFT. .Application Number . . 0:4-0-00023984 Date 5/10/04 Property Address . . . . . 80340 TORREON WY APN: 772-250=997-101 -31349 - Application description DWELLING.- SINGLE FAMILY DETACHED Property Zoning LOW DENSITY RESIDENTIAL Application.valuation 262610 Owner Contractor TOLL.CA V TOLL BROS, INC. C/O KEVIN D DUERMIT 73121 FRED WARING DRIVE, #100 '890.1 E. MOUNTAIN VIEW 200 PALM -DESERT CA 92260 SCOTTSDALE AZ. 85258 WCC: ROGAL.& HAMILTO WC:. WA26D00.4723.0.13 09/01/04' CSLB: 777699 04/30/06 CCC:' B -------------------- 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.. -3.00 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 Additional desc .Permit Fee 1210.00 Plan Check Fee 786.50 Issue Date Valuation . . 262610 Qty Unit Charge Per ExtenEf on 'BASE FEE 6.39.50 163.00 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 .Qty Unit Charge Per Extension P.O. Box 1504 4 4V�� VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760)777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 01 ~ .31194 Date: Applicant: Pychiteqj or Engineer: / KIV I -?n Applicant's Mailing Address: Architect or Engine 's Address: C 0 ✓ter JAic. No.: c 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 Code, and my Lice, a is in full force and effect. I1- p- J /' License Class _ /License No. . / / (� jDate �% — I 'd Contractor 1 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exe 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 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 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 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 self4nsure 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 issped. My workers'cpmpensation insurance carrier and policy number re: �CarrierL-acv dY4.iu�( icy Number "a&DUo�rl��C�/� I certify that, in the performance of lKe 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. WARNING: FAILURE TO SECURE WORKERS' CO,M 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 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 Lender's 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. 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 property for inspection purposes. Xte ��'�/ Signature (Applicant or Agent): r Page .2 Application Number . . . . 04-00003984' 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 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 Qty, Unit Charge Per Extension BASE FEE 15.00 3047.00 .0350 ELEC NEW RES - 1'OR 2 FAMILY 106.65 625.00 .0.200 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, 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 7.50'00 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 Extens=on BASE FEE 15.00 Special Notes and Comments LOT 101. 3047 S.F. SFD. BELIZE u Page 3 Application Number 04-00003984 Date 5/10/04• Special.Notes and Comments CONTEMPORARY +4. PERMIT DOES NOT INCLUDE . BLOCKWALLS,POOL/SPA,OR DRIVEWAY APPROACH.' Other Fees- ART IN PUBLIC PLACES2RES 153.86 DIF COMMUNITY CENTERS -RES 97..00. DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 7.8.65. 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 1694.40 ------------------------------ .00 .00 1694.40 Plan Check Total 903.86 .00 .00 903.86 .Other Fee Total 2663.66 .00 .00 2663.66 Grand Total 5261.92 .00 ._00 5261.92