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04-0399 (SFD)A Laool� m — — BUILDING & SAFETY DEPARTMENT c� 0.120 15044 (760),777-7012 `SOF �' 78-495 CALLIN l`AMPICO. FAX (760).777-7011: LA U14�i A �LN�� L 1Q IM ,CALIFORNIA 92253 INSPECTION REQUESTS (760).777-71.53 C' AQUI A BUILDING PERMIT Aor RMAMM MDT - Application Number . . . 04- 03999 Date. 5/10/04 Property Address .. 80360�TORREON WY APN 772-250-997-103 -31349 - Application description DWELLING - SINGLE FAMILY DETACHED Property Zoning . LOW DENSITY RESIDENTIAL. Application.valuation 241854 Owner Contractor TOLL CA V TOLL BROS, INC.: C/O KEVIN D DUERMIT 73121 FRED WARING DRIVE, 4100 `8901 E MOUNTAIN VIEW 200 PALM DESERT CA.92260 SCOTT.SDALE AZ 8525.8 WCC: ROGAL.& HAMILTO WC WA26D00.4723013 09/01/.04 CSLB: 777.699- 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 610.00,. PATIO.SQ FTG -275.00 .NUMBER OF UNITS ., 1.00. FIRST FLOOR SQ.FTG 2800..00 Permit . . BUILDING PERMIT Additional desc . Permit. Fee 1136.50. Plan Check Fee 738.73 Issue Date Valuation 241354 Qty Unit Charge ,Per Extension -BASE FEE 639.50 142.00 3.5000 THOU BLDG 10.0,001-500,000 497.00 Permit. . . . . . MECHANICAL Additional' desc Permit Fee 96.50 Plan Check Fee.. .24.13 Issue Date Valuati,on 0 QtyUnit Charge Per. Extension P.O. Box 1504 �� VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 Taf LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760)777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Date: Applicant: Architect or Eng ineer: Applicant's Mailing Address: Architect or Engineer's Address: Co Lic. No.: BUILDING PERMIT DECLARATIONS 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 C e, and my LiTp�e is in full force and effect. ce nse Class /S ° icense No. D to —� 3 —�� Contractor �. V� �. / OWNER43UILDER DECLARATION I hereby affirm under penalty of perjury that I am exe pt 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 contractors) 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 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 iss ed. My workers' mpensation irysance Tamer and policy number a �artter �: Wt�a 195 icy Number7�3y/_� _ I certify that, in the performance of tfie 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 PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND D , LLARS ($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.). Lendefs 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 countyto enter upon the above-mentioned property for inspection purposes. ate y �� ignature (Applicant or Agent):J,", Ur. Page 2 Application Number 04-,00003999 Date 5/10/04 Qty Unit Charge Per Extens_on BASE FEE 15.0.0 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 9. O.00,0 EA MECH B/C <=3HP/100K BTU 18.00 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 125.20. Plan Check Fee 28.25 Issue Date . . . . Valuation .". . 0 Qty 'Unit Charge Per Extens-on BASE FEE 15.00 2800.00.. .0350 ELEC NEW RES - 1 OR 2 FAMILY 98.00 610.00 ..0200 ELEC GARAGE OR NON-RESIDENTIAL 12.20 ---------------------------------------------------------------------------- Permit . . PLUMBING Additional desc Permit Fee 189.00 Plan Check Fee 47.25 Issue Date Valuation . . . .� 0 Qty Unit.Chiarge Per Extens-on BASE FEE' 15.00 20.00 6.0.0.00 EA PLB FIXTURE 120.00 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 •6.00 .7500 EA PLB GAS PIPE >=5 4.50 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 103. 2800 S.F. SFD. SEDONA SB. DOES Page 3 Application Number . . . . . 04-00003999 Date 5/10/04 Special Notes and Comments NOT INCLUDE BLOCK WALLS, POOL/SPA, OR DRIVEWAY APPROACH. Other Fees . . . . . . . . . ART IN PUBLIC PLACES=RES 104.63 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 73.87 DIF FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK FEE .00 DTF LIBRARIES - RES 225.-00 DIF PARK MAINT FAC -.RES 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION (SMI) - RES 24.18 - DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid` Credited Due Permit Fee Total 1562.20 .00 00 1562..20 Plan Check Total 838.36 .00 .00 838.36 Other Fee Total 2607.68 00 .00 '2607.68 Grand Total 5008.24 .00 .00 5008.24