04-4012 (SFD)3 �
BUILDING & SAFETY DEPARTMENT
Box 1504(760).777=7012'
OF tltl`` X78-49, CAL E IJTAMPICO A FAX (760) 777-7011
U LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153:
j
JUL 14 2004 ' BUILDING PERMIT
ClYV 01: LA OU1NTA
App a.o�nNue . . . . . 04-00.0.0-4-012 Date 5/10/04
Property.Address . . . 80365 TORREON WY
APN: 772-250-997-137 -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, #1.00
890.1 E MOUNTAIN VIEW 2.00 PALM DESERT CA 92260
S.COT.TSDALE A -Z 85258
WCC: ROGAL & HAMILTO
WC,: WA26DO04723013 09/0-1/04
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 6110.00
PATIO SQ FTG 2.75.00
NUMBER .OF UNITS ...1.00
FIRST FLOOR SQ FTG 2800.00
Permit .^. . . . . BUILDING PERMIT
Additional. desc
Permit Fee 1136.50 Plan Check.Fee 184.68
Issue Date . . . . Valuation 241354
Qty :Unit Charge Per Extension
BASE FEE 639.50
142.00 3.5000 THOU BLDG -100,0-01-500,000 49.7.00,
Permit MECHANICAL..
Additional. desc
Permit Fee 96.50 Plan Check Fee 6.03
Issue Date Valuation . . . . 0
Qty Unit Charge Per. Extension
P.O. Box 1504
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
Date: —X -Ar -S -A -Z'
Archit ct or Engineer:
41001
Arc itect or Engineer's Address:
��� o 4L2,= /qd'.Q-
No: C Z?,. i 7
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereb ffirtm under penalty of perjury that I am licensed under p jsions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
C and my License -s in full force and effect./i y� ) C�
nnsese Class /% License No. J (q
/bate — /3—C)y Contractor CLEL, �c
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exeVptom 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 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.
I have and will amaintainn workers' compens 'dn nsrirance,'as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
i sued. My rscompensation ' urance carrier and gqlicy num��?,r�are:
CarrierLi� i JIAIP/ olicy Number G�� /m L�ccf� 7;Z_3c /
I cerfify 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.
u �
ate .'—/��plic.anl
WARNING: FAILURE TO SECURE WORKERV
TION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSA($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTERTORNEY'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
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, indemnity 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 t t I have read this application rid state that the above information is correct I agree to comply with all city and county ordinances and state laws relating to building
7conston, and hereby authorize r resentatives of this county to enter upon the above-mentioned property for inspection purposes.
`��� nature (Applicant or Agent):
t
�X
l
Page
2
Application Number
.
. . . . 04-00004012.
Date
5/10/D4
Qty Unit
Charge
Per
Extenston
BASE
FEE.
15.00'
2.00
9.0000
EA MECH
FURNACE <=100K
18.00
2.00
.9.0000
EA MECH
B/C <=3HP/100.K 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
7.06
Issue Date
Valuation
0
Qty .Unit
Charge
Per
Extension
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
11..81
Issue•Date
Valuation,
0
Qty Unit
Charge_
Per
Extension
BASE.
FEE
15.00
20.00
6.0000
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
3.000.0
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
Extension
BASE
FEE
15.00
----------------------------------------------------------------------------
Special Notes
and Comments
LOT 137. 2800
S.F. SFD.
SEDONA
:f
e.
Page 3
Application Number
. . . . .
04-00004012. Date
5/10/04
----------------------------------------------------------------------------
Special Notes and
Comments
SB W/ TAILS. DOES
e.
Page 3
Application Number
. . . . .
04-00004012. Date
5/10/04
----------------------------------------------------------------------------
Special Notes and
Comments
SB W/ TAILS. DOES
NOT INCLUDE
BLOCK .
WALLS, POOL/SPA, OR DRIVEWAY APPROACH.
75% PLAN CHECK FEE
DISCOUNT APPLIED
FOR
MULTIPLE,ISSUANCE
OF SAME PLAN
TYPE.'
-------------------------------_---------------------------------------------
Other Fees . . .
. .'. . .
ART IN PUBLIC PLACES -RES
104.63
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
18.47
DIF FIRE PROTECTION -RES
97.00
GRADING PLAN CHECK FEE
00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5.0,0
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
2-09.58
.00 .00
209.58
Other Fee Total
2552.28
.00 .00
2552.28
Grand Total
4324.06
.00 .00
4324.06