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04-4016 (SFD)t ul�trCv o a . BUILDING& SAFETY DEPARTMENT P.O. Box 1504 xfa V' -. ti (760)•777=7012 OF94%' 7_8_4.95 CALL MPICO FAX (760) 777-7011 (} A Q iNTA, C� IFORNIA 02253 INSPECTION REQUESTS (760) 777-7153 U - ` JUL 142004 BUILDING PERMIT _ App ica �o�n,,F, 'ger ... 04 00-004-016 Date 5/10/04 pt Pro tY�'d. �e 80385""TORREON WY' APN:- 772=250-997-139 -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..aD.UERMIT 73121 FRED WARING DRIVE, 4100' '890,1',E MOUNTAIN VIEW 200 PALM DESERT CA 92260 SCOTTSDALE AZ 85258 WCC:. RO.GAL &..HAMILTO WC:: WA26D004723013 09/01/04 CSLB.: .777699*-; 04./30/06 CCC: B. --------------------- - ---- Structure Information ----=------7------------- Construction Type . . . . . TYPE V - NON RATED Occupancy Type DWELLG/LODGING/LONG.<=10 Flood Zone . . . . . NON -AO FLOOD ZONE Other struct info CODE EDITION 20.01.CBC #'B E DROOMS .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 Feb 184.6.8 Issue Date . . . . Valuation 241854 Qty Unit Charge Per { Extension BASE FEE t 633.50 142.00 3.5000 THOU BLDG 100,001-500,000 �. 497.00 - --------------------------------------------------------------------------- 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 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: ( Date:—�.�-�� Applicant: Archite or Engineer: Applicant's Mailing Address.. Arc itect or Engineer's Address: Z! /I 7 I� GQIc. No.: C,2 BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION Fhere ffirm 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 andmyLicens is in full force and effect. 1�je Class License No._ 1 �'� /0 / ate — Contractor Vfrorn OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exethe 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 maintain workers' compensati •nsurance,'as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is iss'yed. My workers' compensation i rence carrier an poli y number e: artier 7`sw /�-/ M. ; ,. olicy Number _ I certify that, in the performance of the work for which this permit is issue , I shall noYemploy 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 tho ( provisions. ate •— 7 �� L pliant \,.ltXs-rte \ . WARNING: FAILURE TO SECURE WORKERS' PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAN�OLLARS ($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 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 Ouinta, 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. 1 agree to comply with all city and county ordinances and state laws relating to building const 'on, and hereby authorize presentatives of this county to enter upon the above-mentioned property for inspection purposes. at�-la'C1 Signature (Applicant or Agent): :! Page. Application.Number . . . . . 04-00004016 Date 5/10/0 Qty* Unit Charge Per Extension BASE FEE 15..0 2.00 9.0-000 EA MECH FURNACE <=1,OOK 18.'D0 ' 2.00 9.0000 EA MECH B/C.<=3HP/100K BTU 18.D0 6.00 6.5000 EA MECH VENT FAN 39.D0 1.00. 6.5000 EA MECH EXHAUST HOOD 6.) 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 11.51 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 3.0000 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 Extension BASE FEE 15.00 Special Notes and.Comments LOT 139.-2800 S.F. SFD. SEDONA Page 3 Application Number . . . . 04-00004016 Date., 5/10/04 Special Notes and Comments SB. 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..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 1562.2.0 .00 .00 1562.20 Plan Check Total 209.58 .00 .00 209.58 Other Fee Total 2552.28 .00 .00 2552.2'8 Grand Total 4324.06 .00 .00 4324.06