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04-3990 (SFD)a BUILDING & SAFETY DEPARTMENT P.O. Box 1504. 777-7012 OF I9 78-495. CALLE_'AMPICO FAX (760)777-7011 LA QBINTA, C°ALIFORNIA 92253 INSPECTION REQUESTS (760) 777-71.53 JJL 14200 BUILDING PERMIT Appli-caOtl-nn N&umber 04=0000.3.99-0 Date 5/10/C4 " Pro pertyrjtAddres"s r.,...-.--�:' . . . . :_80390 TORREON WY Ali 772-250-997-106 -31349. - Application.description . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . LOW DENSITY RESIDENTIAL. Application valuation 227594 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':' WA26DO04723013 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 495.00`. PATIO . SQ" FTG - 399.00 ..NUMBER OF UNITS 1.00 FIRST FLOOR SQ. FTG 2631. 00 Permit . . BUILDING PERMIT Additional desc,. , Permit Fee. 1087:.50. Plan Check 'Fee .... 706.•88 Issue Date Valuation . . . 227594 Qty Unit Charge Per Extension -BASE FEE 639.50, 128.00 3'.5000 THOU BLDG 100,001-500,000 448.,00 Permit. 'MECHANICAL- ECHANICALAdditional Additionaldesc .:Permit Fee 109.50 Plan Check'Fee . 27.38 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: 04 - 3112 Applicant: Applicant's Mailing Address: Gto l' off' Date: Arc itect or Engineer: Architect or Engineer's Address: Ic. No.: If -23 7 7 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 qdge and my Licee is in full force and effect. 6r icense Class FS icense No. 22 / 7 ate oontractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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 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 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 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' compensa ion insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is is—sueJd.My workers' co. ensation i rance carrier andpoJi number arier 5&77;1 cf Folicy Number k,0,0-671007% �aJ� _ 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 forthwitht�comply with t ose provisions. Date % ° 7 plicant�" WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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, 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. 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 const ction, and hereby authorize r presentatives of this county to enter upon the above-mentioned property for inspection purposes. ate -740 r,/ignature (Applicant or Agent): r s Page 2 Application Number .. . . . . 04-000'03990 Date 5/10/04 . Qty Unit Charge Per Extension BASE FEE 15'..00 12.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 9..0000 EA MECH B/C <=3HP/100K BTU 18'.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 116.99 Plan Check Fee 29.25 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 2631.00 .0350 `ELEC NEW RES -.1 OR 2 FAMILY 92.09 495.00, ---------------------------------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.90 Permit . . .: PLUMBING Additional desc Permit Fee . . . . 189.00". Plan Check Fee 47.25 Issue Date . . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.D0 20.00 6.0000 EA PLB FIXTURE 120.0 1.00 15.0000 EA PLB BUILDING SEWER 15.D0 1..00 7.5000 EA PLB WATER HEATER/VENT 7.?0, 1.00 3.0000 'EA PLB WATER INST/ALT/REP 3.D0 - 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.•D0 .6.00 .7500 EA PLB GAS PIPE >=5 4.50. 1.00 15.000.0 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 106. 2631 S.F-. SFD.. CAMINA s Page 3 . Application Number 04-0000399.0 Date. 5/10/04. Special Notes and Comments CONTEMPORARY. PERMIT DOES NOT INCLUDE. BLOCK WALLS, POOL/SPA, OR DRIVEWAY APPROACH. Other Fees . . . . . . . . ART IN PUBLIC.PLACES-RES 68.98 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC. -CENTER - RES 366.00 ENERGY REVIEW FEE. 70.69 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 22.75 DIF STREET MAINT FAC -RES 15.00 DIF.TRANSPORTATION -'RES 10.98.00 Fee summary Charged Paid, Credited' Due- Permit Fee. Total 1517.99 .0000 1517..99 PlaneCheck 'Total' 810.76 .00 00 810.76 Other Fee Total 2567.42. .,00. .00, 2567.42 Grand Total 4896.17 .00 .00 4896.17