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04-3987 (SFD)opo BUILDING & SAFETY DEPARTMENT B`o`x"1504qj (760) 777-7012 OFT1 x;78-49=5_CA-LLpqE s�AMPICO FAX (760) 777-7011 LA QUINTA, LS11, A"LIFORNIA 92253 INSPECTION REQUESTS (760) 777-71.53 JUL 4 2004 BUILDING.PERMIT WONAWEDEPT Appy cat on Number . . . 04-0000398x7 Date 5/10/34 Property Address . . . 80400 TORREON WY APN: '772-250-997-107'-31349 - Application description DWELLING,- SINGLE FAMILY DETACHED Property Zoning . . . . LOW DENSITY RESIDENTIAL. Application valuation '. 261546. Owner Contractor TOLL CA.V TOLL BROS, INC.. C/0 KEVIN D D.UERMIT 73121 -FRED WARING DRIVE, #100 `8901 E MOUNTAIN VIEW 200 PALM DESERT CA 92260 SCOTTSDALE .AZ 85258 WCC: ROGAL- & HAMILTO WC:' WA26DO04723013 09/0=/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 304.7.00 Permit . . . BUILDING PERMIT Additional.desc Permit Fee 1206-.50. Plan Check Fee 196.06 Issue Date Valuation ?�1�4F Qty Unit Charge Per, Extension BASE FEE 639.50 162.00 3".5000 THOU BLDG 10.0,001-500,000 567.00 ----.------------------------------------------------------------------------- Permit. MECHANICAL Additional desc Permit Fee 127.50 Plan Check Fee.. 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 4INSPECTIONS (760)'777-7153 BUILDING & SAFETY DEPARTMENT Application Number: d 4 Sq Is Date: 7-/-3-0y Applicant: Applicant's Mailing Address: GD Arch' ect or En ineer: ��/I Architect or Engineer's Address: T -,-//e-- A 1,A2 Ic. No.: e -o;? -3 �>2 2 BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereb (firm under penalty of perjury that I am licensed under visions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Co and my Lice is in full force and effect. t)p!� cense Class icense No. / f 7 LO nfl l ate ontractor QJ _Y OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 am exe from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city orcounty 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 theapplicant to a civil penalty of not more than five hundred dollars ($500).): U 1, 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 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' compens ion insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is �issued. My workers' mpensation i%rance carrier and policy number re: Cartier �- AtW )' 141�1,;�o�o.Plice Number A la DOci 5� 7� LL3 _ I certify that, in the performance of the work for which thispermit 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. 7 -/3 -r, WARNING: FAILURE TO SECURE WORKERS' COMP NSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND Q9LLARS ($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 pedury 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 .1 Lender's Address IV 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 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 7Dte ntatives of this counnty to enter upon the above-mentioned property for inspection purposes. y gnature (Applicant or Agent): a -� Page .2 Application.Number . . 04-00003.987 Date 5/10/04 Qty. Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K' 27.30 3.00 9.0000 EA MECH B/C-<=3HP/100K BTU 27.D0 8.00 6.5000 EA MECH VENT FAN 52.D0 1.00. 6.51000 EA MECH EXHAUST HOOD 6.50 Permit ... . . . ELEC-NEW RESIDENTIAL Additional'desc . Permit Fee . . . . 134.15 Plan Check Fee 8.39 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 .0200 ELEC ,GARAGE OR NON-RESIDENTIAL'' 12.50 ---------------------------------------------------------------------- Permit . . . . . . PLUMBING, Additional desc'. . Permit Fee .. 207.75 Plan Check Fee 12.99 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 7.5000 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 7.00 .7500 EA PLB GAS PIPE >=5 5.25 s 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 107. 30'47 S.F. SFD. BELIZE SB W/ r J Page 3 Application Number . . ... . 04-00003987' Date 5/10/04 Special Notes` and Comments ' TAILS. PERMIT DOES NOT INCLUDE BLOCK WALLS,.POOL/SPA,OR DRIVEWAY APPROACH. PLAN CHECK FEE REDUCTION APPLIED FOR MULTIPLE ISSUANCE OF SAME PLAN TYPE. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 153.86 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 19.61 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 1690.90 .00 .00 1690.90 Plan Check Total 225.41 .00 .00 225.41 Other Fee -Total 2604.62 .00 .00 2604.62 Grand Total 4520.93 .00 .00 4520.93 S