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04-4013 (SFD)_ acv BUILDING & SAFETY DEPARTMENT C T �IO"�BOx 1504_ (760),777-7012 OFT9 CAi> NTP MPIco FAX (760) 777-7011 L Qu N C+A�IFORNIA 92253 INSPECTION REQUESTS (760) 777-71.53 JULY cNVOFe.AutA BUILDING PERMIT r-IMANCE DEQ Application Number . . . . . (04_0.0.0.04.0-13 Date 5/10/04 . Property Address . . . . . 80410 TORREON.WY APN: 772 -250 -997 -108' -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, #100 8901 E MOUNTAIN VIEW.200_ PALM DESERT CA -92260 SCOTTSDALE AZ 85258 WCC: ROGAL & HAMILT.0 WC:.. WA26D004723.0.13 09/01/,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 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 184.68 Issue Date Valuation . . . 241854 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 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 4 4a INSPECTIONS (760)'777-7153 BUILDING & SAFETY DEPARTMENT Application Number: ��% �D/3 Date: Applicant: Applicant's Mailing Address: yn Aj3Wtect or Engineer: 4 /v/% Architect or Engineer's Address: ic. No.: C.`-3 7 7 ,51 BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hergy affirm under penalty of perjury that I am licensed under rovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals rand my Lice. is in full force and effect. �7 7 se Class g ,cense No. �! b / v OWNER -BUILDER DECLARATION hereby affirm under penalty of perjury that I 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 fora 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. B.& P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 1 have and will maintain a certificate of consent to self-insurefor workers' compensation, as provided for by Section 3700 of the Labor Code, forth e performance of the work for which this permit is issued. I have and will maintain workers' compen on insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' co ensation ' surance carrier and poli y number are: artier L?�E�(T`l ,C.Ic%T,9-E /Policy Numberltze f�00V7-230/3 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 forthwith comply with)h'ose provisions. 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 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. I certiat 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 con ction, and hereby authonz representatives of this county to enter upon the above-mentioned property for inspection purposes. Date 9O ignatura (Applicant or Agent)`. i�!L? Page. t -2 Application Number 04-00004013 Date 5/10/04 Qty Unit Charge J Per Extens=on BASE FEE 15.00 2.00 9.0000 EA MECH.FURNACE <=100K 18 00 2.00 9.0000 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 ti Permit . . . . . .. ELEC-NEW RESIDENTIAL Additional desc Permit Fee 125.20 Plan Check Fee 7.06 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 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.' 5006 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 108. 2800 S.F. SFD. SEDONA Page 3 Application Number 04-00004013 -Date 5/10/04 ----------------------------------------------------------------------------- Special Notes and Comments CONTEMPORARY. 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 1562.20' .00 .00 1562.20 Plan Check Total 209.58 .00 .00 209.58 Other'Fee Total 2552.28 .00 .00 2552.28 Grand,Total. 4324.06. .00 00 4324.06