04-5502 (SFD).i
LoLlwl .1
Z P.O. Box 1504
X4.9 78-495--C° DUMTAMPICO
DLA„QpUINTA?�CALIFORNIA 92253
IPO BUILDING PERMIT
F C17Y0
Application Number�a
Property Address . . . . . .
APN:
Application description . . .
Property Zoning . . . . . . .
Application valuation . . . .
Owner
TOLL CA V
C/O KEVIN D DUERMIT
8901 E MOUNTAIN VIEW 200
SCOTTSDALE AZ 85258
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) .777-7153
04 000055-02_-� Date 7/15/04
80310 TORREON WY
772-250-997-98 -31349 -
DWELLING - SINGLE FAMILY DETACHED
LOW DENSITY RESIDENTIAL
261546
Contractor
TOLL BROS, INC.
73121 FRED WARING DRIVE, #100
PALM DESERT CA 92260
. Qty Unit Charge Per
Extension
WCC: LIBERTY
MUTUAL
WC: WA26DO04723013 09/07./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
625.00
PATIO SQ,FTG
233.00
NUMBER OF UNITS
1.00
FIRST FLOOR SQ FTG
.3047.00
Permit . . . . . .
BUILDING PERMIT
Additional desc
Permit Fee
1206.50 Plan Check Fee
196..06
Issue Date . . . .
Valuation . .
. . 26146
Qty Unit Charge
Per
Extension
BASE FEE
639.50
162.00 3.5000
THOU BLDG 100,001-500,000
567'.00
----------------------------------------------------------------------------
Permit . . . . . .
MECHANICAL
Additional desc
Permit Fee
127.50 Plan Check Fee
7.97
Issue Date . . . .
Valuation
0
. Qty Unit Charge Per
Extension
P.O. BOX 1504 • ��rh�
VOICE (760) 777-7012
78-495 CALLS TAMPICo FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 44INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
e �
Application Number:
Applicant:
Applicant's Mailing Address:
17
SSU a
Date:
—Architect or Engineer:
Cra►q V. s►-�►� h .
Architect or Engineer's Address:
Lic. No.: C Z!32, 79
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
e, and my License "s in full force and effect. : �/
License Class License No. 777 IP l r
--bate 1104 o�C ntractor To l l R r1c, ')1 ev 5
OWNER -BUILDER DECLARATION
I 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 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. B.& P.C. for this reason
Date
WORKERS' COMPENSATION DECLARATION
1 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' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My workgrs' compensation��ance carrier and- policy number are:
�er 66*4/ AWW4lcy Number- W A2AP O O . % 2,30 (ij
_ I certify that, in the performance of the Oork 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.
M
A ey
WARNING: FAILURE TO SECURE WORK�RSCOMPENSATION 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
IMPORTANT APPLICANT ACKNOWLEDGEMENT
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. I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
.4ate 3�101tSign" ature(ApplicantorAgent):
r.
Page
2
Application Number
.
. .
. . 04-00005502
Date
7/15/04
Qty' Unit
Charge-
Per
Extension
BASE
FEE
15.00
3.00
9.0000
EA
MECH
FURNACE <=100K
27.00
3.00
9.0000.EA
MECH
B/C <=3HP/100K BTU
27.00
8.00
6.5.000
EA
MECH
VENT FAN
52.00
1.00'
6.5000
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
Extens-on
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
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
----------------------------------------------
SFD - LOT -98.
3047 S.F.BELIZE
SB.
I
Page 3
Application Number . . . . .
04-00005502 Date
7/15/04
----------------------------------------------------------------------------
Special Notes and Comments
PERMIT DOES NOT INCLUDE BLOCK
WALLS,
POOL/SPA,OR DRIVEWAY APPROACH.
75% 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
I