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04-5801 (SFD)4 v' P.O. BOX 1504 78-495 CALLE TAMPICO LA Q.UINTA, CALIFORNIA 92253 .. BUILDING PERMIT Application Number . 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 04-00005801 Date 8/02/04 51305 EL DORADO DR 772-250-996-183 -31349 - DWELLING - SINGLE FAMILY DETACHED LOW DENSITY RESIDENTIAL 322996 Contractor ------------------------ TOLL BROS, INC. 73121 FRED WARING DRIVE, #100 PALM DESERT CA 92260 WCC: LIBERTY MUTUAL 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 FIRE SPRINKLERS NO GARAGE SQ FTG 756.00 PATIO SQ FTG 444.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 3741.00 -----------------------------------------------=------------------------.--- Permit . . . . ... BUILDING PERMIT `. Additional desc Permit Fee . . . . 1420.00 Plan Check Fee 230.75 Issue Date . . . Valuation . . . . 322996 Expiration Date 2/02/05 Qty Unit Charge Per O Extension BASE FEE O 639.50 223.00 3.5000 THOU BLDG 100,001 5'.0,000.%% 780.50 ----- ----------------------- - - ^ ---AV,-- -- - - - - - - - - - - - -- Permit . . . . . . MECHANICAL Additional desc ^� Permit Fee 103.00 Plan PYC Fee 7.38 Issue Date . . . . ala\luau~�i`on . . . . 0 Expiration Date'. . 2/02/05 P.O. Box 1504�� VOICE (760) 777-7012 T-Vf 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: O Date: ` Applicant: �Ochitect or Engir4er: Applicant's Mailing Address: hi!04Cr En jneer's Address: Z G� Gapes �� Lic. No.. n .>5? Z--7 r; BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under a of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Cede, and my Licens u force and effect. ,/ /) ioense Cl ss 1---L Lic(ense No. ata 1C1 I -7/t.4C/ctor -1 n 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 ft 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 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of erjury one of the following declarations: _ I have and will mai ain 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 ich this permit is issued. I have and will intain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is ss ers' n"74tion insur cam ran c ber are' �rier cy Number ! /� _ I certify that,n he performance of the work for which this permit is issued, I shall not employ an person in any manner so as to become subject to the workers' compens tion 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 forth th mply with those pr 'ions. /B3fe / plicant WARNING: FAILURE TO SECURE WORKERS' COM SATION 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 /j Lender's Address fel 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 constructio and hereby authorize representatives of this county toe err upon the above-mentioned property for inspection purposes. Date Signature (Applicant or Agent): Application Number . . . . . 04-00005801 Page 2 Date 8/02/04 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00, 9.0000 EA MECH BIC <=3HP/100K BTU 18.00 .00 16.5000 EA MECH BIC >3-15HP/>100K-500KBTU .00 7.00 6.5000 EA MECH VENT FAN 45.50 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit . . . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 161.06 Plan Check Fee 9.12 Issue.Date Valuation . . . . 10 Expiration Date 2/02/05 Qty Unit Charge- Per Extension BASE FEE 15.00 3741.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 130.94 756.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 15.12 --------------- Permit . ------------------------------ . . . . . ------------------------------- PLUMBING Additional desc Permit Fee 195.00 Plan Check Fee 12.19 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/02/05 Qty Unit Charge Per Extension BASE FEE 15.00 21.00 6.0000 EA PLB FIXTURE 126.00 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 ------------------=------------------------------------7'-------------------- Permit . . . . . . GRADING PERMIT Additional desc Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/02/05 Qty Unit Charge Per Extension I' Page 3 Application Number . . . . . 04-00005801 Date 8/02/04 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 183 SANTA ROSA-A/41EX. PATIO. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. 75% REDUCTION TO PLAN CHECK FEE DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE ---------'------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLI.C,PLACES-RES 307.49 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 23.08 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 32.29 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged Paid Credited ---------------------------------------- Due Permit Fee Total 1894.06 .00 .00 1894.06 Plan Check Total 259.44 .00 .00 259.44 Other Fee Total 2767.86 .00 .00 2767.86 Grand Total 4921.36 .00 .00 4921.36