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04-3516 (SFD)r BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760) 777-7012 78-495 CALLS TAMPICO— FAX (760) 777-7011 LA QUINTA, CALIFORNIPr22.1.4 UllLS.PEqP1,,1ON REQUESTS (760) 777-7153 Application Number . . Property Address . . . APN: Application description Property Zoning .Application valuation.. BUIL '1W0kR, MIT004 1J ($%!0�0�0�35a161 Date 4/27/04 772-250-996-169 -31349 - . . . DWELLING - SINGLE FAMILY DETACHED LOW DENSITY RESIDENTIAL 311768 Owner Contractor - --=------------------ TOLL CA V -- ------------------------ TOLL BROS, INC. C/O KEVIN D DUERMIT 73121 FRED WARING DRIVE, #100 9901 E MOUNTAIN VIEW 2.00 PALM DESERT CA 92260 SCOTTSDALE AZ 85258 WCC: ROGAL & HAMILTO WC: WA264D004723.01 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 FIRE.SPRINKLERS NO GARAGE SQ FTG 721.00 ;PATIO SQ FTG 435.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 3612.00 ------------------------------------------------------------------------------ Per-mit - . . . . . . BUILDING PERMIT - - Additional desc Permit Fee 1381.50 Plan Check Fee 224.50 Issue Date Valuation .311768 Qty Unit Charge Per, Extension BASE FEE 639.50 212.00 3.5000 THOU BLDG 100,001-500,000 742.00 --------------------------------------------- Permit . . . . . ------------------------------ ELEC-NEW RESIDENTIAL Additional desc Permit.Fee 1.55.84 Plan Check Fee 9.74 'Issue Date.. . . . . Valuation 0 Qty Unit Charge Per Extension • agwo P.O. Box 1504 VOICE (760) 777-7,Q12 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIANIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Date: Applicant: Applicant's Mailing Address: Architect or Engineer. Architect or Engineer's Address: Lic. No.. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTORS DECLARATION 1 hereby afrem under penalty d perjury that 1 am imnud under provisions d ChWW 9 (oamrnenck with Section 7000) d Division 3 cite Business and Probssionsls Code. and my in full fame and ellecl. License Class License No. 7 7� 9 9 17ab ti- o"Z 9 - o �1 contractor- OWNER -BUILDER DECLARATION I hereby alum under penally Of VerJWy that I am exempt from the Contractors! State License Law for" following reason (Sec. 7031.5. Business and Professions Coda: Any city or county that Iegrwes s permit b eonsbuct atter. improve. denroisfh. or repair any strum,lure, prior to its issuancealso requires the applicant far the permit lobe a signed stalenmarrt that he or she N licensed pursuant b the provisions aline Coniraelons' State License Law (Chapter 9 (conrnencing with Section 7000) of Division 3 d the Business and Professions Code) or that he or she is exempt therehomn and the basis forte alleged exenrmptiorL Any violation d Section 7031.5 by any sppicant for a permit subjects the applicant to a cavi penalty of not more than live hundred Adams (5500).r U 1. as owner of the property. or my ermpioyees with wages as their sob compensation, will do the work, and the structure is not inbrhded or offered for sale (Sec. 7044. Business and Professions Code: The CorMrsclons' Stab License Low does not appy to an owner of property who builds or improves therem and who doss the work himself or herself or trough his or her own employees, provided fiat the improvements are not kdended or offered for sale. if. hhowever, the Wilding or improvarent is sold within one year d conpletionh, the owner- itder will have the burden of proving that he or she did not build or improve for the purpose of ssle.� U 1, as owner of the property. am exdusively contracting with licensed confraciors Io construct the project (Sec. 7044. Business and Professions Code: The Connaaclors• State License Law does not appy to an owner d property who builds or improves thereon, and who contracts for" projects with a eontractor(s) boensecipursuant b the Cont actore state License Law.). U I a n exempt under Sec . 64 P.C. for this mason Date Owner WORKERS• COMPENSATION DECLARATION I hereby strum under penalty d perjury one of" kAowk declarations: _ 1 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 Pedamanoe d the work for which this petit Is issued _ I have and will maintain workers' eommpermlion irhsuxanee. as required by Section 3700 d the Labor Code, for the performance d the work for which this permit is issued. My workers compention insurance carrier and number aro: Carrier asae a at I + H% •r. , r +dPoicy. Nhrnber i qp 6 SIC 11 e 6 U> a g a 1 caffly1hak in the performance at the work ter which this peri a issued. I shall not empioy any person in any mater to as to beconhe subbed b the workers' compensation taws of Caifonhia, and agree that. if I should become subject to the workers' compensation provisions of Section 3700 Otto Labor Code, I" kxthwithh comply with those provisions. Date Y" a Of Applicant 'Vi 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 ($/00.000). IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. MEREST, AND ATTORNEYS FEES. . CONSTRUCTION LENDING AGENCY 1 hereby affirm under penalty of perjury that two b a construction lendwp agency for the perfa mance of the work for which this permit is issued (Sec. 3097. Civ. C.). Lenders Name Lenders Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application Is hereby made to the Director of B%"ng and Safety for a permit su4ecl to the conddtions and restrictions set Soft on tis appicabom 1. Each person upon whose belhalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to arry permit Issued as a result of Omit appieatiorh, the owner. and the appiaK each sprees to. and shall, defend. indemnify and hold hhatdess the City of La Omuta, Its officers, agents and employees for any act or omission rotated to the work being performed under or following issuance of this permit. 2 Any permit issued as awe" of this application becomes null and void 11 work is not eomrneneed within 160 d4Ys from date of issuance of such pennll or cessation of work for 180 days will subject permit to cancellation. 1 certity Drat 1 have read this application and state that One stove information 13 Correct I agree to comply with si city and county ordinances and state laws relating a building constructow% end thereby authorize representatives of this county to enter upon the above- mmentioned property for inspection purposes. Date 4/ ^ 2 V -•O `'/ Signahxe (Appfhcant orAge Q. Application Number 04-00003516 Page 2 Date 4/27/04 Qty Unit Charge Per Extension BASE FEE 15.00 3612.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 126.42 721.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 14.42 -------------------------------=-------------------------------------------- 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 ---------------------------- Permit; ------------------ MECHANICAL =------------------------- ---- Additional desc . Permit Fee 169.50 Plan Check Fee 10.60 Issue Date . . . . Valuation . . . . 0 Qty' Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA_ MECH FURNACE <=100K 27..00 3.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 49.50 11.00 6.5000 EA MECH VENT FAN 71.50 1.00 6.5000 EA MECH EXHAUST HOOD 6..50 ---------------------------------------------------------------------------- Permit .... PLUMBING Additional desc . .Permit Fee 225.75 Plan Check Fee 14.11 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 26.00 6.0000 EA PLB FIXTURE 156.00 .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 ----------------------------=----------------------------------------------- Special Notes and Comments SFD LOT 169 PLAN.3612. PERMIT DOES NOT Fee summary ----------------- Permit Fee Total Plan Check Total Other Fee Total Grand Total Charged Paid 1947.59 Page 3 Application Number 04-00003516 Date 4/27/04 --------------------------------------------------.-------------------------- Special Notes and Comments .00 INCLUDE BLOCK WALL, POOL, SPA OR DRIVEWAY APPROACH. 75% REDUCED PLAN CHECK FEE FOR MULTIPLE ISSUANCE OF SAME PLAN TYPE. ---------------7-----------------------------------------------------7------ Other Fees . . . . . . ART IN PUBLIC PLACES -RES 279.42 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER- RES 366.00 ENERGY REVIEW FEE 22.45 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 31.17 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Permit Fee Total Plan Check Total Other Fee Total Grand Total Charged Paid 1947.59 .00 258.95 .00 2738.04 .00 4944.58 .00 Credited Due .00 1947.59 .00 258.95 .00 2738.04 .00 4944.58 s