04-3515 (SFD)P.O. Box 1504 UL;=
78-495 CALLS TAMPICO
LA QUINTAL CALIFORNIA 9 2,551 F._ -1NAN�t�NW-E•f
BUILDING PERMIT
cu
ING & SAFETY DEPARTMENT
(760)777-7012
FAX (760) 777-7011
REQUESTS (760) 777-7153
Application Number
04-00403'515.,
Date 4/27/04
Property Address . .
. . . 51781 EL DORADO DR
APN:
772-250-996-166 -31349 -
Application description
DWELLING - SINGLE FAMILY
DETACHED
Property Zoning ..
LOW DENSITY RESIDENTIAL
..Application valuation.:.
311768
Owner
Contractor
TOLL CA V
TOLL BROS, INC.
C/O KEVIN D DUERMIT
73.121 FRED WARING
DRIVE, #100
8901 E MOUNTAIN VIEW
200 PALM DESERT
CA 92260
SCOTTSDALE
AZ 8.5258
WCC: ROGAL &
HAMILTO
WC:. WA264DO0472301
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
-------------- --------------------------------------------------------------
Permit
BUILDING -PERM -IT
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
155.84 Plan Check Fee
9.74
Issue Date.. . . . .
Valuation
0
Qty Unit Charge Per Extension
P.O. BOX 1504a QUWCV
YOKE (760) 777-7012
7E-495 CALLS TAMPICO FAX (760) 77747011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
Date:
Architect or Engineer.
Architect or Engineer's Address:
Lic. No.
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirmunderppeesnalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and PiolessionMs
CodeLicense and LS in tui force and effect. License No,
Dale • ! / � ' V �/ Contractor_ r O 5
OWNERi3Ua.DER DECLARATION
I hereby affirm under penalty of perjury that I am axemmpt from the Contractors' State Lloerse Law forte following mason (Sec 7031.5. Business and Professions Code. Any
city or county dist requires a permit to construct. cher. Impwe, dervish or repair any structure. prior b its issuance. also requires the sppk:wt for ria P«mlt b W a signed
shtenwit that he or she is licensed pursuant to the provisions of the Contractors' State llown 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 subOcts
the applicant to a cavi penalty of not more than five hundred doiaa (M).r
U I. as owner of the property. or my employees with wages as their sole compensatim wi do the work and the structure Lure Is not intended or oft for sate (Sec 7041.
Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who bolds or improves thereon. and who does the work
himself or herself or Brough his or her own employees, provided that the improvemerks aro not intended or offered for sale. If. however. the building or irtprovernent is
sold within one year of conpiebix the owner builder wit have the burden of prow" that he or she did "build or improve forge pwpose of sale.).
(..) I, as owner of the pop". am exclusively contracting with ioensed contractors b construct the project (Sec. 7044. Business and Piofessias Code: The ConiacloW
State License Law does not apply ban owner of property who builds or improves theieor>, and who contracts for the projects with a oanbacton(s) ioensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec . B.3 P.C. for this mason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the btowi g deckwations:
_ 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 perfomnanoe
of the work for which this pemmilis issued.
I have and w N maintain workers' compensation insurance. as required by Section 3700 of the Labor Code. for the performance a the work for Whid "tis permit is
issued My wakens' —,%p sstion isurmoe carrier and poky number are:
Carrier �Ve G q j -t N A wt -► I ioPoicy Number tai A �;L A _eL )i G O 44,)& a,&0
_ I certif r 1A in the pulomance of the work for %+k h this pon it is issued. I shall not ernpioy any person in any mariner so as to beocn subject to the workers'
eakmpersa6on hos of Cailoria. and. agree Bat. N 1 should beeot. subject b the workers' eonpensation provisions kK Section 3700 of the Labor Code, l shat
forthwith tampty with those provisions.
Date A,(- a - d c/ ApOcant YVl : 11 T- /°et. L ti N
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ANO SHALL SUBJECT AN EMPLOYER TO CRW*4AL PENALTIES ANO
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 ATTORNEYS FEES. .
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that two is a construction lermdrmg agency for the pedemance of the work for which dos permit is issued (Sec. 3097. CN. C.).
Lenders Name
Lenders Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application los hereby mm*de to the Dkecbr of Budding and Safety ter a pemmH subject to the conditions and resbictions set lodh on "is application.
1. Each person upon whose behalf this application is made. each Person at whose request all for whose benefit work los performed oder or pursuant to any porn*
Issued as a result of this application, the owner. and the appieant, each agrees to. and shat. defend, indemnify and hold harmless the City of V Quills, its
officers. agents and employees for any act or omission related to the work being performed under or following issuance of thls permit.
2. Any permit issued as a result of this application becomes nut and void N work is not commenced within 150 days from date of issuance of such pentyl or
cessation of work for 150 days wil subject permit to cancellation.
I cer4fy that I have read this application and state that the above information is correct. 1 agree to corply with ori city and county ordinances and state haws relating b tuYding
oonsvuction, and hereby authorize representatives of this county to enter upon the above.rendiwmed property for inspection purposes.
.ate L .o c.l Signature (Applicant or Agentr ' • J //�/J�
c
Application Number
. . . . 04-00003515
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-50'OKBTU
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 166 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
04-00003515 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.
----------------------------------------------------------------------------
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