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04-3696 (SFD)�F�Q�rw BUILDING & SAFETY DEPARTMENT P.O. BOX 1504 (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 Application Number . . Property Address . . . APN:- Appl.ication description Property Zoning , ..Application valuation.. BUILDING PERMIT .04-0'0003696 Date 4/26/04 . . . 81380 GOLF VIEW DR 762-410-023-23 -28838 - . . . DWELLING - SINGLE FAMILY DETACHED . . LOW DENSITY RESIDENTIAL . 376373 Owner ------------------------- TOLL CA V C/O KEVIN D DUERMIT 8.901 E MOUNTAIN VIEW 2.00 SCOTTSDALE AZ 85258 .Contractor ------------------------ TOLL BROS, INC. 73121 FRED WARING DRIVE, #100 PALM DESERT CA 92260 WCC: ROGAL & HAMILTO WC: WA264D00472301 09/01/04 CSLB: 777699 . 04/30/06 CCC:. B --------------------------- Structure Information -------7----------------- 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 730.00 PATIO. SQ FTG 650.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 4374.00 Permit BUILDING PERMIT_ Additional desc Permit Fee 1609.00 Plan Check Fee 261.46 Issue Date Valuation .37637.3 Qty Unit Charge Per Extension BASE FEE 639.50 277.00 3.5000 THOU BLDG 100,001-500,000 - 969.50 -------------------------- Permit ------------------=------------- ELEC-NEW RESIDENTIAL ----------------- Additional desc - Permit.Fee 182.69 Plan Check Fee �i11.42 Issue Date . . �- Valuation =.'" `_� ;� 0 Qty Unit Charge Per ,w 2 �� ' EXt� nsion r P.Q. Box 15044 QUM& VOICE (760) 777-7012 78-495 CALLE TAM►ICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Date: Applicant: Applicant's Malting Address: Architect or Engineer. Architect or Engineer's Address: Lic. No. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 hereby atrxm under penaty of perjury that I am licensed under provisions d Cthapter 9 (commencing wlh secion 7000) d Division 3 d the Business and Prokssionals CGb in full tomand effect License No. `7 l., Lit Gi • •SIMF WOsJr OWNER -BUILDER DECLARATION 1 hereby aflxmn under penafty of pajury that I am exempt from the Contracfois' Stale License Law for the fokw* reason (Sec. 7031.5. Business and Piolessions Coda: Any city or county that ►-quires a permit to construct atter, knprove, demolish, or repair any strucum Prior to Its issuance. also requires the applicant for the permit to Us a signed statement that he or she Is licensed pursuant to the provisions of" Contractors' State License Law (Chapter 9 (oommenekW with Section 7000) of Divislor 3 d the Business and Professions Code) or that he or she Is exempt rieehom and the basis br the ~exemption, Any violation d section 7031.5 by any appieant for a permit subjects the applicant to a dvi penally of not more than the hundred doians (SSW) -r U 1. as owner of the property. or my employees with rtrapes as Iheir sale compensation, wN do the work and the structure Is not inlernded or offered for sale (Sec. 7044. Business and Professions Code: The Contractors' State License Law does not appy to an owns of property who builds or improves thereon, and who doss to work himself or herself or trough his or her own a mpbyeea. provided that the improvements are not intended or dto for sale. If. however. the buirliN or inpovement is sold within one yea d completions the owner -builder will have the burden of proving that he or she fid not build or improve ter the purposed sale.). U Las owner of the property. am aadusivey contracting with ieensed contractors b construct the project (Sea 7044. Business and Piofesst0ns Code: The Contactors' State License Law does not apply to an owner of property who bunds or npoves vweon, and who contracts for the projects with a contactors) licensed pursuant 10 the Contractors' stale License Law.). U I am exempt under Sec. . BA P.C. for this reason DateOwner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury ore of the folowirg declarations: _ I have and will maintain a certificate of consent to sell -insure for wakes' compensation, as provided for by Section 3700 of the Labor Code. for the performance of the work for which this per.. it Is Issued. I have and will maintain workers' compensation insurance. as required by section 3700 of the Labor Cafe. for the performance of the work ter wthich this permit is sued. Mty a' oor(tp rr��cstim0n insurance carrier a�nd,poicy number ace: Cartier kQ' lc � s P-t'V4poky Number 1x3A 2=d U Q fent 1) Z 0 l _ I 1hak in the perlonnance of tie work for which this pemtit is issued. I sh I not employ any person in any manner so as to became subject to the workers' con w sstion laws d California, and agree stat. V I should become subject to the workers• compensation provisions d Section 3700 of the Labor Code. I sthai forthwilh eorpy wqh those provisions. Date 'U h-0-46 U AppliWmR 1fJ l 1 � {{�Slr S WARN : FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL. AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HJNDRED TMOUSMID 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 penally of perjury that rine is a construction lendirhg agency for the performance of" work for which this permit is issued (Sec. 3097. Ch. C.). Lendees Name Lender's Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application Is hereby m*de to the Director d eullding and Safety Sot a pemdt subject to the conditions and restrictions set Soft on Olds appiarWL 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 Pamdl Issued as • result of thii application, the owner. and the applicant, each agrees to, and shall. defend, indemnify and told hamdess the City d La Ourinla. Its officers. agents and employees for any act or omission related to the work being performed under or tobowmg Issuance of this permit 2- Any pen it Issued as a result of this application becomes null and void U work is not commenced within ISO days from date d issuance of such Pani or cessation of work ter 180 days will subject Pam* to cancellation. 1 certify that 1 have read this application and state that the above intomnation I$ correct. I agree to comply with a6 city and county ordinances and state twos relating to building construction, and hereby authorize representatives Of this county to anter upon the above- mentioned property for inspection purposes. Date � � Signature (Applicant a Agent): 7 Application Number . . . . .. 04-00003696 Page 2 Date 4/26/04 Qty Unit Charge Per Extension BASE FEE 15.00 4374..00 .0350 ELFC NEW RES. -'1 OR 2 FAMILY 153.09 730.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 14.60 -----------------------------------------------------------------.----------- 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 . . . . 156.50 Plan Check Fee .9.78 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 .9.00 6.5000 EA MECH VENT FAN 58.50 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 -------------------------------------------------------------------=-------- Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 216.00 Plan: Check Fee 12.10 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension 'BASE FEE 15.00 24.00 6.0000 EA PLB FIXTURE 144.00 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 10.00 .7500 EA PLB GAS PIPE >=5 7.50 1.00 15.0000 EA PLB GAS METER 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 11.VENTANA-A/4'/CASITA.75% Iq ..t Page 3. Application Number . . . 04-00003696 Date 4/26/04 ------------------------------------------ Special Notes and Comments -------.--------------------------- REDUCED PLAN CHECK FEE FOR MULITPLE .ISSUANCE OF SAME PERMIT TYPE. PERMIT DOES NOT INCLUDE BLOCK WALLS,POOL,SPA OR DRIVEWAY APPROACH --------------------------------------------------------------------- Other Fees . . . . . . . . ART IN PUBLIC PLACES -RES ------- 440.93 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER -RES 366.00- 66.00ENERGY ENERGYREVIEW FEE 26.15 DIF FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK FEE 00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC - RES 16.00 DIF PARKS/REC - RES 502.00 STRONG MOTION (SMI) - RES 50.51 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due Permit Fee Total 217.9.19 .00 .00 2179.19. Plan Check.Total .294.76 .00 .00 294.76 Other Fee Total 2933.59 .00 .00 2933.59 Grand Total 5407.54 .00 .00 5407.54