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04-5101 (SFD)Applicat'f'3 Number . . . Property Address . . . . APN: Application description Property Zoning . . . . . Application valuation . BUILDING & SAFETY DEPARTMENT (760) .777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 ILDING PERMIT `04--',ob005101- Date 6/25/04 81405 GOLF VIEW DR 762-410-040- - - DWELLING - SINGLE FAMILY DETACHED LOW DENSITY RESIDENTIAL 365747 Owner Contractor ------------------------ ------------------------ SRHI TOLL BROS, INC. C/O RIELLY HOMES INC 73121 FRED WARING DRIVE, #100. 3 CORPORATE PLAZA DR 210 PALM DESERT CA 92260 NEWPORT BEACH CA 92660 Qty Unit Charge Per Extension WCC: LIBERTY MUTUAL '. WC: WA26DO04723013 09/01/04 CSLB: 777699 04/30/06 CCC: B -------------------------- Structure Information ------------------------- Constr uction Type . . . TYPE V -. NON RATED Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Flood Zone .. . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CRC FIRE SPRINKLERS NO GARAGE SQ FTG 785.00 PATIO SQ FTG 1058.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG .4162.00 ---------------------------------=------------------------------------------ Permit . . ... . . .BUILDING PERMIT Additional desc Permit Fee . . . . 1570.50 Plan Check Fee 255.21 Issue Date Valuation . . . . 365747 Qty Unit Charge Per Extension BASE FEE 639.50 266.00 3.5000 THOU BLDG 100,001_500,000 931.00 ------------------------------------------- Permit .. . . . . . --------------------------------- MECHANICAL Additional desc Permit Fee . . . . 139.00 Plan Check Fee 8.69 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension P.O. BOX 1504 • '�C��� 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 1 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 BUILDING 8t: SAFETY DEPARTMENT Application Number: Date: Applicant: Applicant's Mailing Address: C"IP --Architect or Engineer: Architect or Engineer's Address: Lic. No.: 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 Code, and my License full force and effect. Q �icense Class /License No. --77-7,9 i /Date 7 �ntra 'octor— OWNER$UILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt tram 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 constrict, 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 isnot 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 1, 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 Owner WORKERS' COMPENSATION DECLARATION I 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 -4of 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 /— �i issue My yvgrker;�oPmperrsation ince carrier and policy number are: Carrier v ✓1,x,7 / iP"oli Number keA26_>a04 7230 /3 I certifyat, in the performance of the work 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. 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 ($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 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, indemnify and hold harmless the City of La Quints, 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. ate2� Signature (Applicant or Agent): 01*_�_�� l Application Number . . , . 04-00005101 Page 2 Date 6/25/04 Qty Unit Charge Per Extension BASE FEE 15.00 4.00 9.0000 EA MECH FURNACE <=100K 36.00 4.00 9.0000 EA MECH B/C <=3HP/100K BTU 36.00 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 . . . . 176.37 Plan Check Fee 11.02 Issue Date Valuation . . . . 0 A'= - Qty Unit. Charge Per Extension BASE FEE .15.00 4162.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 145.67 .- 785.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 15.70 -----=---------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 235.50 Plan Check Fee 14.72 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 27.00 6.0000 EA PLB FIXTURE 162.00 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 12.00 .7500 EA PLB GAS PIPE >=5 9.00 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 40 PLAN CABRILLO CONTEMP 4162 1' _ N^ Fee summary Charged Permit Fee Total 2136.37 Plan Check Total 289.64 Other Fee Total 2881.45 Grand Total 5307.46 Paid Credited Due ---------- ---------- ---------- .00 .00 2136.37 .00 .00 289.64 .00 .00 2881.45 .00 .00 5307.46 Page 3 Application Number . . . . . 04-00005101 Date 6/25/04 ---------------------------------------------------------------------------- Special Notes and Comments S.F. PERMIT DOES NOT INCLUDE BLOCK WALL, POOL, SPA OR DRIVEWAY APPROACH. 75% PLAN CHECK REDUCTION APPLIED FOR MULTIPLE ISSUANCE OF SAME PLAN TYPE. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 414.36 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CEN'=ER - RES 366.00 ENERGY REVIEW FEE 25.52 DIF FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES - RES 225.00 DIF PARK MAIN- FAC - RES 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION (SMI) - RES 36.57 DIF STREET MA -NT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Permit Fee Total 2136.37 Plan Check Total 289.64 Other Fee Total 2881.45 Grand Total 5307.46 Paid Credited Due ---------- ---------- ---------- .00 .00 2136.37 .00 .00 289.64 .00 .00 2881.45 .00 .00 5307.46 06/23/2005 11:52 951-686-8786 WESTERN INSULATION PAGE 09/10 Wester RESIDENTIAL VAI 1AlknUAAA1W 4211 Latham Street - Riverside, California 92501 - Phone: (909) 686-8760 - Fax: (909) 686-8786 License # 794484 CF6R INSULATION CERTIFICATE THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE CURRENT ENERGY REGULATION, CALIFORNIA ADMINISTRATIVE CODE, TITLE 24, STATE OF CALIFORNIA,.IN THE BUILDING LOCATED AT: TRACT/PHASE: MUIRFIELD @ PGA WEST / PHASE 4 LOT#: 40 SITE ADDRESS: `81:-405 GOLF VIEW DRIVE = LA QUINTA, CA ------------------------------------------------ CEILINGS: BLOWN INSULATION MANUFACTURER:, GREENFIBER THICKNESS: 8.1" R- VALUE: R-30 CEILINGS: BATTS MANUFACTURER: KANUF THICKNESS: 10" R- VALUE: R-30 EXTERIOR WAILS: BATTS MANUFACTURER: KANUF THICKNESS: 6 1/4" R --VALUE; R-19 GABLE ENDS & PLUMBING BAYS BATTS MANUFACTURER: KNAUF. THICKNESS: 3 1/2" R -VALUE: R-11 GENERAL CONTRACTOR: TOLL BROTHERS BY: TITLE: DATE: INSULATION CONTRACTOR: WESTERN INSULATION, L.P. LICENSE NUMBER: 794484 TITLE: PRODUCTION MANAGER DATE: JUNE 23, 2005