04-7435 (SFD)Tjhf 4 4 a"
P.O. Box 1504
78-495 CALLE TAMPICO
LA. QUINTA, CALIFORNIA; 92253
BUILDING PERMIT
Application Number . . .
Property Address,r..:-. .. .
APN:
Application description
Property Zoning . . . . .
Application valuation . .
BUILDING & SAFETY DEPARTMENT
L (760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
00
0;00047.T-35 Date 11/23/04
-81325 LEGENDS -WY
762=420-033- - -
DWELLING - SINGLE FAMILY DETACHED
LOW DENSITY RESIDENTIAL
333037.
Owner
----------------
TOLL CA V
KEVIN D DUERMIT
8901 E MOUNTAI 20.
SCOTTSDALE AZ 85258
Contractor
TOLL BROS,�INC.
73121 FRED WARING DRIVE, #(100
PALM DESERT CA 92260
Q TWO
�5
WCC: MARSH USA
INC.
WC: WA762DO04723014
09/01/05
F�Np CSLB: 777699
04/3.0/06
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 CRC
FIRE SPRINKLERS
NO
GARAGE SQ FTG
752:00
PATIO SQ FTG
561,.,00
.,NUMBER' OF'' UNITS
-
1.00
----------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
3847.00
Permit . . . .
. . BUILDING PERMIT r
,
Additional desc
-
Permit Fee
1458.50 Plan Check.Fee
237.01
Issue Date . .
. . Valuation . .
. . 333037
Qty Unit
Charge Per
Extension
BASE FEE
639.50
234.00
3.5000 THOU BLDG 100,001-500,000
819.00
Permit . . . .
. . MECHANICAL
Additional desc
. .
Permit Fee . .
. . 127.50 Plan Check Fee
7.97
Issue Date . .
. . Valuation
0
Qty Unit
Charge Per
Extension
BASE FEE
15.00
3:00
9.0000 EA 'MECH FURNACE <=100K
3.00
9.0000 EA MECH B/C•-<=3HP/100K BTU
r, .27.00
' 27.00
8.00
6.5000 EA MECH VENT FAN
52.00
t
P.O. Box 1504
78-49$ CALLS TAMPICD
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:
Architect or Engineer:
or Engineer's Address:
No.: C,2$19. -%
MUILUINU PLIRMIT 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
gode and my License is in full force and effect.
icenseClass L�se No. -1 "1'2 !g
/ Date — s' tractor_
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 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 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 Owne
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
of 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
issued. my,6vorkers'compensationjperance carrier and policy number are:
amer m4m" W t*r" to olicy Number _ uJ �'7toZn t�4-M'3 0
_ I certify that, 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.
J Applicant
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 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. f 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.
Date 1- 5 r�
Signature (Applicant or Agent):
Application Number . . . . . 04-00007435
Page 12
Date 11/23/04
Qty Unit Charge
Per
Extension
1.00 6.5000
----------------------------------------------------------------------------
r
6.50
Permit . . . . . .
ELEC-NEW RESIDENTIAL
Application Number . . . . . 04-00007435
Page 12
Date 11/23/04
Qty Unit Charge
Per
Extension
1.00 6.5000
----------------------------------------------------------------------------
EA MECH EXHAUST HOOD
6.50
Permit . . . . . .
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee . . .
•164.69 Plan Check Fee
10.29
Issue Date
Valuation . . . .
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
3847.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
134.65
752.00 .0200
---------------------------------------------------------------
ELEC GARAGE OR NON-RESIDENTIAL
15.04
Permit . . . . . .
PLUMBING
------------
Additional desc
Permit Fee . . .
195.00 Plan Check Fee
12.19
Issue Date . . . .
Valuation . . . .
0
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
----------------7-----------------------------------------------------------
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 33 PLAN MIRAMONTE SB 3847 S.F.
PERMIT DOES NOT INCLUDE
BLOCK WALL,
POOL, SPA OR DRIVEWAY
APPROACH. 750
REDUCTION TO PLAN CHECK
FEE DUE TO
MULTIPLE ISSUANCE OF
SAME PLAN TYPE.
------------------------------=---------------------------------------------
Other Fees . . . . .
. . . . ART IN PUBLIC PLACES -RES
332.59
'DIF COMMUNITY CENTERS -RES
97.00
it
i
I
Page 3
Application Number
. . . . .
04-00007435
Date
11/23/04
Other Fees . . .
. . . . . .
DIF CIVIC CENTER -
RES
366.00
ENERGY'REVIEW FEE'.
23.70
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
33.30
DIF STREET MAINT FAC
-RES
15.00
DIF TRANSPORTATION
- RES
1098.00
Fee summary
------------------
Charged
Paid Credited
Due
Permit Fee Total
----------
1960.69
---------- ----------
.00
----------
.00
1960.69
Plan Check Total
267.46
.00
.00
267.46
Other Fee Total
2794.59
.00
.00
2794.59
Grand Total
5022..74
.00
.00
5022.74
I
06/23/2005 11:40 951-686-8786 WESTERN INSULATION
Western
IM&O'luMIN A its"
tion L.P.
ONTRACTING
PAGE 10/11
4211 Latham Street - Riverside. California 92501 • Phone: (909) 666-8760 - 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 0 PGA WEST / PHASE 6
LOT#: 33
SITE ADDRESS: ;8.1-325L'EGENDS WAY- 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 WALLS: 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
BY:
TITLE: PRODUCM AGER
TION
DATE: JUNE 23, 2005