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04-7439 (SFD)ki qty 4 ,(wQrdKYa P.O. Box 1504 78-495 CALLE TAMPICO LA UINTA„CALIFORN.IA 92253 BUILDING PERMIT Application Number . . . Property Address, . APN: Application description Property Zoning . . . . . Application valuation . . Owner BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 04-=-000Q7439— -- Date -11/23/04 .,,_,81345 LEGENDS WY 762-420-035- - - DWELLING - SINGLE FAMILY DETACHED LOW DENSITY RESIDENTIAL 365747 SRHI C/O RIELLY HOMES INC 3 CORPORATE PLAZA DR 210 NEWPORT BEACH A 266• D Contractor TOLL BROS, INC. 73121 FRED WARING DRIVE, #100 PALM DESERT CA 92260 D WCC: MARSH�USA INC. o5 005 WC: A004723014 09/01/05 p,V�N�p 7699 04/30/06 - - -��n p�"DEpS. CCC.: B -------------------- VO4 cture Information ------------------------- Construction T e . . . . . 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 785.00 PATIO SQ FTG 1058.00 r_., NUMBER OF UNITS �' 1.00 1ST FLOOR SQUARE FOOTAGE 4162.00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 1570.50 Plan Check Fee 1020.83 Issue Date . . . . Valuation . . . . 365747 Qty Unit Charge Per Extension BASE FEE 639.50 266.00 3.5000 THOU BLDG 100,001-500,000 i 931.00 ----------------------------------------------------------------------------- Permit . . . . . MECHANICAL Additional desc Permit Fee . . . . 139.00 Plan Check Fee 34.75 Issue Date . . . . Valuation 0 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 �"6.00 7.00 6.5000 EA MECH VENT FAN 45.50 P.O. Box 1504 �� 78-495 CALLS TAMPICO �I VOICE (760) 777-7012 LA QUINTA, CALIFORNIA 92253 4 4 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 041- -7413q Date: ADDlicant Applicant's Mailing Address: chnect or Engineer: rchltect or Engineer's Address: ic. No. CValiq t$UILUINU PhRMIT 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 he Business and Professionals Code , and my License is in full force and effect. License Class_ O tense No. ate 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 he 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 himprorpo ve for the puse of sale.). U I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Prof State License Law does not apply to an owner of property who builds or improves thereon, and o contracts for the pessions Code: The Contractors' rojects with f contractor(s) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , BA P.C. for this reason Date 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 he Labor Code, for the performance of he work for which this permit is issued. My workers' compensation�pcarance carrier and polic number are: Z crier M�A vim I &a/_/.olicy Number .,rlJ�1�; p apo O _ 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. Date I.' — OrpfA plicant 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. I hereby affirm under penalty of perjury that there is a construction lendingI agency orJthe performanLENDING ce of the he work for which this permit is issued (Sec. 3097, Civ. C.). Lenders Name Lender's Address APPLICANT IMPORTANT Application is hereby made to the Director of Buildingand Safety for permit CKNOWLEDGEect o the 1. Each person upon whose behalf this application is ma e, each person at w o es egluest and for Mose benefitions and rtt work is performed under or puestrictions set forth on this rsuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemnity 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. 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. Sig�pplicant or Agent): Page 2 Applicat,ion Number . . .. 04-00007439 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 176.37 Plan Check Fee 44.09 Issue Date . . . . Valuation . . . . 0 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 58.88 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 27.00 6:0000 EA PLB FIXTURE 162.00 1:00 15.0.000 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=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 18 PLAN CABRILLO SB 4162 S.F. PERMIT DOES NOT INCLUDE BLOCK WALL, POOL, SPA -OR DRIVEWAY APPROACH. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 414.36 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 102.08 Page 3 Application Number . . . 04-00007439 Date 11/23/04 ---------------------------------------------------------------------------- Other Fees . . . . . . . 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 36.57 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Permit Fee Total 2136.37 Plan Check Total 1158.55 Other Fee -Total. 2958.01 Grand Total 6252.93 Paid Credited Due ---------- ---------- ---------- .00 .00 2136.37 .00 .00 1158.55 .00 .00 2958.01 .00 .00 6252.93