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04-5497 (SFD):J r,. � �.' .. 4".4 ihf 494M BUILDING & SAFETY DEPARTMENT (760) .777-7012 FAX (760) 777-7011 A 92253 INSPECTION REQUESTS (760) 777-7153 WING PERMIT APN: Application description . . . Property Zoning Application valuation . . . . Owner TOLL CA V C/O KEVIN D DUERMIT 8901 E MOUNTAIN VIEW 200 SCOTTSDALE AZ 85258 --0,4-0-0005A97- -� Date 7./15/04 .5129 -3 -VIA SORRENTO 772-250-997-93 -31349 - DWELLING: - SINGLE FAMILY DETACHED LOW DENSITY RESIDENTIAL 261546 Contractor ------------------------- TOLL BROS,, INC. 73121 FRED WARING DRIVE, #100 PALM DESERT CA 92260 Qty Unit Charge Per. Extension WCC: LIBERTY MUTUAL WC: WA26DO04723013 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 # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 625.00 PATIO'SQ FTG 233.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 3047.00 Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee 1206.5b' Plan Check Fee 196.06 Issue Date Valuation . . . . 261546 Qty Unit Charge Per Extension BASE FEE 639.50 162.00 3.5000 THOU BLDG 100,001-500,000 567.00 ---------------------------------------------------------------------------- Permit . . . MECHANICAL Additional'desc Permit Fee . . . . 127.50 Plan Check Fee 7.97 Issue Date Valuation 0 Qty Unit Charge Per. Extension P.O. BOX 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA.QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: [Z5/� ,��9 Date: "R% 31t • D 4 Applicant: �Chitect or Engineer: Applicant's Mailing Address: Is , M 4 )7 or Engineer's Address: v Lic. No.: C Z 3 2 7!3 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 e, and my LicensT in full force and effect. License Class �� ic�L ens. No. % Ct Bate ? 1 0- Contractor -7011 %jro Ah er-5 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 1, 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 contractors) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. BA P.C. for this reason Date WORKERS' COMPENSATION DECLARATION 1 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 iss ed. My workecompensation i ce carrier and policy number are: Cartier i I bC✓ I'-lJ�}uoll -'Policy Number LU A•'22 ID DO4 7 Z of _I certify that, in the performance of the work for which this permit is' 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. ate 8131104 Ap� �'o l i 13ro-{ h Gr5 `` 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 tilk 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. I a ree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this coun r u a ov rep for inspection purposes. ate 191b_1 k_+ignature (Applicant or Agen - Page 2 Application Number 04-00005497 Date, 7/15/0.4: Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE k=100K 27.00 3.00 9.0000.EA MECH,B/C <=3HP/100K BTU 27.00 8.00 6.5000 EA MECH VENT FAN, 52.00 1..00 6..5000 EA MECH EXHAUST HOOD 6.50 Permit . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee 134.15 Plan 'Check Fee 8.39. Issue Date 'Valuation �0 Qty Unit Charge Per Extension BASE FEEv 15.00 3047.00 .0350- ELEC NEW RES - 1 OR 2 FAMILY. 106.65 625.00 .0200 ELEC GARAGE.OR NON-RESIDENTIAL 12.50 Permit . . . --------------------------- PLUMBING - Additional desc Permit.Fee. 207.75 Plan Check Fee 12.99" Issue Date - Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00. .. 23.`00 6.0000 EA PLB FIXTURE 138.00,- 1.00 15.0000 EA PLB BUILDING SEWER 15.0.0 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 PI°PE >=5 5.25 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 93. 3047.S.F.BELIZE SB. Page 3 Application Number 04-0000549,7 'Date 7./15/04 Special Notes and Comments ". PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL/SPA;OR:DRIVEWAY APPROACH. 75% PLAN CHECK FEE REDUCTION APPLIED FOR MULTIPLE ISSUANCE OF,SAME.PLAN TYPE. Other Fees _ ART -IN PUBLIC PLACES=RES 153.86 D`IF'COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER -."RES 366.`00 ENERGY REVIEW FEE 19.61 DIF FIRE 'PROTECTION -$ES 97.00 . GRADING PLAN'CHECK FEE 00' DIF'LIBRARIES - RES 225.0'0 DIF`PARK MAINT FAC - RES 5:00' 9: DIF PARKS/REC - RES' 502.00 ' STRONG MOTION ( SMI) - ` RES -26.15' DIF STREET MAINT FAC -RES.. 15-00. DIF TRANSPORTATION - RES 1098..00 Fee summary Charged' •---=--------=----=---- Paid_ Credited --- - -- - -- 'Due , ---- -- Permit Fee Total 16.90.90 --=.- ----- - - - .00.1 .00'" 1" ---- - - - - - 1690.90 : Plan,Check Total 225.41 .00 .00 225.41 Other <. Fee `Total 2604.62 00 : 00 , ` 21604.62 Grand Total 4520.93 .00 00 452.0.93 a