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04-5492 (SFD)u�l'�,r6v BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 1 78-495.O.ALLELIT PIe�o FAX 760 777-7011 L7A-0UINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 �'� o BUILDING PERMIT OF Application Nurrtber Property Address ... . . . . APN: Application description . . . Property Zoning.. . . . . . . Application valuation . . . . Owner TOLL CA V C/O KEVIN D DUERMIT 8901 E MOUNTAIN VIEW 200 SCOTTSDALE AZ 85258 "04_-0.0.0.05492_ QDate 7/15/04 51389 VIA SORRENTO 772-250-997-89 -31349 DWELLING -SINGLE FAMILY DETACHED LOW DENSITY RESIDENTIAL 241854 Contractor ------------------------- TOLL ` BROS , INC. 73121 FRED WARING DRIVE, #100 PALM DESERT CA 92260 Qty Unit Charge Per..Extension . 9 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/LONG <=10 Flood Zone NON -AO FLOOD ZONE Other struct info . . ... . CODE EDITION 2001 CBC # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG. 610..00 PATIO SQ FTG 275.•00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG - 2800.00 -------------------------- Permit .. . . . . . --------------------------------- BUILDING PERMIT` ---------------- Additional desc Permit Fee . . . . 1136.50 Plan Check Fee 184.68 Issue Date . . . . Valuation 241854 Qty Unit Charge Per Extension BASE FEE 639.50 142.00 3.5000 THOU BLDG 100,001-500,000 ;' 497..00 -----'----------------------------------------------------------------------- Permit . . . . MECHANICAL Additional desc Permit Fee . . . . 96.50 Plan Check Fee 6.03 Issue Date Valuation 0 Qty Unit Charge Per..Extension . 9 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: Date: �• 3'IyK Architect or Eneer: CT -Ci 1 g Ins m tly) Architect or Engineer's Address: ic. No.: C 2 3 2 7e 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 Vie, and my License is in full force and effect. p G icensa Class icense No. ..--- Date 913111D#- 'Contractor e, I, 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 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. 1 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 issu d. My y(orker� com ensation in rance carrier and policy number are: artier t4.6Gr �-y I"��tyW �y Number W A % 2(o DC)047230lI3 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 4jF 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 Lenders Address A Z ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for set forth on this 1. Each person upon whose behalf this application is made, each person atwhose request and for hose benefit ork srmit subject to the cotions andnperformed under or pulrsuant to an 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 pernit 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 nter u entioned property for inspection purposes. g / ignature (Applicant or Ag t Page 2 Application Number 04-0.0005492 Date 7/15/04 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.00,00 EA MECH FURNACE <=100K 18.00 2.00 9.0000 EA MECH B/C.,<=3HP/100K BTU 18.00 6.00 6.5:000 EA :MECH' VENT TAN 39.00 1.00 6,5000 EA MECH ' EXHAUST '.HOOD. 6.50 Permit . . . . . ELEC-NEW RESIDENTIAL " Additional des.c Permit Fee 125.-20 '''Plan Check. Fee 7.06' Issue Date •..Valuation 0 Qty Unit .Charge Per Extension BASE FEE 15.00 2800.00 .0350 ELEC.NEW RES - 1 OR 2 FAMILY 98.00. 61.0.00 .0200 •ELEC GARAGE.OR NON-RESIDENTIAL 12.20 Permit PLUMBING Additional"desc,. Permit Fee 189.00 Phan Check. Fee 11:81 Issue Date . . . . Valuation . . . . -0 Qty, Unit Charge Per. Extension BASE,'FEE 15.00 20.00 6:0000 EA PLB FIXTURE 120.00-." 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 .9.001 6,00 .7500 EA PLB GAS.PIPE >=.5 4.5Q.. 1.00 .15. 0000 EA PLB GAS METER 15.00,• ----------------------=-------------------------------=-------------1-------- 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 89. 2800 S.F. SEDONA-SB.DOES -Page 3 Application Number 04-00005492 Date 7/15/04 Special Notes'and'Comments NOT INCLUDE BLOCK WALLS,-POOL/SPA, OR DRIVEWAY APPROACH. 75% PLAN CHECK FEE DISCOUNT APPLIED FOR'MULTIPLE ISSUANCE OF SAME PLAN TYPE. Other Fees . . . . . . . ART IN PUBLIC'PLACES-RES. 10.4.63 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 18.47 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 24.18 " DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due Permit -Fee Total 1562'.20 .00 .00 1562.20 " Plan Check. Total. 209.58 .00 .00 209.58 Other Fee Total 2552.28.00 0,0' !' 2552.28 Grand Total 4324.06 .00 .004324.06.