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04-8066 (SFD)ate" 0)� Q•C O O'Tar ��Glw 1~ BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760)•777=7011 OFT1'� 78-495 CALLE TAMPICO ` FAX (760) 777-7011. LA QUINTA, CAL1F6RNIA 92253 INSPECTION REQUESTS (760).777-7153 BUILDING PERMIT Application Number. 04-00008066 Date,'" 1/12/05 Property Address'._ 51485 VIA SORRENTO APN: .. 772-250-997-85 -31349 Application description DWELLING.- SINGLE FAMILY DETACHED Property Zoning LOW DENSITY.RESIDENTIAL Application valuation 227594 Owner Contractor•. --------------------------------------'---- ----- -- - ---- TOLL CA V TOLL BROS, INC. C/O KEVIN D•DUERMIT 73121 FRED WARING DRIVE, #10.0 .8901 E MOUNTAIN VIEW 200 PALM DESERT, CA 92260 SCOTTSDALE, .AZ 85258 WCC,: MARSH USA INC_-, WC:: WA762D004723014.09/01/05 CSLB: 777699 04_/30/06 CCC: B QUIi�T�` CIF NA�CE�E�' P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 Tedf Ot INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Date: Applicant: Applicant's Mailing Addre ,,,% IV- Archit . En le f _j Architect or Engineer's 1Addd-ress: Lic. No.: _ (:, A !212 9 BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under na t of perjury that I am licensed under pr isions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals C and my License II force and effect. icense Class icense No. 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 ttie 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 constrict 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. 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 issu c nsation i nce cam r a d oli numbs are: Carrier r ��icy Number 0 lot _ 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 provisi s. ate �i 4 ant WARNING: FAILURE TO SECURE WQRKERS' 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 ot /� Lenders Address /moi 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 agree to comply with all city and county ordinances and state laws relating to building construction`, and h�r/ereby authorize resentatives of this county toe ter p the abov -mentioned property for inspection purposes. ate/ v Signature (Applicant or Agent): Application Number . . . 04 -00008066 -------------------------=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 495.00 PATIO SQ FTG 399.00 NUMBER OF UNITS 1.00 1ST FLOOR.SQUARE FOOTAGE 2631.00 Permit . . BUILDING PERMIT Additional desc Permit Fee- . . . . 1087.50 Plan Check -Fee 706.88 Issue Date . . . . I Valuation 227594 Qty Unit Charge Per Extension BASE FEE 639.50 128.00 3..5000 THOU BLDG 100,0017.500,000 448.00 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 Permit . . . ... . ELEC-NEW RESIDENTIAL Additional desc Permit Fee 116.99 Plan Check Fee 29.25 Issue Date Valuation . . . 0. Qty Unit Charge Per Extension BASE FEE 15.00 2631.00 0350 ELEC NEW RES - 1 OR 2 FAMILY 92.09 4.95.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.90 Permit . . . . .. MECHANICAL -Additional desc Permit Fee . . . . 109.50 Plan Check Fee 27.38 . Issue Date Valuation, 0. Qty Unit Charge Per Extension BASE FEE 15..00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2;00..."' 9.0000 EA MECH B/C <=3HP/1OOK-BTU 18.00 8.00 6.5000 EA MECH VENT FAN 52.O0 1.00 ------------------------------------------------------------------------------- 6.5000 EA MECH EXHAUST HOOD 6.50 Perm-t . . . . PLUMBING Additional desc Permit Fee 189.00 Plan Check Fee 47..-25 ;< -Application'Number . . . . . 04-00008066 Permit . . . . PLUMBING Issue Date Valuation- r 0 Qty Unit Charge Per Extension BASE FEE 15.00 20.00' 6.0000 EA PLB FIXTURE 120.00 . 1.00 1.5.0000 EA PLB BUILDING.3SEWER 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,'EA PLB GAS METER .15.00 Special,,Notes and Comments r SFD - LOT 85., 2631 S.F. CAMINA/SB. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL/SPA,'-OR DRIVEWAY APPROACH. Other Fees ------------------------------ ART IN PUBLIC PLACES -RES _ 68..98 DIF COMMUNITY CENTERS -RES 97.00' DIF CIVIC CENTER-- RES 366.00 ' ENERGY REVIEW FEE70.69' DIF FIRE PROTECTION -REST 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` 22.75 DIF STREET'MAINT FAC -RES, •15.00' DIF TRANSPORTATION - RES- '1098.00. Fee' summary Charged Paid Credited Due --- Permit 'Fee Total' -.- - - ------- - - - -------- - - - -•-- 1517.99 .00 .06 -- - - - - -- 1517.99 Plan Check Total 810.76 .00 .00 810.76 ' Other Fee Total 256.7.42 00 :00 2567.42--. Grand Total, 4896.17 .00 .00-`� 4896.17 ,