04-8080 (SFD)f�'ft�dv
ce
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
78=495 CALLE TAMPICo FAX (760) 777-7011
LA Qq! TA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number., . . . . 04-00008080 .Date 1/12/05
Property Address ., 51542 VIA. SO RENTO
APN: 7,72-250-997-146 -313.49 -
Application description . DWELLING SINGLE FAMILY DETACHED
Property Zoning LOW DENSITY RESIDENTIAL
Application -valuation 227594
Owner Contractor
----------------------------------
TOLL
-------.--------------------- ---TOLL CA V TOLL-BROS, INC.
C/O KEVIN D.DUERMIT 73121 FRED WARING DRIVE, #100
8901 _E MOUNTAIN VIEW 200 PALM DESERT,•CA 92260
SCOTTSDALE, AZ 85258 (760)674-9699
WCC: MARSH USA INC.
". WC: WA7621)0-04.723014 09/01/05
CSLB: 777699 04/30/06
O CCC: B
MAY 12 2005
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: 0 14 - IR090 Date:
Applicant: Archirct tv En ip r
Applicant's Mailing Address:uxn
hitect or Engineer's Address:
Llfl� %o� L-lz�-- r
No.: L;?)Z5-7/ q
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under alty 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 ' full force and effect.�% //
License Class cense No. / l0
_ /
ro
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 fora 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 Owner
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.
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
;;yygd�,)v1y o o q� �I•on i ce ca r a d��ggoI- uc�b �rQ� [r1 '1 f�
arrie� I .YI/Y� LI U oar.�F licy Number U.N IJU D 7 /.1 �
_ I certify that, in the performance of the work for which this l5efmit is issued, I shall not employ any persdn 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, 1 shall
forthwith comply with those provisioDs.
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 A
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 thisapplication 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 hereby authorize representatives of this county to enter og the above-mentioned property for inspection purposes.
D.te/" Signature (Applicant or Agent):
�---_ Application Number ---1.--,.-.--04-00008080=------
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Structure Info3rmation----"---
Construction Type .
. . . TYPE V - NON RATED
Occupancy Type
. . .
. . DWELLG/LODGING/LONG <=10
Flood Zone .
. .i.
. . 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
• f
"1ST FLOOR SQUARE FOOTAGE
2631.00
Permit
•BUILDING
PERMIT
Additional.desc
Permit Fee
1087.50 ` Plan Check Fee
176.72
Issue Date.
Valuation
'227594
Qty Unit
Charge
Per
Extension
BASE FEE
639:50.
' 128.00
----------------------------------------------------------------------
3.5000
THOU BLDG 100,001-500,000
448,.00
Permit . . . .
MECHANICAL
Additional desc
' .
' Permit Fee
109.50 Plan Check Fee
6.85
Issue Date . .
. .
- Valuation
0
:Qty Unit
Charge
Per
Extension.
BASE FEE.
15.00
2.00
9.0000.
EA MECH FURNACE t<=100K
18.00
2.00
9.0000
EA MECH•B/C <=3HP/100K BTU
18.00
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
116.99 Plan Check Fee
7.31
Issue Date . .
. .
Valuation .. . . .
- 0
Qty Unit
Charge
Per
-Extension
BASE FEE
15.00
2631.00
.0350
ELEC NEW RES - 1',OR 2,FAMILY
92.0'9
495.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
9.90
Permit . . . .
..
PLUMBING
Additional desc
Permit Fee . .
. .
189.00 Plan 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
7.50,00
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
:.-----------------------------------------------------•------------------------
w Application Number
04-00008080
_!--------------.--- ------------
-------- -------=- - _ --
---- ----'.
Permit . . . . . .
PLUMBING
Qty Unit Charge
Per
Extension
6.00 .7500
EA PLB GAS PIPE >,=5
4.50
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 146. 2631 S.F.CAMINA-SB
PERMIT
DOES NOT .INCLUDE BLOCK
WALLS, POOL/SPA,
OR DRIVEWAY`APPROACH.
75% PLAN CHECK FEE
- REDUCTION APPLIED FOR
MULTIPLE ISSUANCE
OF SAME PLAN TYPE.
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Other Fees
ART IN PUBLIC PLACES -RES
68.98
DIF COMMUNITY CENTERS -RES.
97.00
DIF CIVIC"CENTER - RES
-366..00
ENERGY REVIEW FEE
17.67
.
DIV,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
,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 .00
1517.99
Plan Check Total.
202.69 .00 .00
202.69
Other Fee Total.
2514.40 .00 .00
2514.40
Grand Total
4235.08 .00 .00
4.235.08