04-8078 (SFD)r
s .
BUILDING & SAFETY DEPARTMENT
4� P:O. Box 1504 (760).777-7012
78-495 CALLE TAMPICo FAX ('760) 777-7011
LA QUINTA;.uCALIFORNIA 9.2253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT ,
Application Number. 04�0.0A_0_8_0_1 Date 1/12/05
Property Address, 51605 VIA SORRENTO
APN: 772-250-997-80 31349 -
Application'description `. DWELLING - SINGLE FAMILY DETACHED.
Property Zoning LOW DENSITY RESIDENTIAL
Application' valuation . . . 241854
Owner i Contractor
---------------- - - - - - - -- - - - -- ---- -- -
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 WCC: LIBERTY MUTUAL
WC: WA26DO04723013 09/01/04
CSLB: 777699. 04/30/06
CCC: B
MAY 12 2005
CITY OF LA 0 INTI®
FINANCE DEPT.
P.O. BOX 1504 • ��I�G�
1� 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: �y- FsL7S-' Date:
Applicant: Archct
Applicant's Mailing Address: itect
c. No.
Ena
Millger
Or Engineer's Address:
�' ? 477 �
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm unde enalty of perjury that I am licensed underpp��nnvisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
,
C and Lice in full force and effect. / 07 / n
icense Class ss � /Lice]ns%e No.
�te � 10 on/C tractor
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 1, 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 i }
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations: ' r
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.
KMI 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
�M issue M Llork W. corensation i�ance camp[ apdAolic gumbo are:
&rs�. yt�s L0 oicyNumber V' 61Ii��Do [^�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 provisio
O6 - ppIi4C cant
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
Lender's Address
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, indemnity and hold harmless the City of La Quinta, its
officers, agents and employeesfor 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, nd hereby
authorize repre entatives of this county toXenerpon the above-mentioned property for inspection purposes.
date V Signature or Agent):
t
S.�N x •,�: :fy:"r. el(i C 'q` 7 1 .:y'
'Application
----------------------------------------------------------------------------
--
Number "`` "'. "04 -0000'81078
--.=--------=--------------
'Structure Information -------------------------
` Construction
Type
TYPE V - NON RATED
Occupancy
Type . . .
. . . DWELLG/LODGING/LONG <=10
Flood Zone
. . . . .
,NON -AO FLOOD ZONE
w 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
1ST FLOOR SQUARE FOOTAGE
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
BASE FEE
15.00
2.00
9.0000.EA
MECH FURNACE <=100K
18.00
2.00
9.0000
EA MECH B/C <=3HP/100K BTU
18.00
6.00
6.5000
EA MECH VENT FAN
39.00
1.00,
6.5000"EA
MECH EXHAUST.HOOD
6.50
Permit .
. . . . .
ELEC-NEW RESIDENTIAL
Additional
desc
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
610.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
12.20
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
7.5000
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
----.--------,-------------------------------------------------------------
5�'Application Number
04-.00008078
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: 80.2800 S.F.
_ SEDONA-SB/WITH TAILS.
PERMIT DOES 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
104.63
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 .00
2552.28
Grand Total
4324.06 .00 .00
4324-.06"