04-8070 (SFD)BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760),777-7012.
OF9�`' 78-495 CALLE TAMPICo FAX (760) 777-7011
LA QUI�ITA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT,',,
Application Number Y-0�44O000807-0 Date 1/12/05
Property Addre'ssti,• `5,1653 VIA S'ORRENTO
APN: 77272507997-78 -31349
Application description DWELLING - SINGLE FAMILY'DETACHED
Property Zoning LOW DENSITY RESIDENTIAL
Application valuation . . 241854
Owner 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(76.0)6.74-9699
WCC: MARSH USA INC.
WC WA762D004723014 09/01/05
CSLB-: 777699 04/30/06
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: to [.E - '60-70
Applicant:
Applicant's Mailing Address:
Date: 5.12 oS
Archjc or ft_
---Architect or Engineer's Address:
. No.: Q,
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under nezalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Cod e, and ss License full force and effect. !� ^ / /] n —
icense Class icense No. ! ` (P 7T
ate !7 bnt. or
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 arid 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. , B.& 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
t�[ 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
��/y� q �u 1 Iujy rs,�er�pgnsation�ysarance carrjelAryA ppti)Fy rrDy7�3e),
erYl )(If�j�J'� („(J/�t' 1J)[_ /Policy Number (1�
I certify that, in the performance of the work for which this permit is issued, I shall not employ any6erson 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 provis //
Date/,% o6 ,;cant Q /1
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
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 1 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 re Dresentatives of this county to enter upo the above-mentioned p party for inspection purposes.
ate !�It V V Signature (Applicant or Agent):
=--------------------.----
1------------------------ -
b
Application Numer :tf '':"' '04-��0000`6070
--- -----
1 ------------------------------------
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Structure Information -------- ----------------
'Construction Type
TYPE V NON RATED.
Occupancy Type
,-
DWELLG/LODGING/CONG <=10
f
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
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-
142.100
-----------------------------------------------------------------------------
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.Q000
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
Lssue 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
r ---------=-=-----------------------
Application Number 04-000"08070
.%------------------------------------------------ - - - --- - - - - - - -
- - - - - - - - - - - - - -
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 78. 2800 S.F.
SEDONA-SB. 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 MAI -NT 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