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04-8074 (SFD)BUILDING & SAFETY DEPARTMENT P.O. Box --1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LX. QiJINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number .._0_4�Q_0008_��07 1/12/05 _T4 S_O Property Addres:§_ 516��iA _SJO RENTO APN: 772-250-997-151 -31349 Appl.ication description.. DWELLING - SINGLE FAMILY DETACHED. Property Zoning . . . . . . .. LOW DENSITY RESIDENTIAL Application valuation Owner I Contractor- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - TOLL -CA V TOLL"BROS, INC. C/O KEVIN D DUERMIT 73121 FRED WARING DRIVE, #100 890.1 E MO.UNTAIN.VIEW 200 'PALM DESERT, CA 92260 SCOTTSDALE,:AZ 85258, (760);674-9699 WCC: _MARSH USA INC. vyt-: WA/620004/2.3014 09/01/05 CSLB': 777699 04/30/06 CCC: B MAY 1 200'5 CITY OF LA QUINTA I. FINANCE DEPT 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 $074I Date: �- I.Z •06' Applicant: Arcljtect or Engineer: A c . i j .Applicant's Mailing Address: or Engineer's Address: No.: C x,3779 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 C e, and my Lic is in full force and effect.'11n/ o^ nse Class icense No. 77 F s G 9 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 pennit 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 _l, 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 a �r 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 �/y� issueo. rrs' gorjpensation i nce carrier an po icy umber are' �er 1 I I U. FY l N�.� /Policy Number _1.d (R� DA��% 1-3 y I certify that, in the performance of the work for which th t i�ermit is issued, I s all 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. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINALPENALTIES 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 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 Ouinta, 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 160 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 ente upon the above-mentioned property for inspection purposes. Date56 0C Signature (Applicant or Agent): "rte t'a` Charge !.. - - - - - - - - - - - - - - - - -.- - - - - - - - - r - - - - - - - - - - - - - - - - - - - - - - - - - - - --- - - - - - - - - - - - - - - - - - - - - - Application Number . . . . . 04-00008074 BASE FEE -------------------------- Structure Information ------------------=.------ .0350 Construction Type TYPE V -,.NON RATED RES - 1 OR 2 FAMILY Occupancy Type DWELLG/LODGING/CONG <=10 .0200 Flood Zone . . . . . . NON -AO FLOOD ZONE GARAGE OR NON-RESIDENTIAL Other struct-info . . . . . CODE EDITION 2001 CBC PLUMBING # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 610.00. PATIO SQ FTG. 275.00 189.00 NUMBER OF UNITS 1.00 ----------------------=------------------ 1ST FLOOR SQUARE FOOTAGE ----------------------------------- 2800.00 Permit . . . . . . BUILDING PERMIT Valuation . . . . Additional desc Qty Unit Charge Permit Fee 1136.50 Plan Check Fee 184.68 Issue Date . . . . Valuation . . . . 241854 Qty Unit Charge Per Extension 15.00 BASE FEE 639.50 142.00 3.5000 ----------------------------------.------------------------------------------ THOU BLDG 100,001-500,000. 497.00 Permit . . . . . . MECHANICAL 15.0000 Additional desc PLB BUILDING SEWER Permit Fee . . . . 96.50 Plan Check Fee 6.03 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension EA BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 9.0000 EA MECH BIC <=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 . . . . . . Additional desc Permit Fee Issue Date . . . . ELEC-NEW RESIDENTIAL 125.20 Plan.Check Fee 7.06 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 R Permit Fee 189.00 Plan Check Fee 11.81 Issue -Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 20.00 6.00OOJEA 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 Application Number . . . . . 04-00.008074 ;i -----------------------------------------------------=---------------------- 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 151. 2800 S.F. SEDONA/CONT. 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 .0.0 .00 2552.28 Grand Total 4324.06 .00. .00 4324.06,'