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05-2696 (SFD)e*- P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT. BUILDING PERMIT Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: r-05-000 2696 51710 VIA SORRENTO 772-250-997-153 -31349 DWELLING - SINGLE FAMIL) LOW DENSITY RESIDENTIAL 241854 �hitectbr E Owner: TOLL CA V C/O KEVIN D DUERMIT 8901 E MOUNTAIN VIEW 200 SCOTTSDALE„AZ 85258 Contractor: TOLL BROS, INC. 731.21 FRED WARING DRIVE, #100 PALM DESERT, CA 92260 (760)674-9699 Lic. No.: 777699 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/30/05 LICENSED CONTRACTOR'S DECLARATION - - WORKER'S COMPENSATION DECLARATION • ' I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: _ Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: 'B License No.: 777699 _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is � Date: 2 >� ontracto( r: L IL (i ^ y issued: r /V 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 issued. My workers' compensation OWNER -BUILDER DECLARATION insurance carrier and policy number are: hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier LIBERTY MUTUAL Policy Number WA762Do04723014 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to 1 certify that, in the performance of the work for which this permit is issued, I shall not employ any - construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the _ person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or - 3700 of the La 0 Code, I shall forthwith comply with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by p � any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: e: 2/Cd plicant: (_ 1 1, 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL - Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that theDOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN .improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). - - APPLICANT ACKNOWLEDGEMENT - - I, as owner of the property, am exclusively contracting with licensed contractors to construct the project .(Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the - 7044, Business and Professions Code: The Contractors' State License Law does not apply town owner of conditions and restrictions set forth on this application. - - property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). • whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_ 1 I am exempt under Sec. _ , B.&P.C. for this reason 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.' Date: Owner: 2. Any permit issued as 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 - CONSTRUCTION LENDING AGENCY permit to cancellation. ' I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). - city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this count to enter upon th above-mentioned property for inspection purposes. _ Lender's Name: �2/®��8 Address: gnat�(Applicant or Agent):Lender's LQPERAIIT - - . Application Number 05-00002.696 Structure Information Construction Type . - . TYPE V - NON RATED Occupancy Type. DWELLG/LODGING/CONG <=10 - 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 Expiration Date 12/27/05 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 Expiration Date 12/27%05 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 Expiration Date 12/27/05 Qty Unit Charge Per Extension - BASE FEE 15.00 - 2800.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 98.00 LQPEnl[T .. -. .. .. Application Number .'. . 05-00002696 " Permit ELEC-NEW RESIDENTIAL Qty Unit Charge ,.Per Extension 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 Expiration Date.. .12/27/05 Qty. Unit Charge Per Extension BASE FEE - 15.00 20.00 6.0060 EA PLB FIXTURE 120.00 1.00" 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.8000 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 - !Permit GRADING PERMIT Additional desc . Permit Fee 15.00 Plan Check Fee .00 Issue Date -Valuation . . . . 0 Expiration Date 12/27/05 Qty `Unit -Charge Per Extension BASE FEE 15:00 Special Notes and Comments . SFD - LOT 153. 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" LQPERMIT .. .. .. ... " Application Number 05-00002696 ------------------------------------------.-------.--------------------------- Other Fees . . 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 LQPERMIT _ .. .