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05-2687 (SFD)' . X 1504 � " + VOICE 760 777-7012 o- ( ) 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, _CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760)-777-7153 BUILDING PERMIT Date: 6/30/05 Application Number. FI-05'-0000268.7. Owner: Property Address: 51725 VIA SORRENTO - TOLL CA V APN`." 772-250-997-75 -31349 C/O KEVIN D DUERMIT Application description: DWELLING - SINGLE FAMILY. DETACHED 8901' E MOUNTAIN-VIEW 200 Property Zoning: LOW DENSITY RESIDENTIAL SCOTTSDALE, AZ 85258 Application valuation: 241854 D p -Contractor. Applicant: Architect or in er: SEP -o �j 2005 TOLL BROS, INC. 7Cf 73121 FRED WARING DRIVE, #100 Ito C F �A(�gJI�TA PALM DESERT, CA 92260. K,V vim ame.EDEPT. (760) 674-9699 Lic. No.: 777699 ----------------—---------------- LICENSED CONTRACTOR'S DECLARATION. - WORKER'S COMPENSATION DECLARATION - 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 CI ss: B License No.: 777699 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is - issued. / Date: �Z�s ontractor. �� ems. • �t/ - I have and will maintairi workers<compensation insurance; asrequired 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: I 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_ I 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 Labor 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. ^y/, n� .. any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001.:.- ate: licant: V 4. C. 1 /� - (_ 1' I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and • o the structure is not intended or offered for sale1Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply toan 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 the DOLLARS ($100,0001. 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 1—) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Seo. 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 to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and whocontractsfor 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, (_d 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 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 Workfor180 dayswill 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 cou ty to enter up o I the above-mentioned property for inspection purposes. - Lender's Name: Or r1/L - . - - _ - te: ` •Z,J Signature (Applicant or Agent): Lender's Address: - - Application Number . . . 05-00002687 - Structure Information Construction Type TYPE V - NON RATED Occupancy.Type DWELLG/LODGING/LONG.<=10 Flood,Zone: NON -AO FLOOD ZONE Other struct info . . CODE EDITION .2001 CBC # BEDROOMS3.00 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 738.73 Issue Date Valuation . . . . 241854 ,. Expiration Date 12/27/05 Qty Unit Charge Per Extension BASE FEE 639.50- 142.00 3.50.00 THOU BLDG 100,001-500,000 497.00 Permit . . . MECHANICAL - Additional.desc . Permit Fee 96.50 Plan Check Fee 24.13 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 28.25 Issue Date Valuation . . . . 0 Expiration Date 12/27/05 Qty Unit Charge Per a Extension BASE FEE 15.00 2800.00 .0350 ELEC NEW RES - 1 6R,2 FAMILY 98.00 LQPERMIT " Application Number . . . . . 05-00002687. 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 47.25, Issue Date Valuation 0 Expiration Date 12/27/05 - 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 6.06 .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 75. 2800 SF," SEDONA SB.PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL/SPA,- OR DRIVEWAY APPROACH. ----------------------------------------------------------------------- Other Fees . . . . ... . . . ART IN PUBLIC PLACES -RES 104.63 DIF COMMUNITY CENTERS -RES. 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 73.87 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 LQPERMIT - , • -"i01' Application Number. .. . 05-00002687 Other Fees . ... . . . . DIF TRANSPORTATION - RES 1098.0.0 Fee summary Charged Paid Credited" Due ----------------- ' Permit Fee Total ----- -- 1562:20 .00 .00 1562.20 Plan Check Total 838.36 .00 .00" 838.36 Other Fee Total 2607.68 .00 .00 2607.68 Grand Total 5008.24 .00 .00 5008.24 LQPERMIT