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05-2690 (SFD)4 P.O. BOX O VOICE (760) 777-7012 78-49. -' ALLE CO'AA��-- FAX (760) 777-7011 LA Q CALIFQ4� L%&25 BUILDING & SAFETY. DEPARTMENT INSPECTIONS (760) 777-7153 c Q vvBUILDING PERMIT ' J� �P. ' ' Date: 6/30/05 Application N mb �(_" 90: Owner: Property Addre s: VIA SORRENTO TOLL CA V APN:- 772-250-997-154 -31349 - C/O KEVIN D DUERMIT Application desc ption: DWELLING - SINGLE FAMILY DETACHED 8901 E MOUNTAIN VIEW 200 Property Zoning: LOW DENSITY RESIDENTIAL SCOTTSDALE, AZ 85258 Application valuation: 261546 Contractor: Applicant: rchitect or Engineer: TOLL BROS, INC. 73121 FRED WARING DRIVE,.#100 nIV I'"i G ?377S PALM DESERT, CA 92260 _ WCC:. LIBERTY MUTUAL Lic- No.: B - ------------------------------------------------ ` 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 Cla License No.: 13 for by Section 3700 of the Labor. Code, for the performance of the work for which this permit is issued. • /Date: 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 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 WA762DO04723014 09/01/015olicy Number 777699 following reason (Seca 7031.5, Business and Professions Cade: 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'/ "YZ m any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: th ~ pplicant: 'Q ` 1 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure i§ 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 the DOLLARS ($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 (_ 1 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 to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractors) 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 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 Date: Owner: - 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: Pi LQPERMIT - 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 I have read this applicatiodand state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating tobuilding construction, and hereby authorizerepresentatives oft is county to enter upon .e above-mentioned property for inspection purposes. Date: /Z�vJ nature(Applicant.orAgent): 6= Application Number <- 05-00002690 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 # BEDROOMS 3.00" FIRE SPRINKLERS NO GARAGE SQ FTG 625.00 DnmTn en r ma 3,11 nn ActaiLional aesc . Permit Fee, 1206.50 Plan Check Fee 196.06 •Issue Date . . Valuation 261546 Expiration Date 12/27/05 Qty _.Unit Charge- Per' Extension ' BASE FEE 639.50 162.00 ------------------------------------------------------------------------------- 3.5000 THOU BLDG 100,001-500,000 567.00 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . .127.50 Plan Check Fee 7.97 Issue Date . . . . Valuation 0 Expiration Date 12/27/05 . Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 3.00 9.0000 EA MECH B/C <=3HP/10OK BTU 27.00 8.00 6.5000 EA MECH VENT FAN 52.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 134.15 Plan Check Fee 8.39 Issue.Date . . . Valuation 0 Expiration Date .. 12/27/05 Qty Unit Charge .Per Extension BASE FEE -15.00 3047.00: .0350 ELEC NEW RES - 1 OR 2.FAMILY 106.65 :. LQPERA•IIT: ,. .., _ Application Number 05700002690 Permit ELEC-NEW RESIDENTIAL Qty Unit Charge. Per Extension 625.00.':"' .0200 ELEC GARAGE OR NON-RESIDENTIAL 12.50 " Permit- PLUMBING- LUMBINGAdditional Additionaldesc . Permit Fee . . . . 207.75 Plan Check Fee 12.99 Issue Date . . .. Valuation . . . 0 ' Expiration Date 12/27/05 Qty Unit Charge Per Extension - BASE -FEE 15.00 23.00 6.0000 EA PLB FIXTURE 138.00 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 7.00 .7500 EA PLB GAS PIPE >=5 5.25 1.00 15.0000 EA PLB GAS METER 15.00 Permit . GRADING PERMIT . . Additional desc . Permit Fee 115.00, Plan Check Fee .00 Issue Date, Va'luation' 0 Expiration Date 12/27/05 Qty Unit Charge Per Extension BASE FEE 15.00 -------- -- ------------------------- Special Special Notes -and Comments. -- SFD - LOT 154. 3047 S.F. BELIZE -SB PERMIT DOES NOT INCLUDE,BLOCK WALLS,- POOL/SPA,OR DRIVEWAY APPROACH. 75% PLAN - CHECK FEE REDUCTION APPLIED FOR MULTIPLE ISSUANCE OF SAME PLAN TYPE. ------------------------------------------------------------------------------ Other Fees . . . . ... . ART IN PUBLIC PLACES -RES 153.86 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366..0.0 ENERGY REVIEW FEE 19.61 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 LQPERMIT Application Number 05-00002690 • Other Fees . . . . . STRONG MOTION. (SMI) - RES 26.15 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION -RES 1098.-00 . Fee summary Charged Paid Credited Due ` Permit Fee Total 1690.90 .00 .00 1690.90 Plan Check Total 225.41 .00 .00 225.41 Other Fee Total 2604.62 .00 .00 2604.62 Grand Total 4520.93 .00 .00 4520.93 LQPERMIT - - - -