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05-2688 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: - Application description: Property Zoning: Application valuation: Applicant: �05�000026'88 51749 VIA SORRENTO. 772-250-997-74 -31349 DWELLING - SINGLE FAMII LOW DENSITY RESIDENTIAI 261546 BUILDING & SAFETY DEPARTMENT /rchitect or Engineer: --------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION I hereby affiim 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 Code, and my License is in full force and effect. License Class: License No.: 13 i e: �'t/>11 ontraaor: *bl.� gr0f. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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).: (_ 1 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 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.). _ 1 1 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 contractors) licensed pursuant to the Contractors' State License Law.).. ( ) 'I am exempt under Sec. , B.&P.C. for this reason 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: P LQPER11i1T PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/30/05 Owner: TOLL CA V C/O KEVIN D DUERMIT 8901 E MOUNTAIN VIEW 200 .SCOTTSDALE, AZ 85258 Contractor: TOLL BROS, INC. 73121 FRED WARING DRIVE, #100 PALM DESERT, CA 92260 WCC: LIBERTY MUTUAL Lic. No.: B ------------------ WORKER'S 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 issued. My workers' -compensation insurancecarrier and policy number are: - Carrier WA762DO04723014 09/01/00olicy Number 777699 I certify that, in the performance of the work for which this permit is issued, I shall 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 forthwithcomplywith those provisions. ate: 12 pplicant: C -C• I OL� Y�✓'0! �Z 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 0100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 thi's 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 I haveread 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 ofthis counW t enter upon the above-mentioned property for inspection purposes. 1Sate: r gnr atum (Applicant or Agent): C4&^4- Application Number 05-00002688 Structure Information Construction Type . ._ . . TYPE V - NON RATED -Occupancy Type: DWELLG/LODGING/CONG <=10 Flood Zone . . . ... . NON -AO FLOOD ZONE Otherstruct. info .. .. CODE EDITION .. 2001 'CBC - ## BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG. y 625.00 PATIO SQ FTG 233.00 - NUMBER OF UNITS 1.00 ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 3047.00 Permit . . . BUILDING PERMIT Additional desc . 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/100K'BTU 27.00• 8.00 6,5000 EA MECH VENT FAN J 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 LQPERHfTT - - Application Number 05-00002688 Permit ELEC-NEW RESIDENTIAL Qty Unit Charge Per Extension 625.00 .0200 ELEC'GARAGE OR NON-RESIDENTIAL 12.50 Permit PLUMBING Additional desc . 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 6.00,00 EA -PLB FIXTURE 138.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.0.0 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 : . . . 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 74. 3047 S -F. BELIZE -CONTEMPT ; 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 366.00 ENERGY REVIEW`FEE 19.61 DIF FIRE "PROTECTION -RES 97.00 GRADING PLAN CHECK FEE .00. - _ DIF LIBRARIES - RES 22.5.00 - DIF PARK MAINT FAC - RES _ 5.00 DIF PARKS/REC - RES 502.00 LQrExnsrr ... Application Number; . . . . . 05-00002688 . ..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 .60 4520.93