05-5312 (SFD)4 P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 05-00005312 Owner:
Property Address: 80525 VIA TAliAVERA TOLL CA V
APN: 772-250-999-144 -30357 - 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: 376373
Arav�g �i
i��, Q Contractor: '
Applicant: Architect or nglneer: TOLL BROS, INC.
73121 FRED WARING DRIVE,
PALM DESERT, CA 92260
(760)674-9699
Lic. No.: 777699'
------------------
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 Code, and my License is in full force and effect.
License Class: B ense No.: 777699
,Bate: %; - 06 factor: '010
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 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 .
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 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.).
I—) 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: t"
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/05/05
ryA��l��s Q
-------------------------- =`�Qv ----�
WORKER'S COMPENSATIONDE �F IlyTq-
I hereby affirm under penalty of perjury one of the following declarations: �7
I have and will maintain a certificate of consent to self -insure for workers' co tion, as p vided
for by Section 3700 of the Labor Code, for the performance of the work for whic a it is
issued.. -
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
insurance carrier and policy number are: '
Carrier ZURICH INS Policy Number WC387821300
_ I certify that, in the performance of the work for which this permit is issued,,l 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 L r Code, I shall forh comply with those provisions.
te: l J� plicant' ��
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 ($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.
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 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 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,d hereby authorize representatives
of this county to enter upon the above-mentioned property for inspectio a ses.
at' jl� Signature (Applicant or Agent):
Application Number
05-00005312
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 2001CBC
FIRE SPRINKLERS NO
GARAGE SQ FTG
730.00
PATIO SQ FTG
650.00
NUMBER OF UNITS
1.00
------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE.
4374.00
Permit BUILDING PERMIT
Additional desc .
Permit Fee
1609.00 Plan Check Fee
- 1045.85
'Issue Date . . .
Valuation
376373
Expiration'Date
6/03/06
Qty Unit Charge
Per
Extension
BASE FEE
639:50
277:00 3.5000
THOU BLDG 100,001-500,000
969.50
Permit MECHANICAL
Additional desc .
Permit Fee
134.00 Plan. Check Fee
39.13
Issue Date . .
Valuation
0
Expiration Date
6/03/06
\
. Qty Unit,Charge
Per.
Extension
BASE FEE
15.00
3.00 9..0000
EA MECH FURNACE <=10'OK
21.00
3.00 9.0000
EA MECH B''/C'<=3HP/100K BTU,
27.00
' .00 16._5000
EA MECH-B/C >3-15HP/>100K-50OKBTU
.00
.00 22:5000.EA
MC B/C,>15 <=30HP/500K-1M-BTU
.00
9:.00. 6.5000
EA MECH VENT FAN
58.50
- 1.00. 6.5000
EA MECH EXHAUST HOOD
6.50
Permit ELEC-NEW RESIDENTIAL
Additional desc .
Permit Fee
182.69 Plan Check Fee
45.67
Issue Date . .
Valuation .. :
0
Expiration Date
6/03/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
LQPERMIT
,
LQPERMIT
Application Number .
. . . . 05-00005312
Permit . . . . .
ELEC-NEW RESIDENTIAL
Qty Unit Charge
Per
Extension
4374.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
•153.09
730.00 •.0200
ELEC GARAGE OR NON-RESIDENTIAL
14.60
Permit . . .
PLUMBING
Additional desc .
Permit Fee
216.00 Plan Check Fee
48.38
Issue Date
Valuation . . .
0
Expiration Date
6/03/06
Qty Unit Charge
Per.
Extension
BASE FEE
15.00
24.00 6.0000
EA PLB FIXTURE'
144.00
1.00 15.0000
EA PLB BUILDING SEWER
15.00
1.00 7.5.000
EA PLB WATER HEATER/VENT
7.50
1.00 3.0000
EA PLB WATER,INST/ALT/REP
3.00
1.00 9.0000
EAPLB LAWN SPRINKLER SYSTEM
9.00
.10.00 .7500
EA PLB GAS PIPE >=5.
7.50
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
6/03/06
Qty - Unit Charge
Per
Extension
BASE FEE
15.00
------------------------------------------------------------------------------
Special Notes and Comments
SFD - LOT 144 VENTANA-S.C:/4'/CASITA;
4374 SF.PERMIT.DOES NOT INCLUDE BLOCK
WALLS,POOL, SPA OR DRIVEWAY
APPROACH
Other Fees
. . . . ART IN PUBLIC PLACES -RES
440.93,
DIF COMMUNITY CENTERS -RES
97.00,
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
104.59
DIF FIRE PROTECTION -RES
.97.00 "
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES _
225.00
DIF PARK MAINT FAC - RES
16.00
DIF PARKS/REC - RES
502.00
STRONG MOTION (SMI) - RES
50.51
LQPERMIT
Application Number
05-00005312
---------------------------------------------------------
Other Fees . .. .
. . . . . .
.DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
Charged
Paid 'Credited
Due
Permit Fee Total
2156.69
---------- ----------
.00 .00
2156.69
Plan Check Total
1179.03
.00 .00
1179.03
Other Fee Total
3012.03
.00 .00
.3012.03
Grand Total
6347.75
.00 ..00
.6347.75
• r
CITY OF LA QUINTA
BUILDING & SAFETY DEPARTMENT -.,
777-7012
INSPECTION REQUEST LINE
777-7153
Owner
Contractor
Permit Nu e AN
POS JOB IN CON U US PLACE
INSPE O T�I(�OIL�TAPPLI BLE SPACES
�-F - ..��
RA
'JOB ADDR ! -
TANA-S.C./4'/CASITA;
SFD -LOT 144 VEN
4374 SF.PERMIT DOES NOT INCLUDE BLOCK -
WAL•LS,POOL, SPA OR DRIVEWAY APPROACH
TYPE OF.INSPECTION DATE INSP. .
TEMPORARY POWER
SETBACKS
U/G PLUMBING / WASTE G
U/G ELECTRICAL / GROUNDING
FOOTINGS / STEEL _
CONCRETE SLAB .
DO NOT POUR CONCRETE UNTIL ABOVE SIGNED
ROOF NAIL./ PRE -ROOF
OKAY TO WRAP •-� -
.I,NG COMBINATION 111
6UGH ELECTRIC
-ROUGH PLUMBING - -O
ROUGH MECHANICAL -
INSULATION
COVER NO WORK UNTIL ABOVE SIGNED '
INTERIOR GYP. BD. DRYWALL
EXTERIOR LATH
GAS TEST
SEPTIC ABANDONMENT
SEWER CONNECTION �!
SEPTIC / GREASE INTERCEPTOR
MASONRY INSPECTIONS
FOOTINGS / STEEL
BOND BEAM
.A . WATER FEATURE_WS�PP .TICINS
POOL / SP / - -
PRE-GUNITE / SETBACKS
U/G PLUMBING
U/G GAS
U/G ELECTRICAL
PRE -PLASTER ALARMS/BARRIERS
FINAL INSPECTIONS
TEMP. USE OF PERMANENT POWER
ELECTRICAL AI
PLUMBING
z;- :3IANICAL I
�cdLlC WORKS DEPARTMENT
COMMUNITY DEVELOPMENT DEPT. b
_....
FINAL / JOB COMPLETED d 2�' ✓ ®�
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES pR OCCUPY :BUILDING ;