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07-1405 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4'tt 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 07-00001405 Owner: Property Address: 80172 VIA TESORO TOLL CA V APN: 772-250-018-8 -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 Contractor: Applicant:rchaect or Engineer: t kA A ^ ��. (_ �r� TOLL BROS, INC. 73121 FRED WARING DRIVE, #100 PALM DESERT, CA 92260 IS -7'? 0 G Z !! (760)674-9699 LiC. No.: 777699 n 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. LicenClass: B License�Noo..: 777699 Date: 1�� antractor: �� �_R(J�• 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 (5500).: 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 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 704.4. RiusinP95 and Prnfaminns CrIdP: Tha Contractors' S1a1a Licens4 Law dges ngt agQly tQ an QWner Qf 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 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: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS 0916 ? - 3 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. 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 AMERICAN Policy Number WC387821301 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 forthwith comply with those provisions. plicant: l% «- L, 0 S WARNING: FAIL RE 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 QQnQIt!Qns eno res(riojions 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 �ate: and c my ordinances and state laws relating to building construction, and hereby authorize representatives hiounty to enter upon 'above-mentioned property for inspection purposes. ` nature (Applicant or Agent): Ca #% -t /✓ Application Number . . . . . 07-00001405 Permit . . . Additional desc . . Permit Fee . . . . Imaue Dab:C . . Expiration Date . Qty Unit Charge 2800.00 .0350 LQPERMIT ELEC-NEW RESIDENTIAL 125.20 Plan Check Fee . Valuation . . . . 11/06/07 Per BASE FEE ELEC NEW RES - 1 OR 2 FAMILY 28.24 0 Extension 15.00 98.00 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 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 738.72 Issue Date Valuation . . . . 241854 Expiration Date 11/06/07 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 24.12 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 11/06/07 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 . . . Additional desc . . Permit Fee . . . . Imaue Dab:C . . Expiration Date . Qty Unit Charge 2800.00 .0350 LQPERMIT ELEC-NEW RESIDENTIAL 125.20 Plan Check Fee . Valuation . . . . 11/06/07 Per BASE FEE ELEC NEW RES - 1 OR 2 FAMILY 28.24 0 Extension 15.00 98.00 Application Number . . 07-00001405 Permit . . . . . . ELEC-NEW RESIDENTIAL Qty Unit Charge Per Extension 610.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 12.20 ---------------------------------------------------------------------------- Permit . . . Additional desc . Permit Fee Issue Date . . . . Expiration Date . . PLUMBING 189.00 Plan Check Fee . . 47.24 Valuation . . . . 0 11/06/07 Qty Unit Charge Per BASE FEE 15.00 Extension SFD - LOT 8. 2800 S.F. 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 6.00 .7500 EA PLB GAS PIPE >=5 4.50 1.00 ---------------------------------------------------------------------------- 15.0000 EA PLB GAS METER 15.00 Permit . . . Additional desc . Permit Fee Issue Date . . . . Expiration Date'. . GRADING PERMIT 15.00 11/06/07 Plan Check Fee . . .00 Valuation . . . . 0 Qty Unit Charge 'Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 8. 2800 S.F. SEDONA-CONT. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL/SPA, OR DRIVEWAY APPROACH. 2001 CBC, CMC, CPC, 2004 CEC, 2005 ENERGY CODES ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 104.63 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER- RES 995.00 ENERCY REVIEW FEE 139.27 DIF FIRE PROTECTION -RES 140.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES - RES 355.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 LQPERM[T F1 Application Number . . . . . 07-00001405 ---------------------------------------------------------------------------- Other Fees . . . . . . STRONG MOTION (SMI) - RES 24.18 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1930.00 Fee summary Charged Paid Credited Due ----------------- Permit Fee Total ---------- 1562.20 ------------------------------ .00 .00 1562.20 Plan Check Total 838.32 .00 .00 838.32 Other Fee Total 4733.08 .00 .00 4733.08 Grand Total 7133.60 .00 .00 7133.60 LQPERMIT