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09-0216 (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: T4ht 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT x'09.7.00000216;� 80236 VIA TESORO 772-250-018-12 -31349 - DWELLING - SINGLE FAMILY DETACHED LOW DENSITY RESIDENTIAL 227594 H - Architect or Engineer: -------------------------------------------------- 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 y� 1— _Liicense No.: 777699 S_tJQt T/fit 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 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, 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 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 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 (760)674-9699 Lic. No.: 777699 VOICE (760) 777-7012 , FAX (760) 777-7011 INSPECTIONS (760) 777-7153 J 3/09/09 MAR 61U� ----------------------------------------------- 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 WC3878213-03 _ 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 /)Q 3700 of the abor Code, I shall forthwit comply wi h those provisions. �`' pplicant: WARNING: FAILURE TO SECURE WORKERS'ENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL S 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, and hereby authorize representatives of this county to center upon a above-mentioned pro y for inspection urposes., Faidnature (Applicant or Agent): Application Number . . . . . 09-00000216 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 2001 CBC # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 495.00 PATIO SQ FTG 399.00 NUMBER UN uN1'1'b i. 00 1ST FLOOR SQUARE FOOTAGE 2631.00 ---------------------------------------------------------------------------- Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 1087.50 Plan Check Fee 706.88 Issue Date . . . . Valuation . . . . 227594 Expiration Date . . 9/05/09 Qty Unit Charge Per Extension BASE FEE 639.50 128.00 --------------------7------------------------------------------------------- 3.5000 THOU BLDG 100,001-500,000 448.00 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 109.50 Plan Check Fee 27.40 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 9/05/09 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 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 . . . . 116.99 Plan Check Fee 29.24 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/05/09 Qty Unit Charge Per Extension BASE FEE 15.00 2631.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 92.09 LQPMIIT Application Number . . . . . 09-00000216 Permit . . . . . . ELEC-NEW RESIDENTIAL Qty Unit Charge Per Extension 495.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.90 ---------------------------------------------------------------------------- Permit . . . PLUMBING Additional desc . Permit Fee . . . 189.00 Issue Date . . . . Expitati6ft Ldte . . 9/US/Uy Plan Check Fee 47.24 Valuation 0 Qty Unit Charge Per BASE FEE Extension ---------------------------------------------------------------------------- Special Notes and Comments 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 . . . GRADING PERMIT Additional desc . . Permit Fee . . . . 15.00 Issue Date . . . . Expiration Date . . . 9/05/09 Plan Check Fee . . .00 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 12. 2631 S.F.CAMINA-SB PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL/SPA, OR DRIVEWAY APPROACH. 2007 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 68.98 BLDG STDS ADMIN (SB1473) 10.00 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 70.69 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 STRONG MOTION (SMI) - RES 22.75 LQPERMIT Application Number . . . . . 09-00000216 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1930.00 Fee summary ----------------- Charged ---------- Paid ---------- Credited -------------------- Due Permit Fee Total 1517.99 .00 .00 1517.99 Plan Check Total 810.76 .00 .00 810.76 Other Fee Total 4647.42 .00 .00 4647.42 Grand Total 6976.17 .00 .00 6976.17 LQPERMIT