09-0830 (SATT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
09-00000830
Property Address:
80250 VIA TESORO
APN:
772-250-019-45 -30357 -
Application description:
DWELLING - SINGLE FAMILY
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
235565
mum
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/10/09
Owner:
TOLL CA V
C/O KEVIN D DUERMIT
ATTACHED 8901 E MOUNTAIN VIEW 200
SCOTTSDALE, AZ 85258
Contractor:
Applicant: Architect or Engineer: TOLL BRO
73121 FR
PALM DES
(760) 674
Lic. No.
LICENSED CONTRACTOR'S DECLARATION
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 p License No.: 777699
Date:�id �0 / ontractor: /�1Z
ER -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 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.).
( 1 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:
LQPERA11T
C. � l
RI VE, #100
CA 9226.0
699 v� It
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
3700 of the Labor Code, I Spall forth . comply with those provis'ons.
Da�plicant:
WARNING: FAIL RE TO SECURE WORKERS' CIZENSATION 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 ago county ordinances and state laws relating to building construction, and hereby authorize representatives
oft (�//county [o enter upon the above-mentioned propert or 'n ection pur es.
DateV' 0oO� S' 01sture (Applicant or Agent):
,til -
Application Number . . . . . 09-00000830
Structure Information
Construction Type . . . . . TYPE V - 1 HR
Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10
Flood Zone . . . . . NON -AO FLOOD ZONE
Other struct info . . . . . CODE EDITION 2007
# BEDROOMS 2.00
FLOOD ZONE NO
GARAGE SQ FTG 503.00
PATIO SQ FTG 173.00
TOT ELIGIBLE NO
NUMBER OF UNITS 1.00
2ND FLOOR SQUARE FOOTAGE 2694.00
----------------------------------------------------------------------------
Permit . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 1115.50 Plan Check Fee 725.08
Issue Date . . . . Valuation . . . . 235565
Expiration Date . . 2/06/10
Qty Unit Charge Per Extension
BASE FEE 639.50
136.00 3.5000 THOU BLDG 100,001-500,000 476.00
----------------------------------------------------------------------------
Permit . . . ELEC-NEW RESIDENTIAL
Additional desc . .
Permit Fee . . . . 122.81 Plan Check Fee 30.70
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 2/06/10
Qty Unit Charge Per Extension
BASE FEE 15.00
2694.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 94.29
676.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 13.52
----------------------------------------------------------------------------
Permit . . . MECHANICAL
Additional desc . .
Permit Fee . . . . 90.00
Issue Date . . . .
Expi rati nn T)atP ?,Inti/in
Plan Check Fee . .
Valuation . . . .
Qty Unit Charge Per
BASE FEE
2.00 9.0000 EA MECH FURNACE <=100K
2.00 9.0000 EA MECH B/C <=3HP/100K BTU
22.50
0
Extension
15.00
18.00
18.00
LQPERMIT - -
Application Number . . . . 09-00000830
Permit . . . . . . MECHANICAL
Qty Unit Charge
Per
Extension
5.00 6.5000
EA MECH VENT FAN
32.50
1.00 6.5000
---------------------------------------------------------------
EA MECH EXHAUST HOOD
6.50
-------------
Permit . . .
PLUMBING
Additional desc .
Permit Fee . . . .
183.00 Plan Check Fee
45.75
Issue Date . . . .
Valuation . . . .
0
Expiration Date
2/06/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
19.00 6.0000
EA PLB FIXTURE
114.00
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 7.5000
EA PLB OTHER BACKFLOW <=2 INCH
7.50
8.00 .7500
EA PLB GAS PIPE >=5
6.00
1.00 15.0000
EA PLB GAS. METER
15.00
----------------------------------------------------------------------------
Special Notes and Comments
SFA - PLAN TYPE C2 -
UPPER FLOOR UNIT -
2694 SQ.FT. LIVING, R-3
OCCUPANCY, TYPE
VA-1HR CONSTRUCTION,
2007 CODES.
**PERMIT DOES NOT INCLUDE
TEMP POWER,
TRASH ENCLOSURE, BLOCK
WALLS AND SITE
LIGHTING** BLDG. 9, LOT 45 SEE PERMIT
#05-3154 FOR PREVIOUS
RECORDED
INSPECTIONS.
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . BLDG STDS ADMIN (SB1473)
10.00
ENERGY REVIEW FEE
72.51
STRONG MOTION (SMI) - RES
23.55
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
f;ranr9 Tntal
LQPERMIT
Charged Paid
1511.31 .00
824.03 .00
106.06 .00
'?11,41.44 .44
Credited Due
.00 1511.31
.00 824.03
.00 106.06
.00 2111,10
No, 4791 P. 7-" -J '
c -02
04 � yao
TY OF LA OUNTA
o DING & SAFETY DEPARTMENT
op �� w (760) 777-7012
INSPECTION REQUEST LINE
7
.5-0 (760) 177-7153
Permit Nu lb
POST ON J B CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS—Qn_2en VI A T UJR
SFA -)-LAN TYPE CS - UPPER FLOOR UNIT
2690 SQ.FT, LIVING, R-0 OCCUPANCY, TYPE VA-IIIR CONSTRUCTION, 1007 CODES.
""PERMIT DOES NOT INCLUDE TENY M%VER,TRASH ENCLOSURE, BLOC$( WALLS ANP
SITE LIGHTING" BLDG. 9. LOT 45 SEE PERMIT HOSJ154ROkPFYVIOUSRECORDED
INSPECTIONS,
TYPE OF INSPECTION DATE INSP.
L
DO N
ROOF NAIL / RE -R
OKAY TO WSAP
FRAMING (COMBIN
UGH FLECTRI
CONCRETE UWIL ABOVE SIGNED
NTIL
INTERIOR GYP, BD. DRYWALL
EXTERIOR LATH
GAS TEST
SEPTIC ABANDONMENT
SEWER CONNECTION
SEPTIC / GREASE INTERCEPTOR C4 ov
MASONRY IN SP TIONS
FOOTINGS /STEEL
BOND BEAM
POOL / SPA / WATER FEATURE INSPECTIONS
PRE-GUNITE / SETBACKS_
U/G PLUMBING
PRE -PLASTER (ALARMS/ BARRIERS)) I
FINAL INSPECTIONS
TEMP. USE OF PERMANENT POWE
ELECTRICAL
PLUMBING
MFr'HANICAL
C '10 WORKS DEPARTMENT 10
CUMMUNITY DEVELOPMENT DEPT I
FINAL / JOB COMPLETED
r yltr�! -1Q
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
Certificate of Occupancy
°� .�i,Qrtlafa
Building & Safety Department
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at the time of . issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
BUILDING ADDRESS: 80-250 VIA TESORO
Use classification: SFD Building Permit No.:9-830
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL
Owner of Building: TOLL CA V Address: 8901 E MOUNTAIN VIEW
City, ST, ZIP: SCOTTSDALE AZ 85258
By: KIRK KIRKLAND
Date: 3-11-2010
Building Officiaf
POST IN A CONSPICUOUS PLACE