08-1354 (SATT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
T-ityl 4 4v Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
08-00001354
80255 VIA TESORO
772-250-019-34 -30357 -
DWELLING - SINGLE FAMILY ATTACHED
LOW DENSITY RESTDRNTIAL
195692
Architect or Engineer:
A�
---------------------------------------------------
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 Licen a No.: 777699
Date,/Lo'��"�%s tractor:
WNER-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.).
(_) 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. , BAP.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:
A P4
Lender's Address: �\ 1
LQPERMIT
Owner:
TOLL CA V
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/08/08
C/O KEVIN D DUERMIT
8901 E MOUNTAIN VIEW 200 D
SCOTTSDALE, AZ 85258
Contractor: OCT 14 2008
TOLL BROS, INC.
73121 FRED WARING DRIVE #100CTY FQU,Iyr
PALM DESERT, CA 92260 ANCEDEPT,
(760)674-9699
Lic. No.: 777699
------------------
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 WC3878213-02
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
`` 37000 of the Labor Code, I shall fort ith comp) with those provisions./le
ate:/o ��o pplicant:
WARNING: FAILURE TO SECURE WORKERS' MPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PEN LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$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 enter upon the above-mentioned property for inspection urposas,
/Date _/-3 gnature (Applicant or Agent):
11�6—
Application Number . . . . . 08-00001354
LQPERMIT
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
2001
# BEDROOMS
2.00
FLOOD ZONE
NO
GARAGE SQ FTG
901.00
PATTO $Q FTG
156.00
TOT ELIGIBLE
NO
NUMBER OF UNITS
1.00
----------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
2110.00
Permit . . .
BUILDING PERMIT
Additional desc . .
Permit Fee . . . .
975.50 Plan Check Fee
634.08
Issue Date . . . .
Valuation . .
. . 195692
Expiration Date . .
2/04/09
Qty Unit Charge
Per
Extension
BASE FEE
639.50
96.00 3.5000
----------------------------------------------------------------------------
THOU BLDG 100,001-500,000
336.00
Permit . . .
MECHANICAL
Additional desc . .
Permit Fee . . . .
91.50 Plan Check Fee
22.88
Issue Date . . . .
Valuation . .
. . 0
Expiration Date . .
2/04/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 9.0000
EA MECH FURNACE <=100K
9.00
1.00 9.0000
EA MECH B/C <=3HP/100K BTU
9.00
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 . . . .
110.07 Plan Check Fee
27.52
Issue Date . . . .
Valuation . .
. . 0
Expiration Date . .
2/04/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
LQPERMIT
Application Number . . . . . 08-00001354
Permit . . . . . . ELEC-NEW RESIDENTIAL
Qty
Unit Charge
Per
Extension
2110.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
73.85
1061.00
----------------------------------------------------------------------------
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
21.22
Permit
. . .
PLUMBING
Additional
desc .
Permit Fee
. . . .
173.25
Plan Check Fee
43.31
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date . .
2/04/09
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
16.00
6.0000
EA
PLB
FIXTURE
96.00
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
1.00
7.5000
EA
PLB
OTHER BACKFLOW <=2 INCH
7.50
7.00
.7500
EA
PLB
GAS PIPE >=5
5.25
1.00
----------------------------------------------------------------------------
15.0000
EA
PLB
GAS METER
15.00
Permit . .
Additional desc .
Permit Fee . . .
Issue Date . . .
Expiration Date .
GRADING PERMIT
15.00
2/04/09
Plan Check Fee
Valuation . .
Qty Unit Charge Per _ Extension
BASE FEE 15.00
----------------------------------------------------------------------------
Special Notes and Comments
SFA - LOT 34 PLAN TYPE Al - GRND FLOOR
UNIT
2,110 SF LIVING, R-3 OCCUPANCY, TYPE
V-1HR CONSTRUCTION, 2007 CODES. [PLAN
TYPE B2 GARAGE ATTACHED TO THIS PLAN
TYPE] **PERMIT DOES NOT INCLUDE TEMP
POWER, TRASH ENCLOSURE, BLOCK WALLS AND
SITE LIGHTING**
----------------------------------------------------------------------------
Other Fees . . . . . . . DIF COMMUNITY CENTERS -RES 56.00
DIF CIVIC CENTER - RES 325.00
ENERGY REVIEW FEE 63.41
DIF FIRE PROTECTION -RES 45.00
LQPERMIT
Application Number . . . . . 08-00001354
----------------------------------------------------------------------------
Other Fees . . . . . . . . . DIF
LIBRARIES - RES
266.00
DIF
PARK MAINT FAC - RES
16.00
DIF
PARKS/REC - RES
669.00
STRONG MOTION (SMI) - RES
14.05
DIF
STREET MAINT FAC -RES
67.00
DIF
TRANSPORTATION - RES
1930.00
Fee summary Charged
Permit Fee Total 1365.:32
Plan Check Total 727.79
Other Fee Total 3451.46
Grand Total 5544.57
LQPERMIT
Paid Credited Due
.00 .00 1365.33
.00 .00 727.79
.00 .00 3451.46
.00 .00 5544.57