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05-2655 (SATT)`P.,�X 1504 • 4Q" 78-495 CALLE TAMPICO 0 LA QUINTA, CALIFORNIA 92253 B D & SAFETY DEPARTMENT �� UIL - G PERMIT Application Number: 05-00002655 � ?O Owner: Property Address: 80280 VIA TESORO A,, TOLL CA V APN: 772-250-019-13 -30357 - {��j_ DOS D C/O KEVIND DUERMIT Application description: DWELLING - SINGLE FAMILY AT AC CF Q, 8901 E MOUNTAIN VIEW 200 Property Zoning: LOW DENSITY RESIDENTIAL ��`p' SCOTTSDALE, AZ 85258 Application valuation: 195692 Contractor: Applicant: rrcchitect or Engineer: % TOLL BROS , INC. I FRED 226IVE, #100 PALMDESERT, CA (760)674-9699 Lic. No.: 777699 LICENSED I hereby affirm under penalty of perjury that I am lice Section 7000) of Division 3 of the Business and Pr License Class: B to 7 ntractor OWNER-EDILDER DECLARATION I hereby affirm under penalty of perjurZorrshe t I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Busind Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, oir any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that 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).: (_) I, as owner of the property, or my employees with wages as their sale 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 am exempt under Sec. , B.&P.C. for this reason rRACTOR'S DECLARATION under provisions of Chapter(commencing with tats Code, and my License ig m full force and effect. license Nn.: 7776994 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: LQPERi11IT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/29/05 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 1 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 LIBERTY MUTUAL Policy Number WA762DO04723014 _ I certify that, in the performance of 3 work for which this permit is issued, I shall not employ any person in any manner so as to be ome subject to the workers' compensation laws of California, and agree that, if I should beco 'e subject to the workers' ensation provisions of Section 3 00 Lor Cod I sh f h ith capovisions. /2q^r•.41 D tr WARNING: FAILURE TO SECURE W RKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRI AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDIT N 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 i ormation is correct. I r to comply with all city and county ordinances and state laws relating to building co truction, and hereby rize representatives of this�c%o my o en u the above-mentioned property or i i p DatQ: / 'Signature (Applicant or Agent): Application Number . . . . . 05-00002655 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 PATIO SQ FTG 156.00 TOT ELIGIBLih 11O NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 2110.00 ---------------------------------------------------------------------------- Permit . . Additional desc . Permit Fee . . . Issue Date . . . Expiration Date . BUILDING PERMIT 975.50 12/26/05 P1an.Check Fee . . 158.52 Valuation . . . . 195692 Qty Unit Charge Per Extension BASE FEE 639.50 96.00 --------------------------------------------------7------------------------- 3.5000 THOU BLDG 100,001-500,000 336.00 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 91.50 Plan Check Fee 5.72 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/26/05 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 6.88 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/26/05 Qty Unit Charge Per Extension BASE FEE 15.00 LQPERAIIT LQPERMIT Application Number . . . . . 05-00002655 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 10.83 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/26/05 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 --------------------------------------------------------- ------------------ Special Notes and Comments SFA - PLAN TYPE Al - GRND FLOOR UNIT 2,110 SF LIVING, R-3 OCCUPANCY, TYPE V-1HR CONSTRUCTION, 2001 CODES. [PLAN TYPE B2 GARAGE ATTACHED TO THIS PLAN TYPE] **PERMIT DOES NOT INCLUDE TEMP POWER, TRASH ENCLOSURE, BLOCK WALLS AND SITE LIGHTING** REDUCED PC FEES FOR REPITITION OF IDENTICAL PLAN TYPE. BLDG. 3, LOT 13 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . DIF COMMUNITY CENTERS-RES 68.00 DIF CIVIC CENTER - RES 229.00 ENERGY REVIEW FEE 15.85 DIF FIRE PROTECTION-RES 78.00 DIF LIBRARIES - RES 158.00 DIF PARK MAINT FAC - RES 3.00 DIF PARKS/REC - RES 352.00 STRONG MOTION (SMI) - RES 14.05 DIF STREET MAINT FAC-RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid . Credited --------------------------------------------------------- Due LQPERMIT Application Number Permit Fee Total Plan Check Total Other Fee Total Grand Total LQPERAIIT 05-00002655 1350.32 .00 .00 1350.32 181.95 .00 .00 181.95 2030.90 .00 .00 2030.90 3563.17 .00 .00 3563.17