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05-2659 (SATT)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 TL DINQ & SAFETY DEPARTMENT. UIL G PERMIT Application Number: 05-00002659 �V� Owner: Property Address: 80282 VIA TESORO®ry TOLL CA V APN: 772-250-019-14 -303570M `j%C C/O KEVIN D DUERMIT Application description: DWELLING - SINGLE FAMILY ATTA yq P ✓. 8901 E MOUNTAIN VIEW 200 Property Zoning: LOW DENSITY RESIDENTIAL NC�Oa!//H� SCOTTSDALE, AZ 85258 Application valuation: 244630 FAj '4 Contractor: Applicant:.-,A-rchitect or Engineer: TOLL BROS, INC. 73121 FRED WARING DRIVE, #100 YYY��` fi "•1"`\ PALM DESERT, CA 92260 (760)674-9699 Lic. No.: 777699 I hereby affirm under penalty of perjury that I am 11 ' nsed under provisions ' hapter 9 (commencing with Section 7000) of Division 3 of the Business and P fessionals Code, and�,'(,/License is in full force and effect. License Class: $ / / A 4, License No.: 77699 �te:`�7/�ontractor: ry `F7 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjYe' 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,air 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).: (_) 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 ari 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 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 (760) 777-7153 Date: 6/29/05 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. 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 _ 1 certify that, in the performance of the work for which this permit is issu , I shall not employ any person in any manner so as to come subject to the workers' com _tion laws of California, and agree that, iJCobec a subject to the workers' compe on provisions of Section OO�f-tfie Labs r II with comply i those pr 'ions. 7� f t5 scant:iING: FA URSECURERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CPENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN AD0THE 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 permi , or cessation of work for 180 days ill subject permit to cancellation. I certify that I have read this application and state that the abov information is correct. I agree to o ply with all city and county ordinances ate laws relating to bu�'ng truction, and hereby authorize ep sentatives of this co '7ty to nt on the above-mentioned pro r f i ti n purposes Vie: / f% gntu e Applicant or Agent): Application Number . . . . . 05-00002659 LQPERHITT Structure Information Construction Type . . . . . TYPE V - 1 HR Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10 Flood Zone . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 # BEDROOMS 3.00 FLOOD ZONE NO GARAGE SQ FTG 547.00 PATIO SQ FTG 418.00 TUT E1,iUi8LE PTO NUMBER OF UNITS 1.00 ------------------------------------------- 2ND FLOOR SQUARE FOOTAGE -------------------------------- 2748.00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 1147.00 Plan Check Fee 186.39 Issue Date . . . . Valuation . . . . 244630 Expiration Date . . 12/26/05 Qty Unit Charge Per Extension BASE FEE 639.50 145:00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 507.50 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 116.00 Plan Check Fee 7.25 Issue Date . . . . Valuation 0 Expiration Date 12/26/05 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 9.00 6.5000 EA MECH VENT FAN 58.50 1.00 6.5000 ----------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . . Permit Fee . . . . 130.48 Plan Check Fee 8.16 Issue Date Valuation . . . . 0 Expiration Date 12/26/05 Qty Unit Charge Per Extension BASE FEE 15.00 LQPERHITT Application Number . . . . . 05-00002659 Permit . . . . . . ELEC-NEW RESIDENTIAL Qty Unit Charge Per Extension 2748.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 96.18 965.00 ---------------------------------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 19.30 Permit . . . . . PLUMBING Additional desc . Permit Fee 183.75 Plan Check Fee 11.49 Issue Date Valuation . . . . 0 Expiration Date 12/26/05 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 9.00 .7500 EA PLB GAS PIPE >=5 6.75 1.00 15.0000 EA PLB GAS METER 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFA - PLAN TYPE A2 - UPPER FLOOR UNIT - 2748 SF LIVING, R-3 OCCUPANCY, TYPE V-1HR CONSTRUCTION, 2001 CODES. **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 14 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 111.57 DIF COMMUNITY CENTERS -RES 68.00 DIF CIVIC CENTER - RES 229.00 ENERGY REVIEW FEE 18.64 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 23.83 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 LQPERMIT . . . . . 05-00002659 1577.23 .00 .00 1577.23 213.29 .00 .00 213.29 2155.04 .00 .00 2155.04 3945.56 .00 .00 3945.56