05-2664 (SATT);- P . BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05-00002664
Property Address: 80287 VIA TESORO 185
APN: 772-250-019-9 -30357 -
Application description: DWELLING - SINGLE FAMILY
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 195908
Applicant:
T4tyl 4 4Qur«rw
& SAFETY DEPARTMENT
PERMIT
/rc�J ct or E
J
--------------------------------------------------
LICENSED ONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am li nsed under provisions o Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and P ofessionals Code, and License is in full force and effect.
License Class: License No.:77699
te: tractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjur that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Busin ss 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 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
1 _) 1 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: wu
Lender's Address: r •
LQPERA11T
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/30/05
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
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.
1 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 �,n work forwhich this permit is issued, I shall not employ any
person in any manner so as to me subject to the orkers' compensation laws of California,
and agree that, if I should becoubject to the wo ers' compensation provisions of Section
e Labor Code, I hawith comply w -provisions.
ate:14700:!�_
r Applicant:
WARNING: FAILURE TO SECURE WO COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINPENALTIES 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 n II and void if work is not commenced
within 180 days from date of issuance of such permit, or essation of work for 180 days will subject
permit to cancellation.
I certify that 1 have read this application and state that the above in rmation is correct I agree to comply with.all
city and c unty dinances an ate laws relating to building con 'on, and hereb thorize representatives
of this co my to enter the above-mentioned property f in n p s
bete: ignature (Applicant or Agent):
Application Number . . . . . 05-00002664
Structure Information
Construction Type . . . . . TYPE V - 1 HR
Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10
F1ood.Zone . . . . . NON -AO FLOOD ZONE
Other struct info . . . . . CODE EDITION 2001
# BEDROOMS 3.00
FLOOD ZONE NO
GARAGE SQ FTG 450.00
PATIO SQ FTG 140.00
Tu'r ELIGIBLE N
NUMBER OF UNITS 1.00
1ST FLOOR SQUARE FOOTAGE 2233.00
--------------------=-------------------------------------------------------
Permit . .
Additional desc .
Permit Fee . . .
Issue Date . . .
Expiration Date .
BUILDING PERMIT
975.50
12/27/05
Plan Check Fee . . 158.52
Valuation . . . . 195908
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 . .
. .
72.00
Plan Check Fee
4.10
Issue Date . .
. .
Valuation . . .
. 0
Expiration Date
. .
12/27/05
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
5.00
6.5000
EA MECH
VENT FAN
32.50
1.00
----------------------------------------------------------------------------
6.5000
EA MECH
EXHAUST HOOD
6.50
Permit . . .
Additional desc . .
Permit Fee . . . .
Issue Date . . . .
Expiration Date . .
Qty Unit Charge
LQPERDSIT
ELEC-NEW RESIDENTIAL
104.96 Plan Check Fee . .
Valuation . . . .
12/27/05
Per
BASE FEE
6.56
0
Extension
15.00
0 Application Number . . . . . 05-00002664
Permit . . . . . . ELEC-NEW RESIDENTIAL
Qty Unit Charge
Per
Extension
2233.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
78.16
590.00 .0200
----------------------------------------------------------------------------
ELEC GARAGE OR NON-RESIDENTIAL
11.80
Permit . .
PLUMBING
Additional desc . .
permit PPP
178,50 Plan Check Fee
11.16
Issue Date . . . .
Valuation . . . .
u
Expiration Date . .
12/27/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
17.00 6.0000
EA PLB FIXTURE
102.00
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
6.00 .7500
EA PLB GAS PIPE >=5,
4.50
1.00 15.0000
EA PLB GAS METER
15.00
----------------------------------------------------------------------------
Special Notes and Comments
SFA - PLAN TYPE B1 -
GROUND FLOOR UNIT,
2233 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
REPETITION OF IDENTICAL PLAN TYPE.
BLDG. 2, LOT 9
----------------------------------------------------------------------------
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
19.59
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary Charged
---------------------------
Paid Credited
------------------------------
Due
LQPERMIT
Application Number 05-00002664
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
LQPERMIT
7.330.96 .00 .00 1330.96
180.34 .00 .00 180.34
2036.44 .00 .00 2036.44
3547.74 .00 .00 3547.74