13-1425 (SFD)P.O. BOX 1504 TAt, VOICE (760) 777-7012,
78-495 CALLE TAMPICO t44 FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMEN INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 11/21/13
Application Number' 13-00001425
Property Address: 52050 ROSEWOOD LN
APN: 772-410-997-25 -32070
Application description: DWELLING - SINGLE FAMILY DETACHED
Property Zoning: MEDIUM HIGH DENSITY RES
Application Valuation: 114693
Applicant: . Architect or Engineer:
Lic. No.: OOR SQUARE FOOT
------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed sions of Chapter 9 lcommencing with
Section 7000) of D ivision 3 of the !�piilss and Pr d my License is in full force and effect.
License Class: A B 690645
1 Date:'11'7-1 ' 2-01 k—ontractor:
VWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason JSec. 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 7600) 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, 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, 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
Owner:
RJT HOMES - CODORNIZ
P.O. BOX 810
LA QUINTA, CA 92253
Contractor:
RJT,INVESTMENTS INC
1425 E. UNIVERSITY
PHOENIX, AZ 85034
.(602)257-1656
Lic. No.: 690645
DR I �E . NOV�2,1201]3�
CITYOFLAQUINTA
FINANCE DEPT.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - —
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 i�
issued.
I have and will maintain workers' compensation in;urance, 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 LUMBERMEN'S LTND _ Policy Number 429034
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 subjec the workers' compensation laws of California,
and agree that, if I PlId,become s to t workers' compensation provisions 'of Section
3700 of the Lab h I I rt co with those provisions.
Date: 11"V-201pplicant7
WARNING: FAILURE TO SECURE WORKERS' COMPENSATI 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.
ubl
2. Any permit is ued as a result of this application becomes null and void if work is not commenced
within 180 ifays from date of issuance of such permit, or cessation of ork for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that th ove inform ton r ct. I agree to comply with all
city and county ordinances and state laws relating to g constru io r by authorize representatives
of this county to enter upon the above-mentioned p pe for insp rp9i
2
Date _/'70[?Signature (Applicant or Agent):
Application.Number . . . . . 13.-00001425
j
LQPERMIT
Permit .
. ... . .
BUILDING 2013
Additional'desc
Permit Fee
. . . .
50 4.76
Plan Check Fee
00
Issue Date
Valuation
114693
Expiration
Date
5/20/14
Qty Unit Charge
Per
Extension
BASE
FEE
431.86
90.00
.8100
THOU BLDG
$25,001-$200,000
72.90-*
Permit .
. . . . .
ELECTRICAL
2013
Additional
desc
Permit Fee
. . . .
191.15
Plan Check Fee
.00
Issue Date
. . . .
Valuation . . .
. 0
Expiration
Date
5/20/14
Qty Unit Charge
Per
Extension
1.00
23.8300
EA ELEC
SERVICES
23.83
1.00
143.0000
LS ELEC
NEW RES, FIRST 1 KSF
143.00
2.00
----------------------
12.1600
7 -----------------------------------------------------
EA ELEC
NEW RES, ADDIL 1 KSF
24.32
Permit . .
. . . .
MECHANICAL
2013
Additional
desc
Permit Fee
. . . .
143.02
Plan Check Fee
.00
Issue Date
. . . .
Valuation
0
Expiration
Date
5/20/14
Qty Unit -Charge
Per
Extension
1.00
35.7500
EA MECH
FURNACE
.35.75
1'.00
35.7500
KA MECH
CONDENSER/COMP
35.75
5.'00
11.9200
EA MECH
VENT FAN
59.60
1.00
-----------------------------------------------------------------------------
11.9200
EA MECH
EXHAUST HOOD
11.92
Permit . .
. .
PLUMBING 2013
Additional
desc
Permit Fee
. . . .
226.47
Plan Check Fee
.00
Issue Date
. . . .
Valuation . . .
. 0
Expiration
Date
5/20/14
Qty Unit Charge
Per
Extension
13.00
11.-9200
EA PLBG-FIXTURE/TRAP
154.96
1.00
11.9200
EA PLBG
BUILDING SEWER
11.92
1.00
11.9200
EA PLBG
WATER HEATER/VENT
11.92
1.00
11.9200
EA PLBG
WATER INST/ALT/REP
11.92
j
LQPERMIT
Application Number . . . . .. 13-00001425
Permit . . . . . PLUMBING 2013
Qty Unit Charge
Extension
-Per
1.00 35.7500 LS PtBG GAS SYS,'5+ OUTLETS
35.75'
-
-------------------------------------------------------------
Special Notes and Comments
----------------
..1,731SF DWELLING - PLAN SF3ASG, LOT 25
[VB/RES-3/CLASS A-FR/13D/ENGINEERED]
THIS PERMIT DOES NOT INCLUDE BLOCK WALLS,
OR WATER FEATURES. 2010 CALIFORNIA
DUILDING CODEJ.
----------------------------------------------------------- ----------------
Other Fees . . . . . . . ... BLDG STDS.ADMIN (SB1473)
5.00
DIF COMMUNITY CENTERS -RES
129.00
DIF,CIVIC CENTER - RES
942.00
DIF FIRE PROTECTION -RES
433.00
DIF LIBRARIES - RES
344.00
MULTI -SPECIES (MSHCP) FEE
531.00
PLAN CHECK, ELECTRICAL
69.13
DIF PARK MAINT FAC - RES
40.00
PLAN CHECK, MECHANICAL
76.28
PLAN CHECK, SFD GRADING
143.00
PLAN CHECK, PLUMBING
209.78
DIF PARKS/REC - RES
2048.00
BLDG PC 25001-200K
990.15
STRONG MOTION (SMI) RES
.11.47
TUMF: RESIDENTIAL
1837-44
DIF STREET MAINT FAC -RES
116.00
DIF TRANSPORTATION - RES
2842.00
-Fee summary Charged. Paid Credited
---------- ---------- ---------- ----------
Due
-----------------
Permit Fee Total 1065.40 .00 ..00
.1065.40
Plan Check Total ..00 .00 .00
.00
Other Fee Total 107,67.25 .00 .00
10767.25
Grand Total 11832.65 .00 .00
11832.65