05-4645 (SFD)P.O. BOX -1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&t!t440"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 05-0000464-5::::__'_\_ Owner:
Property Address:
52170 ROSEWOOD—LN
RJT HOMES - CODORNIZ
APN: -
772-410-997-38 -32070 -
P.O. BOX 810
Application description:
DWELLING - SINGLE FAMILY DETACHED
LA QUINTA, CA 92253
Property Zoning: -
MEDIUM HIGH DENSITY RES_
Application valuation:
79869
ctor:
Applicant:
Architect or Engineer:
HOMES LLC
®XT 2 8 2U05NIX,
E. UNIVERSITY DRIVE
AZ 85034
( 0)123-4567
Li No.: 690645
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 Cod nd my License is in full force and effect.
Li se Class: A -B a No.: 690645
Dat ontractor: -
OWNER -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 ($500).:
(_ 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
I—) 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 thispermitis 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: 10/14/05
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 STATE FUND Policy Number 0014793-2005
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 subjec 1f''-rkers' compensation provisions of Section
3700 of ther Code, I shall fo comply with those provisions.
"Dale/_6/-
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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.
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 pr tion purposes.
ate, gnat ture (Appli or Agent):
U
.5
Application Number . . . . 05-00004645
Permit
. . .
BUILDING PERMIT
Additional
desc .
Permit Fee
. .
549.50
Plan Check Fee
89.30
Issue Date
Valuation . . . .
79869
Expiration
Date
4/12/06
Qty Unit Charge
Per
Extension
BASE
FEE
414.50
30.00
---------------------------------------=------------------------------------
4.5000
THOU RLDS
50.00.1-1.00..000
1.35.00
Permit
MECHANICAL
Additional
desc .
Permit Fee
. . . .
46.00
Plan Check Fee
2.88
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
4/12/06
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
1.00
6.5000
EA MECH
VENT FAN
6.50
1.00
6.5000
EA MECH
EXHAUST HOOD
6.50
Permit
ELEC-NEW RESIDENTIAL
Additional
desc .
Permit Fee
. . . .
67.29
Plan Check Fee
4.21
Issue Date
. . . . .
Valuation . .
0
Expiration
Date
4/12/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1250.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
43.75
427.00
----------------------------------------------------------------------------
.0200
ELEC
GARAGE•OR NON-RESIDENTIAL
8.54
Permit.
.
PLUMBING
Additional
desc .
Permit Fee
. . . .
128.25
Plan Check Fee
8.02
.Issue Date
Valuation . . .
0
Expiration
Date..
4/12/06
Qty Unit Charge
Per
Extension
BASE
FEE
- 15.00
10.00
6.0000
EA PLB
FIXTURE
60.00
1.00
15.0000
EA PLB BUILDING SEWER
15.00'
LQPERMIT
r r `
r
Application Number . . . . . 05-00004645.
Permit . . . PLUMBING
Qty Unit Charge Per
Extension
1.00 7.5000 EA PLB WATER HEATER/VENT
7.50 -
1.00 3.000.0 EA PLB WATER INST/ALT/REP
3.00
1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM
9.00
5.•00 .7500 EA PLB GAS PIPE >=5
3.75
1.00 15..0000 EA PLB GAS METER
15.00
Permit .GRADING PERMIT
Additional desc .
Permit Fee . . . . 15.00 Plan Check Fee
.00
Issue Date Valuation . . .
. 0
Expiration Date 4/12/06
Qty Unit Charge Per
Extension,
BASE FEE
15.00
Special Notes and Comments
SFD - LOT 38, PLAN SF1B, 1250 S.F.
PERMIT DOES NOT INCLUDE POOL, SPA,
BLOCK WALLS OR DRIVEWAY APPROACH. 75% 01 BLDG. M,
P/ 04 CEC/ 05 ENERGY
REDUCTION TO PLAN CHECK FEES DUE TO �.
MULTIPLE ISSUANCE.OF SAME PLAN TYPE
----------------------------------------------------------------------------
Other Fees DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
8.93
DIF FIRE PROTECTION -RES
97.00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
502.00
STRONG MOTION (SMI) - RES
7.98
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION-- RES
1098.00
Fee summary Charged Paid Credited
Due
----------------- ------------------------------ --
Permit Fee Total 806.04 .00 :00
806.04
Plan Check Total 104.41 .00 .00
104.41
Other Fee Total 2421.91. .00 .00
2421.91
Grand Total 3332.36 .00 .00-
3332.36
LQPERMTT
AW
J
Loj: Certificate of Occupancy
444
r' L.vcvr:elTM
OF Building & Safety Department
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at the time of issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City. regulating building
construction' and/or use.
BUILDING ADDRESS: 52-170 ROSEWOOD LANE "
Use classification: SFD Building Permit No.: 05-4645
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RMH
t
Owner of Building: RJT-CODORNIZ Address: P.O. BOX 810
City, ST, ZIP: LA QUINTA, CA 92253
By. DAVID GATICA
Date: AUGUST 25, 2006
Building Official
POST IN A CONSPICUOUS PLACE
09/17/2006 22:35 7605646505
f
CITY OF LA QUANTA
BUILDIN\ P ENT
CMDF TN<. I
INSPE , N REQUEST LINE
r 1777-7153�� ,
Owner - 2005
P LA QUINTA
Contractor
Permit Number -05.4645
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALI_ APPLICABLE SPACES
JOB ADDRESS-52,17-aRROSE-W-QQD LANE
SFD. LOT-38,PLAN SFIH. PERMIT DOES NOT INCLUDED
POOL, SPA, BLOCK WALLS OR DRIVEWAY
APPROACH.
TYPE OF INSPECTION DATE INSR
TEMPORARY POWER
SETBACKS /• _� fJ S
U/G PLUMBING / WASTE
U/G ELECTRICAL. /GROUNDING
FOOTING$ / STEEL
CONCRETE SLAB
-#10.NOT POUR CONCRETE UNTIL ABOVE SIGNED
R OF NAIL PRE -ROOF
OKAY -TIO -WRAP
FFA• UNG COMBINATION
cJGH ELECTRIC
ROUGH PLUMBING
ROUGH MECHANICAL
INSULATIONG.
COVER NO WORK UNTIL ABOVE SIGNED
INTERIOR GYP? BD. (DRYWALLI _ /..
SEPTIC ABANDONMENT
SEWER CONNECTION
SEPTIC / GREASE INTERCEPTOR
ST
BOND
POOL / SPA / WATER FEATURE INSPECTIONS
,PRE-GUNITE / SETBACKS
-U/G PLUMBING M-
U/G GAS
U/G ELECTRICAL
PRE -PLASTER ALARMS /BARRIERS)
FINAL INSPECTIONS
TEMP. USE OF PERMANENT POWER /
ELECTRICAL
PLUMBING
Pb,—IC WORKS DEPARTMENT - Q� N✓ M_
COMMUNITY DEVELOPMENT DEPT. -D 6
FINAL/ JOB COMPLETED
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURNON• UTILITIES OR 00CUPY BU1LDiNG: