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05-4634 (SFD)P:O. BOX 1504 78-495 CALLE TAMPICO -LA-QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: '05=00004-634'' . Property Address: 52177'ROSEWOOD LN APN: 772-410-997-140 -32070 Application description: DWELLING - SINGLE FAMILY DETACHED Property Zoning: - - . = MEDIUM HIGH DENSITY RES Application valuation: 88677 Applicant: Krchitect or Engineer: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/14/05- Owner: RJT HOMES - CODORNIZ P.O. BOX 810 LA QUINTA, CA 92253 IDontractor: OCT.�� JT HOMES LLC 425 E. UNIVERSITY DRIVE OENIX, AZ 85034 Cffy.0, 760) 123-4567 'c. No.: 690645 LICENSED CONTRACTOR'S DECLARATION YI hereby affirm under penalty of perjurythat I am licensed under provisi s of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals , and my License is in full force and effect. License Class: A -B nse No.: 690645 ate v ntractor. 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 apermit 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.). ( 1 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 ISec. 3097, Civ. C.). Lender's Name: - - Lender's Address LQPERMIT 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. 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 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 subject tot ters' compensation provisions of Section 3700 of the Labor Code, I shall forth omply with those provisions. ' + atr0pplicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED: THOU SAND DOLLARS ($100,000)..INADDITION 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 of 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 thai the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, an rIwauthorize representatives of this county to enter upon the above-mentioned property. for inspec ' poses. at�� gf n�re (Applicant or Agent): . Application Number 05-00004634 Permit . . BUILDING PERMIT Additional desc . Permit Fee 590.00 Plan Check Fee 95.88 Issue Date Valuation 88677 Expiration Date 4/12/06 Qty Unit Charge Per Extension BASE FEE 414.50 3.9.00 4.5000 ---------------------------------------------------------------------------- THOU BLDG 50,001-100,000 175.50 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 72.72 Plan Check Fee 4.55 Issue Date . . . . Valuation 0 Expiration Date 4/12/06 Qty Unit Charge Per Extension BASE FEE 15.00 1385.00 .0350 ELEC NEW RES -.1 OR 2 FAMILY 48.48 462.00 .0200 ------------------------------------------------------------------------------ ELEC GARAGE OR NON-RESIDENTIAL 9.24 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 . f 'Application Number 05-00004634 , . Permit `. PLUMBING. Qty Unit Charge Per_ ,Extension 1.00 . 7 . 5000 .EA PLB .WATER- HEATER/VENT r. 7:50 • 1.00 • 3.0000 EA PLB•WATER.INST/ALT/REP 33.00•; e 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 ' • ; - -----------------------.----- ;- --'---, -------------------- ,----------- r .----M 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. - '. t --- ---r----------------------------------.------------------------------- Special Notes and Comments + - SFD - LOT. 140,'PLAN'SF2A, 1385'S.F. . -PERMIT,DOES•NOT INCLUDE POOL, SPA',BLOCK ` l OR 01 BLDG. M, P/ 04 CEC/'05TNERGY • REDUCTIONLTO PLANT HVEWAY ECK FEESODUE T05g MULTIPLE -ISSUANCE OF SAME PLAN TYPE ' •---•'.=--------------------------------------------=-.------------------------ - - - Other Fees' DIF COMMUNITY CENTERS -RES 97.00, DIF CIVIC CENTER --RES -366..-00 r k ENERGY REVIEW FEE 9.59 DIF FIRE PROTECTION -RES 97.00 ` DIF LIBRARIES - RES- 225.00 f DIF PARK MAINT'FAC _ RES• 5.00`. - • DIF PARKS/REC-- RES, 502.00 - ` STRONG STRONG MOTION -(SMI) - RES 8.86 - DIF STREET MAINT'FAC-RES 15.00 • - DIF TRANSPORTATION - RES •,y 1098.0.0 ter• � ' Fee summary: Charged f� Paid Credited -:Due, ,• ---'---------=----------------------- -- ------=-=----------- Permit Fee•.Total_ 851.97 .00 .00 851.97• _ �• Plan Check Total' 111.33- ..00 00 111:33 r. r Other Fee•Total 2423.45 .00 .'00 - 2423.45 t' 'Grand Total., 3386.75'- .00 •.00 3386.75 r • ♦ LQPERMIT r .. '. .. - " .f , - . _ - - •