05-4644 (SFD)4 P.O: BOX 1504- ^�
78-495 CALLE TAMPICO
LA. QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 05-00004644 Owner:
Property Address: 5218"6-ROSEWOOD-�LN RJT HOMES - CODORNIZ
APN:772-410-997-39 -32070 -P.O. BOX 810
Application description: DWELLING - SINGLE ' FAMILY DETACHED/V' LA QUINTA, CA 92253
Property Zoning: MEDIUM _HIGH DENSITY -RES
Application valuation: 79869
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/14/05
v ®c ontractor:
Applicant: rchitect or Engineer: � �JT HOMES LLC
C/ ?O 1425 E. UNIVERSITY DRIVE
PHOENIX, AZ (760) 85034
123-456
®lE�NPq Lic. No.: 690645
--------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section .7000) of Division 3 of the Business and Professionals , and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation; as provided
License C ass: A -B ense No.: 690645 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
,11tratV4a4&,-<on1,actor: 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the . Carrier STATE FUND Policy Number 0014793-2005
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any -
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subje workers'
.compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or l,�C _ 37DOof the or Code, I shall f it comply with those provisions.
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).: Date: 0pplicant:
(_ 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 applyto 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 (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address: t4 ' 1%
LQPERMIT
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 constructs;;,,pnd hereby authorize representatives
of this county to enter upon a above-mentioned property fo pe purposes.
afT te�/0���� ignature
(Applicant or Agent):
LQPERMIT
Application Number .
. . . . 05.-00004644
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 BLDG
50,001-100,000
135.00
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
LQPERMIT
Application Number 05-00004644
Permit . . . . . . PLUMBING
Qty Unit Charge Per
Extension
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
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 39, PLAN SF1A, 1250 S.F.
PERMIT DOES NOT INCLUDE POOL, SPA,
BLOCK WALLS OR DRIVEWAY APPROACH. 7516 i 01 BLDG. M,
P/ 04 CEC/ 05 ENERG
REDUCTION TO PLAN CHECK FEES DUE TO l
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.
22.5.00"
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
LQPERMIT
t
... , -
a-er tificcu C y.
'
iez �
o �' ° _ Building, &- Safet .. De • artment
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. 4
- - -- ' -BUILDING ADDRESS: 52-186 ROSEWOOD LANE
Use classification: SFD Building Permit No.: 05-4644
Occupancy Group: R3. Type of Construction VN Land Use Zone: RMH •
Owner of Building: RJT-CODORNIZ� Address: P.O. BOX 810
City, ST ZIP: LA QUINTA, CA 92253
By: DAVID GATICA '
Date: AUGUST 11, 2006 '{•
Building Official
- POST IN A CONSPICUOUS PLACE -
09/17/2006 22:35 7605646505.
CITY 0 TA
BUILDING & D RTM
7012
INSPECT NRE F -ST LINE
77 �711f• r 2 8'2005
Owner R.TT HOMES, i.L CITYpF�
Contractor J TNVEC
SIMEN S, INC�EpEp
R
-Permit Number___05,.4644
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOBADDRESS_ 57-18612Cl.SEW IDD 1',ANE
SFD. LOT39:l?,LAN SF.IA. PERMIT DOES NOT INCLUDED,
POOL, SPA, BLOCK WALLS OR DRIVEWAY
APPROACH. •
TYPE OF INSPECTION f DATE
INSP.
TEMPORARY POWER ?
SETBACKS
U/G PLUMBING /WASTE _ / `- u - ;
5_
U/G ELECTRICAL/ GROUNDING
'u
FOOTINGS / STEEL 1
D
CONCRETE SLAB
ROUGH MECHANICAL
INSULATION
/2 .;
�.r' '
:"
.--DO NOT POUR CONCRETE UNTIL ABOVE SIGNED /.
R OK NA / PRE -ROOF
0 Y-rO WRAP
MING COMBINATION
'u
-UUGH ELECTRIC r
ROUGH PLUMBING
D
ROUGH MECHANICAL
INSULATION
,o D
�.r' '
:"
COVER NO WORK UNTIL ABOVE SIGNED
/
INTERIOR GYP. BD, DRYWALL
/,WD
/..'4
EXTERIOR LATH
GAS TEST
SEPTIC ABANDONMENT
SEWER CONNECTION
SEPTIC / GREASE INTERCEPTOR T
MASONRY INSPECTIONS I
FOOTINGS / STEEL _
BOND BEAM
POOL / SPA / WATER FEATURE INSPECTIONS
PRE-GUNITE / SETBACKS
U/G PLUMBING
U/G GAS `
U/G ELECTRICAL
PRE -PLASTER ALARMS / BARRIERS
FINAL INSPECTIONS ;
TEMP. USE OF PERMANENT POWER
ELECTRICAL
.'PLUMBING
iANICAL
LIC WORKS DEPARTMENT P
COMMUNITY DEVELOPMENT.DERT. f►
.:`...'.'FINAL/ J.OB.COMPLETED ;-.
ABOVE APOROVALS DO.
:NOT-INbLUD ' 91644T TO
TURN'ON-.UTILITIES OR 6CCUPY BUCL-DING' +