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05-4610 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: r'05-00004610 t �--52193--ROSEWOOD! LN 772-410-997-134 -32070 - DWELLING - SINGLE FAMILY PIEDZUM IIICI•I EENCITY REE 100157 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: RJT HOMES.- CODORNIZ P.O. BOX 810 DETACHED LA QUINTA,.CA 92253 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 Code, and my License is in full force and effect. License Cie AA B o.: 690645 oate�37�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 signedstatement 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.). (_) 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 (Sec. 3097, Civ. C.). - Lender's Name: Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 ------------------ WORKER'S COMPENSATION DECLARATION Date: 10/14/05 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 to the workers' compensation provisions of Section 3700 of the La>or Code, I shall fo/rthw/ith,� ith those provisions. ate plicant: / 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. j 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 permitissued 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 prop�oses. nature (Applicant or Agent): Contractor: ct or ineer: a RJT HOMES LLC 1425 E. UNIVERSITY DRIVE PHOENIX, AZ 85034 _oc.T_1) i _ (760) 123-4567 c�✓Z�o�-r'}' _. j CITY OF LA Ql11NTA Lic. 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 Code, and my License is in full force and effect. License Cie AA B o.: 690645 oate�37�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 signedstatement 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.). (_) 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 (Sec. 3097, Civ. C.). - Lender's Name: Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 ------------------ WORKER'S COMPENSATION DECLARATION Date: 10/14/05 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 to the workers' compensation provisions of Section 3700 of the La>or Code, I shall fo/rthw/ith,� ith those provisions. ate plicant: / 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. j 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 permitissued 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 prop�oses. nature (Applicant or Agent): -4 - Application Application Number . . . . . 05-00004610 Permit . . . BUILDING PERMIT Additional desc . Permit Fee 643.00 Plan Check Fee ". 104.49 Issue Date . . . . Valuation . . . . 100157 Expiration Date 4/12/06 Qty-' Unit Charge Per Extension BASE FEE 639.50 1.00. 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,Q01-500,000 3.50 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 52.50 Plan Check Fee 3.28 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 2.00 6.5000 EA MECH VENT FAN 13.00 1.00 6.5000 ---------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . 79.66 Plan Check Fee 4.98 Issue Date . . . . Valuation 0 Expiration Date , 4/12/06 Qty Unit Charge Per Extension BASE FEE 15.00 1592.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 55.72 447.00 .0200 ---------------------------------------------------------------------------- ELEC GARAGE OR NON-RESIDENTIAL 8.94 Permit. PLUMBING Additional desc Permit Fee . . . . 140.25 Plan Check Fee 7.83 Issue'Date . . . . Valuation . . . . 0 Expiration,Date 4/1,2/06 Qty Unit Charge Per Extension BASE FEE 15.00 12.00 6.0000 EA PLB FIXTURE 72.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 LQPERMIT LQPERMIT Application Number . . . . . 05-00004610 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 --------------------------------------------------------------_-------------- Notes and Comments .Special SFD - LOT 134, PLAN SF3B, 1592 SF. =13 PERMIT DOES NOT INCLUDE POOL, SPA, DRIVEWAY APPROACH. 75% BLOCK WALLS OR REDUCTION TO 04 CEC/ 05 ENERGYPLAN CHECK FEES DUE TO tp,BLP/ MULTIPLE ISSUANCE OF SAME PLAN TYPE ----------------- . Other Fees . . . . DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 10.45 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 10.01 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due Permit Fee Total 930.41 .00 .00 930.41 Plan Check Total 120.58 .00 .00 120.58 Other Fee Total 2425.46 .00 .00 2425.46 Grand Total 3416.45 '.00 .00 3476.45 i Certificate of Occupancy yaw G OFTk�9�S 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 variousordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 52-193 ROSEWOOD LN Use classification: SINGLE FAMILT DWELLING Occupancy Group: R_3 Type of Construction: VN Owner of Building: RLT HOMES - CODORNIZ Building Official Building Permit No.: 05-4610 Land Use Zone: RMH Address: P.O. BOX 810 City, ST, ZIP: LA QUINTA, CA 92253 By: STEVE TRAXEL Date: AUGUST 2, 2007