06-3063 (PC)4f�
tK
P.O. BOX 1504
78=495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoninq:
Application valuation:
Applicant:
4w"r.
06-00003063
52250—ROSEWOOD LN
772-410-997-143 -32070 -
PATIO COVER - RESIDENTIAL
MEDIUM HIGH DENSITY RES
22344
T Architect or EI
Aid*¢l
#�' 3,7A
4.4 Qulk&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760).777-7012
FAX(760)777-7011
INSPECTIONS (760) 777-7153
Date: 8/23/06
Owner:
RJT HOMES - CODORNIZ
P.O. BOX 810 .
LA QUINTA, CA 92253
l�
a 4 Contractor:
RJT INVESTMENTS INC
SEP 192006 1425 E. UNIVERSITY DRIVE
PHOENIX, AZ 85034
Cm'OF (602)257-1656
�F�NAIunAQ�11NTe LiC. No.: 690645
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70 0) of Division 3'of the Business and Professionals Code, and my License is in full force and effect.
Licenseal ss: r B License No.: 690645
\ate: 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).:
(_) 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 withlicensed 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 _ 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
------------------
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 0460014793
_ 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
3 00 of the Labor Cy omply with those provisions.
gate: �pplicant:
WA NTNG. 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 personupon 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 isnot commenced
4cnt
ithin 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
t to cancellation. -
I cee read this application and state that the above information is correct. I agree to comply with all
citydinances and state laws relating to building construction, and hereby authorize representatives
of tter upon the above-mentioned propert or inspection purposes.
SatSignature (Applicant or Agent): �/
-Application Number . . . . . 06-00003063.
Permit PATIO COVER PERMIT
Additional desc .
' Permit Fee 234.00 Plan Check Fee
152.10
Issue Date .. Valuation . .
. 22344
Expiration Date 2/19/07
Qty Unit Charge Per
Extension.
:BASE ' 'FEE
45.00
21.00 9.0000 THOU BLDG 2,001-25,000
189.00
Permit ELEC-MISCELLANEOUS
Additional desc
Permit Fee . . . . 39.90. Plan Check Fee
9.98
Issue Date Valuation . . .
. 0 ~'
Expiration Date 2/19/07
Qty Unit. Charge` Per
Extension
BASE FEE
15.00
20..00 .7500'PER ELEC DEVICE/FIXTURE 1ST 20
15.00
22.00 .4500 .EA ELEC DEVICE/FIXTURE >20
*
9.90
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Special Notes and Comments
Special
21 QTY. 80 SQ.FT..TRELLIS W/ LIGHTING"
LOCATION IN COMMON AREAS. U=1 OCC. TYPE
V -N CONSTRUCTION.2001 CBC,CMC,CPC, 2004
CEC, 200.5 ENERGY CODES
----------------- - --------------------- --------------------------------------
Other Fees . . . . STRONG MOTION (SMI) RES
2.23
Fee summary Charged Paid Credited
Due
Permit Fee Total 273.90 .00 .00
273.90
Plan Check Total 162.08. .00 .00
162.08
r' Other Fee Total 2.23 _00 .00
2.23
Grand Total 438.21 .00 .00
438.21
LQPERMIT