06-3990 (BLCK)A,
P.O. BOX 1504.
.
78-495 CALLE TAMPICO
LA,QUINTA, CALIFORNIA 92253 '
Application Number:
06'00-003-990
Property Address:.
52250—ROSEWOOD LN
APN:
772-410-997-143 -32070 -
Application description:
WALL/FENCE
Property Zoning:
MEDIUM HIGH DENSITY. RES
Application valuation:
. ' 4450
Applicant:
Architect or Engineer:
plC-
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LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am licensed under_ provisions of Chapter 9 (commencing with
Section 70 O) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License CI s: -B Of, License No.: 690645
ate: ontractor:
OWNER -BUILDER DECLARATION
I hereby affir 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 1$5001.:
(_ I 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: I 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:
LQPHRMIT
Owner:
RJT HOMES - CODORNIZ
P.O. BOX 810
LA-QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/16/06 ,
Contractor:
RJT INVESTMENTS INC
1425 E. UNIVERSITY DRIVE N' 16 2006 I
PHOENIX, AZ 85034 U IM)
(602) 257-1656 CiTYOF
LA Lic. No.: 69.0645 QUINTA
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WORKER'S COMPENSATION DECLARATION
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.
_Y_ 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 LUMBERM INS . Policy Number 283257
_ 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,
a d agree that, if I should become subject to the workers' compensation. provisions of Section
004 of the Labor Code, 1 s II f rthwith comply with those provisions.
ate: G/� pplicant:
WARNI G: AILURE 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 atwhose 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. .
1 certify that I have read this applica ' n and state that the above information is correct. 1 agree to comply with all
city and co ty o finances and to laws relating to building construction, and hereby authorize representatives
of this c to nter upo a above-mentioned property4ition purposes.
Datgnature (Applicant or Agent): ,
LQPERAIIT
Application Number . . . ... 06-00003990
Permit . . . WALL/FENCE
PERMIT
Additional desc .
Permit Fee . . . 72.00
Plan Check
Fee
00
Issue Date
Valuation
4450
Expiration Date 5/15/07
Qty Unit Charge Per
Extension
BASE
FEE
45.00 -
3.00 9.0000 THOU BLDG
2,001-25,000
27.00
-------------•----------------.-----------------------------------------------
Special Notes and Comments
178 LF 6' BLOCK WALL PER ORCO STANDARD
& APPROVED PRECISE.
Fee summary Charged
Paid Credited
Due
Permit Fee Total 72-.00
.00
.00
72.00
Plan Check Total .00
.0.0
.00
.00
Grand Total 72.00
.00
.00
72.00
Bin t# i✓�O City of La Quinta
Building U -Safety Division
Permit P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
,5-2J�}� Building Permit Application and Tracking Sheet
Project Ad m, , r p-
Owner's Name: RJT Homes-Codorniz, LLC
A. P. Number:
Address: P.O. BOX 810
Legal Description: Tract 32070
City. ST, Zip: La Quinta.
Contractor: RJT Investments
Inc.
Telephone: 760 564-6555
Address: P.O. BOX 810
Project Description:jig �, , ^LA
cit., ST, zip: La Quinta CA
92247
Telephone: 760 564-6555
5 z1;-?-�0
State Lie. # : 690645
city Lie. #: 4990DA
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Ceposit
Truss Calcs.
Called Contact Person
flan Check Ealance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
flans resubmitted
Mechanical
Grading plan
2nd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
flans picked up
S.I.I.
H.O,%. Approval
Plans resubmitted
Grading
LN IIOUSE:-
"' Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fecs
Total PermiaFees
%2