06-0280 (TT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 .
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
-,06-00000280 ,
52265 ROSEWOOD LN
772-410-997-127 -30270
TEMPORARY TRAILER
MEDIUM HIGH DENSITY RES
. 2000
Architect or
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
s
LICENSED CONTRACTOR'S DECLARATION
I.hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70PO) *Division 3 of the Business and Professionals Code, and my License is in full force and effect.
LicensgC ss: A- Ages
0645
Contracip�
OWNER -BUILDER DECLARATION
I hereby ffirm 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 Coder 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 licensedpursuant 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 _ 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 ISec. '
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 rhe Contractors' State Licenoc Low.).
(_ 1 I am exempt under Sec. , BAP.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
Owner:
RJT HOMES - CODORNIZ
P.O. BOX 810
LA QUINTA, CA 92253
Contractor:
RJT INVESTMENTS INC
1425 E. UNIVERSITY DRIVE
PHOENIX, AZ 85034
(602)257-1656
Lic. No.: 690645
VOICE (760) 777-7012
FAX (760) 777-7011 .
INSPECTIONS (760) 777-7153
Date: 2/07/06
----------------------------------------------—
WORKER'S COMPENSATION DECLARATION /
I hereby affirm under penalty of perjury one of the following declarations: - I
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. '
1(1 have and will maintain workers' compensation insurance,,as required by Section 3700 of the Labor
7` 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
arson in any manner so as to become subject to the workers' compensation laws of California,
a agree that, if I should become subject to the workers' compensation provisions of Section
0 of the Labor Co wi , o ly wi a provisions.
D ( Applica..___"� -
WARNI G: AILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJE T N EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLAR ($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 persoo aL 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 or finances and state laws relating to building construction, and hereby authorize'representatives
of this cou to -ter upon the above-mentioned property ford p cction�pperrrUoses..
Date 7 ignature (Applicant or Agentll.' // i�`%�/
f
Application Number . . . . . 06-00000280
Permit I. . . TEMP TRAILER / MOBILE.HOME
Additional desc .
Permit Fee 200.00 Plan Check Fee
.00
Issue Date Valuation
2000
Expiration Date 8/06/06
Qty Unit Charge Per
Extension
BASE FEE
200.00
----------------------------------------------------------------------------
Special Notes and.Comments
TEMPORARY SALES TRAILER ON LOT 127 PER
MUP 2006-735.
Fee summary Charged Paid Credited
Due
Permit Fee Total 200.00 00 .00
200.00
Plan Check Total .00 .00 .00
.00
Grand Total 200.00 .00 •.00
200.00
LQPERMIT
' Bin #.
(� City of La Quinta _
Building & Safety Division
Permit # $� P.O. Box. 1504, 78-495 Calle Tampico
La Quinta, CA 922.53 -.(760) 777-.7012
Building Permit Application and Tracking Sheet
Projec-Address:
13 Z�� Owner's Ne: l LL�
A.P.Number:
Address: C"
320 O ,h D Yo�
Legal Description: do ryt I Z -7�z City, ST, Zip: &W
Contractor:
Telephone:
Address: _ _ i) Project Description: 5
City, ST, Zip: Z27
Telephone:
State Lit. # : CityLic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
1 �"
Telephone:
Constructs n Type: Occupancy:
State Lic. #:
_ . ..
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: `
w
# Sto 'es: #Units:
Sq. Ft.:.�h,
Telephone # of Contact Person: — b
stimated Project: ZOO
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Recd TRACKING-. PERMIT FEES
Plan Sets (18 Plan Check submitted d Item
-
Amount
Structural Calcs. Reviewed, ready for corrections Plan Check Deposit
Truss Calcs, Called Contact Person Plan Check Salance
Energy Calcs. Plans. picked up 'aConstruction
Flood plain plan Plans resubmitted
Mechanical
Grading, plan 2"" Review, ready correctionsrssne Electrical
Subcontactor List Called Contact Person Plumbing
Grant Deed Plans picked up
S.M.I:
H.O.A. Approval Plans resubmitted
Grading
IN HOUSE:- 3"" Review, ready for corrections/issue Developer Impact Fee
Planning Approval Called Contact Person A.I.P.P.
Pub. Wks. Appr Date of permit issue
School Fees
Total PermitYces
�RH • �rl��
TRACT NO.
32070
AVENUE
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