BWFE2015-0226LICENSED 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 Professions Code,
and my License is in full force and effect.
License Class: B. A / License No.: 6906
Date: ! Contractors
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 3
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.).
(_) 1, 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.).
( ) 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
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:. Policy Number:
I certify that in the performance of the work for which this permit is issued, u
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 Labor Code, I shall forthwith
comply with those provisions. I
Date: Applicant zZ ti
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 Building Official 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
construction, and herebyauthorize representatives of this city to enter upon the above-
mentioned'property for inspection purposes.
Date: 9" Signature (Applicant or Agent): s/
VOICE (760) 777-712E
78-495 CALLE TAMPICO
D `
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT.
INSPECTIONS (760) 777-715:
BUILDING PERMIT
Date: 6/26/2015
Application Number: BWFE2015-0226
Owner:
Property Address: 80028 SILVER SAGE LN.
RJT HOMES CODORNIZ.
APN: 777450007
.1425 E UNIVERSITY DR
Application Description: CODORNIZ / RJT HOMES / 31 LF OF 6' BLOCK WALL
PHOENIX, AZ 0
Property Zoning:
Application Valuation: $1,550.00
D
Applicant:
Contractor:
R J T INVESTMENTS INC
®2015
R J T INVESTMENTS INC
1130 E MISSOURI AVE STE 890
JUN 3
1130 E MISSOURI AVE STE 890
PHOENIX, AZ 85034
'
CRY CF LA QUINTA
PHOENIX, AZ 85034
COMMUNITY DEV IO PMENTDEPARTMENT
(602)2571656
Uc. 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 Professions Code,
and my License is in full force and effect.
License Class: B. A / License No.: 6906
Date: ! Contractors
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 3
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.).
(_) 1, 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.).
( ) 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
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:. Policy Number:
I certify that in the performance of the work for which this permit is issued, u
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 Labor Code, I shall forthwith
comply with those provisions. I
Date: Applicant zZ ti
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 Building Official 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
construction, and herebyauthorize representatives of this city to enter upon the above-
mentioned'property for inspection purposes.
Date: 9" Signature (Applicant or Agent): s/
111 l01 Eel, • • •
+a'DESCRIPTION l:i+'��`s Y; �ACCOUi.:i F •TY-� AINIOUNT =`w�`'T 13s'�.-�e!�`+PAID 41
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BSAS SB1473 FEE 101-0000-20306 0 $1.00
$0.00
a'4tt
PAIMETHOD'�'�{HECKY#"3
y CLTD BY;
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00- $0.00
,. DESCRIP,TION yet }�{
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tQTY�C'
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..,2.•..u".
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_
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101-0000-42600
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Total Paid forFENCE OR FREESTANDING WALL- $108.77 • $0.00
r
Description: CODORNIZ / RJT HOMES / 31 LF OF 6' BLOCK WALL
Type: WALL/FENCE Subtype: Status: APPROVED
Applied: 6/26/2015 SKH
Approved: 6/26/2015 SKH
Parcel No: 777450007 Site Address: 80028 SILVER SAGE LN LA QUINTA,CA 92253
Subdivision: TR 32070 Block: Lot: 7
Issued:
Lot Scl Ft: 0 Building Scl Ft: 0 Zoning:
Finaled: 1
Valuation: $1,550.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
_ -+F Tfr ,�����_•.
il'_�_'47�'.. 4';.-+,r�`^t,�
."`.r�:..
Details: 31LF OF 6' GARDEN WALL PATIO ENCLOSURE AND A/C EQUIPMENT WALL [PROTO 2 SPECIFICATIONS] PRECISION CONCRETE BLOCK
SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA
BUILDING CODES.
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
CONTACTS
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APPLICANT
R J T INVESTMENTS INC
1130 E MISSOURI AVE
STE 890
PHOENIX
AZ
85034
CONTRACTOR
R J T INVESTMENTS INC
1130 E MISSOURI AVE
STE 890
PHOENIX
AZ
85034
OWNER
RJT HOMES CODORNIZ
1425 E UNIVERSITY DR
PHOENIX
AZ
0
FINANCIAL INFORMATION r 1
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-
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City Of La Quinta
Building 8t Safety Dfvlalon
P.O. Box 1504,78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # _
3wK' a of S
Project Address:,FQ _(j � . S ZA)
Owner's Name: RJT Homes - Codorni z ,
LLC
A. P. Number:
Address: P.O. Box 6089/,V0—/ -0!F
Legal Description:
Contractor: RJT Investments, Inc.
City, ST, Zip: La Qu int a , CA 92248
Telephone.. 760-564-6555
Project Description:
Address: P.O. Box 6089
City, ST, Zip: La Quints, CA
92248BiIJWa,IL
S
Telephone: 760- 564 -6555
State Lia #: 6 9 0 6 4 5City
Lie. #; 6 0 8 9
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
Construction Type:,6'0/XA7)1AbCcupancy:
State Lic. #:
Project type (circle one)• ew Add'a Alter Repair
Demo
Name of Contact Person: .1 1i m MAP-TIA
.Q¢ F
I # Stories: # Units:
Telephone # of Contact Person:..' 6
— 64
Estimated Value of Project: X /5--6y, bfl
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Coles.
Called Contact Person
Plan Check Balance.
Tide 24 Cala.
Plans picked up
Construction
Flood plain plan
Plana resubmitted
Mechanical
Grading plea
V Review, ready for correctionvImue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plana picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review, ready for correctionvissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
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