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BRES2014-1066s 78-495 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 V' 4 4v Qu!Krru COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BRES2014-1066 Property Address: 80037 SILVER SAGE LN APN: 777450010 Application Description: CODORNIZ TM 32070 PH 6A Property Zoning: Application Valuation: $82,720.10 Applicant: R J T INVESTMENTSINC 1130 E MISSOURI AVE STE 890 PHOENIX, AZ 85034 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. Licens{e(Class: A License No.: 690(6((45 / Date: " ContractoriJ` OWN`*�_� ER -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).: (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. (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 Na Lender's Add VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7_53 Owner: RJT HOMES CODORNIZ 1425 E UNIVERSITY DR PHOENIX, AZ 0 Contractor: R J T INVESTMENTS INC 1130 E MISSOURI AVE STE 890 PHOENIX, AZ 85034 (602)257-1656 LIC. No.: 690645 Date: 7/24/2014 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 W h this permit is issued. d will maintain workers' compensation insurance, as required by Labor Code, for the performance of the work for which this permit rs' compensation insurance carrier and policy number are: Carrier: _ Policy Number: _ _ I certify that in the performance of the work for which this permit is iss.ied, I shall not employ any person in any manner so as to become subject to the worker' 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 hose pr visions. Dat01 Applicant:---, WARNI : FAILU E TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP r0 ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR ODE, 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 whore request and for whose benefit work is performed under or pursuant to any perms issued as a result of this application , the owner, and the applicant, each agrees b, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agems, 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 wor< 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 city to enter upon the above - men ropert for inspection purposes. Date: / Signature (Applicant or Agent) °'DESCRIPTION r°;; r, FINANCIAL •R �, ,`ACCOUNT.• ` ' • ,. -.QTY s'• AMOUNT _ PAID .. '` PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $4.00 $0.00 PAID BY R = `METHOD' RECEIPT # `` z CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $4.00 $0.00 = DESCRIPTION = "ACCOUNT -,'' QTY AMOUNT-' ', PAID _ PAID DATE DIF - CIVIC CENTER 252-0000-43200 0 $942.00 $0.00 PAID BY "'METHOD-T-: - ;'RECEIPT # _ r : CHECK # CLTD BY . DESCRIPTION' - " "� ro `ACCOUNTQTY AMOUNT "` PAID,_,: PAID DATE, DIF - COMMUNITY CENTERS 254-0000-43200 0 $129.00 $0.00 ' PAID:BY `:- ` ' METHOD ' ' K ' ' RECEIPT # .> y CHECK # . r CLTD '3Y ; DESCRIPTION _" r ACCOUNT QTY= AMOUNT PAID _ PAID DATE DIF - FIRE PROTECTION 257-0000-43200 0 $433.00 $0.00 . 'PAID BY METHOD'. RECEIPT # s _ 'CHECK # CLTD 3Y DESCRIPTION �,"` _�_ ,, `A000UNTr' QTYi AMOUNT_'. 7 -.- PAID '' PAID DATE DIF - LIBRARIES 253-0000-43200 0 $344.00 $0.00 PAID BY - _- j METHOD., _ ' ; RECEIPT#' r •.. 4 +<< CHECK # . CLTDBY:• DESCRIPTION Y : :'' .ACCOUNT- -' * `CITY --AMOUNT, `� . � PAID -, PAID DATE DIF - PARK MAINTENANCE 256-0000-43200 0 $40.00 $0.00 _ ' :PAID BY , ' ` ., ; —;: METHOD... . ' RECEIPT# CHECK # .. "' CLTDZY -` . 'DESCRIPTION _ Y, ACCOUNT-' _' C(TY' r AMOUNT ._. 'PAID , - PAID DATE DIF - PARKS/REC 251-0000-43200 0 $2,048.00 $0.00 ,PAID BY'= ; `METHOD , " RECEIPT# = `. c "CHECK # �` CLTD BY.. DESCRIPTION`ACCOUNT CITY AMOUNT: ; ' , '. P AI D P AID LATE DIF - STREET MAINTENANCE 255-0000-43200 0 $116.00 $0.00 PAID BY METHODRECEIPT # CLTD:.BY " ACCOUNT, NQTY AMOUNT _ ` PAID PAID DATEDESCRIPTION DIF-TRANSPORTATION 250-0000-43200 0 $2,842.00 $0.00 METHOD . _ k."•'RECEIPT,# s Xi;. ,' CHECK # .. • CLTD BY Total Paid for DIF - SINGLE FAMILY DWELLING $6,894.00 $0.00 ` -.DESCRIPTION .. ACCOUNT QTY AMOUNT,- PAID - PAID DATE TEMP POWER SERVICE 101-0000-42403 0 $23.83 $0.00 PAID BY `' ,; METHOD . RECEIPT # „ r _. 'CHECK # • CLTD 6Y Total Paid for ELECTRICAL: $23.83 $0.00 =. DESCRIPTION :.: :; ;,'ACCOUNT: ti QTY _ AMOUNT;=, ”: RAID' PAID DATE, RESIDENTIAL, EA ADDITION 1,000SF 101-000042403 - 0 $12.16 $0.00 PAID BY ;, . METHOD r. . RECEIPT-# CHECK # CLTD 6Y _ `� �z DESCRIPTION' '-`. �_. LL �� ACCOUNT QTY "` -AMOUNT"'; _' 'PAID �, 'PAIDDATE RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $143.00 $0.00 'PAID BY METHOD '- RECEIPT# - ., , -`` :CHECK'# CLTD BY Total Paid for ELECTRICAL - NEW CONSTRUCTION: ' $155.16 $0.00 �• DESCRIPTION_ - '' ACCOUNT °CITY AMOUNT - :PAID; - PAID DATE RESIDENTIAL FINISH GRADING PC 101-0000-42600 0 $143.00 $0.00 PAID BY :'s _- < METHOD- ' RECEIPT #_^.,.' CHECK # CLTD 6Y Total Paid forGRADING: $143.00 $0.00 DESCRIPTION°,QTY ,AMOUNT -' PAID y PAID DATE CONDENSER/COMPRESSOR 101-0000-42402 0 $35.75 $0.00 PAID METHOD Y - �r�-RECEIPT# _}. ,CHECK#�- "CLTD BY "DESCRIPTION "" . ACCOUNT QTY ...AMOUNT - PAID PAID DATE EXHAUST HOOD 101-0000-42402 0 $11.92 $0.00 ._ PAID BY ."r' METHOD - RECEIPT # ,, _ ''CHECK # - CLTD BY ' DESCRIPTION :r- r. ACCOUNT QTY- -AMOUNT' " PAID PAID DATE FURNACE 101-0000-42402 0 $35.75 $0.00 PAID W'. METHOD' r _ 'RECEIPT CHECK# CLTD BY ; A DESCRIPTION .: _ 4 ... ACCOUNT ' ,' CITY = AMOUNT. = PAID PAID DATE VENT FAN 101-0000-42402 0 $47.68 $0.00 PAID BY ., - •' -METHOD RECEIPT #. - v :CHECK # CLTD BY Total Paid forMECHANICAL: $131.10 $0.00 F DESCRIPTION -.. x. `-, ACCOUNT ` ' QTY.. AMOUNT - , i PAID PAID DATE MULTI STRUCTURE PLAN CHECK - EACH 101-0000-42600 0 $47.67 $0.00 ` ' F "-PAID BY METHOD �„ . -r: x RECEIPT # CHECK # CLTD-BY Total Paid forMULTI STRUCTURE PLAN CHECK - EACH: $47.67 $0.00 DESCRIPTION 4 ACCOUNT QTY° ;AMOUNT . ; f.. PAID :. PAID DATE MULTI-SPECIES RESIDENTIAL 8.1-14 UNITS 101-0000-20310 0 $537.00 $0.00 ' PAID, BY =, , '.. -'METHOD;,- RECEIPT # CHECK # CLTD BY Total Paid forMULTI-SPECIES RESIDENTIAL, $537.00 $0.00 ' w�DESCRIPTION _- - x t ::T A ; ,,.- ACCOUNT i� rC�TY ' `AMOUNT PAID'. s :°i" ,PAID DATE NEW CONSTRUCTION PERMIT w 101-0000-42400 0 $478.84 $0.00 PAID BY . ° :. METHOD RECEIPT # CHECK # CLTD BY Total Paid forNEW CONSTRUCTION PERMIT: $478.84 $0.00 DESCRIPTION - ° "'. . _ , _ACCOUNT QTY r , AMOUNT '° ' PAID ? PAID DATE BUILDING SEWER 101-0000-42401 0 $11.92 $0.00 `PAID BY METHOD RECEIPT # ,;x :CHECK # . , - CLTD BY "DESCRIPTION, 4.. t,, . ;., ACCOUNT QTY AMOUNT `` PAID PAID DATE. FIXTURE/TRAP 101-0000-42401 0 $107.28 $0.00 . 6 PAID BY„.: ; y ; RECEIPT#` GHECK# CLTD BYMETHOD= .DESCRIPTION' ACCOUNT s ; : QTY AMOUNT ?? PAID PAID DATE GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 $$11.92 $0.00 ..PAID BY _ ,' ':'METHOD w RECEIPT # . 1<, CHECK # s . CLTD BY ' 'DESCRIPTION'.,', ACCOUNT'•, ` � „' 'QTY; , ' :, .AMOUNT.., s � s: PAID, PAID DATE WATER HEATER/VENT 101-0000-42401 0 $11.92 $0.00 ' . •`". PAID BY "::.. '.'.':r METHOD r ; " ., REC RECEIPT CHECK # :F CLTD, BY ` 'DESCRIPTION', V. ACCOUNT"' QTY. 'AMOUNT : ' PAID PAID DATE WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $11.92 $0.00 ,PAID By; ' ' ; _ METHOD ".RECEIPT # CHECK # .CLTD BY Total Paid for PLUMBING FEES: $154.96 $0.00 .DESCRIPTION , , .'PAID. PAID DATE SMI - RESIDENTIAL 101-0000-20308 0 $8.27 $0.00 PAID BY = a s METHOD y ..aY; RECEIPT # s :CHECK# CLTD BY.. Total Paid forSTRONG MOTION INSTRUMENTATION SMI $8.27 $0.00 >: DESCRIPTION . - ACCOUNT, . - :• QTY" AMOUNT ” ' "• PAID PAID DATE SINGLE FAMILY DETACHED 224-0000-20320 0 $1,837.44 $0.00 :. PAID BY -, - *. ,v .METHOD ' RECEIPT # -,CHECK # ''CLTD EY Total Paid forTUMF - RESIDENTIAL: $1,837.44 $0.00 TOTALS:• ••