13-0792 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA .92253
4. ar&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 13-00000792
Property Address: 80046 SILVER SAGE LN
APN: 772-410-997-3 -32070 -
Application description: DWELLING - SINGLE FAMILY DETACHED
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 115026
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
I her affirm under penalty of perjur that I am lice a under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the B i ess and Pr es als Code, and my License is in full force. and effect.
License Class: A B License No.: 690645
Date: �� �, Contractor:
OWNER -BUIL ER 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 apermit 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.).
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
f 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:
LQPER1111T-
--
VOICE (760) 777-7012'
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/05/13
Owner:
RJT HOMES CO
1425 E UNIVE Y DR
.PHOENIX, AZ 0 4 JUL 05 2013
J
CITY OF LA QUINTA
Contractor: FINANCE DEPT.
RJT INVESTMENTS INC
1425 E. UNIVERSITY DRIVE
PHOENIX, AZ 85034
(602)257-1656
Lic. No.: 690645
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 LUMBERMEN'.S UND Policy Number 429034
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 ahe workers' compensation laws of California,
and agree that, if I sho ecome suorkers' compensation provisions of Section
8q3,�700 of the Labor C shall fort wwith those provisions.
Date: / - u/1 Applicant:
WARNING:. FAILURE TO SECURE RKERS OMPENSATION VERAGE 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
EES.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 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 t above infor a 'o is co rect. I agree to comply with all
city and county ordinances and state laws relating to b ing constr do , a he eby authorize representatives
of this county to enter upon the above -mention( pr e y for inspe ti urpo
Date: i5 W 1 Signature (Applicant or Agent)
Application Number
. . . . 13-00000792
------ Structure Information
1,731SF DWELLING/VB/RES-3/CLASS A-FR/13D-----
Other struct.info .
CODE EDITION
2010
# BEDROOMS-;
3".00
FIRE SPRINKLERS
13D
GARAGE SQ FTG
598.00
PATIO SQ FTG
25.00
NUMBER OF UNITS
1.00
1ST FLOOR SQUARE FOOTAGE
989.00
2ND FLOOR SQUARE FOOTAGE
742.00
'Permit
BUILDING.2013
Additional desc .
Permit Fee . . . .
505.57 Plan Check Fee
.00
Issue Date
Valuation . . .
. 115026
Expiration Date
1/01/14 r
t
Qty Unit Charge
Per
Extension
BASE FEE
431.86
91.00 .810.0
THOU BLDG $25,001-$200,000
73.71
-------------------------------------------------
-------------------
7 --------
Permit . . .
ELECTRICAL 2013
Additional desc .
Permit Fee
191.15 Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
1/01/14
Qty Unit Charge
Per
Extension
1.00 23.8300
EA ELEC SERVICES
23.83
1.00 143.0000
LS ELEC NEW RES, FIRST 1 KSF
143.00.
2.00 12.1600
----------------------------------------------------------------------------
EA ELEC NEW RES, ADD'L 1 KSF
24.32
Permit
MECHANICAL 2013
Additional desc .
Permit Fee . . . .
143.02 Plan Check Fee
.00
Issue Date . . . .
Valuation
0
Expiration Date..
1/01/14
1
Qty Unit Charge
Per
Extension
1.00 35.7500
EA MECH FURNACE
35.75,
1.,00 35.7500
EA MECH CONDENSER/COMP
35.75
5.00 11.9200
EA MECH VENT FAN
59.60
1.00 11.9200,EA
----------------------------------------------------------------------------
MECH EXHAUST HOOD
11.92
Permit . . . . . .
PLUMBING 2013
LQPERIIIIT
Application Number . . 13-00000792
Permit . . . PLUMBING 2013
Additional.desc .
Permit Fee . . . . 226.47. Plan Check Fee..
.00
Issue Date Valuation . . .
. 0
Expiration Date 1/01/14
Qty- Unit Charge Per
Extension
13.00 11.9200 EA PLBG FIXTURE/TRAP
154.96
1.00 11.9200 EA PLBG BUILDING SEWER
11.92 '
1.00 11.9200 EA PLBG WATER HEATER/VENT
11.92
1.00 11.9200 EA PLBG WATER INST/ALT/REP
11.92
1.00 35.7500 LS PLBG GAS_SYS, 5+ OUTLETS
------,-------------------------------------
35.75
-----------------------
Special Notes and Comments
----------
1.,731SF DWELLING - PLAN SF3ASGR, LOT 3
[VB/RES-3/CLASS A-FR/13D/ENGINEERED]
THIS,PERMIT DOES NOT INCLUDE BLOCK WALLS
OR WATER FEATURES .**APPLICATION
ASSESSED A BASE PLAN REVIEW FEE OF
$47.67 DUE TO MULTIPLE ISSUANCE OF
BUILDING TYPE**. 2010 CALIFORNIA BUILDING
CODES.
June.25, 2013 4:48:52 PM AORTEGA
---------------------.-----------------------------------
Other Fees . . . . . . BLDG STDS ADMIN,(SB1473)
5.00
DIF COMMUNITY CENTERS" -RES
129.00
'DIF CIVIC CENTER - RES
942.00
DIF FIRE PROTECTION -RES
433.00
DIF LIBRARIES'- RES
344.00
MULTI -SPECIES (MSHCP) FEE
531.00
DIF.PARK MAINT FAC - RES
40.00
-DIF PARKS/REC - RES
2048.00
PLAN CHECK, MULTIPLE STR
47.67
STRONG MOTION (SMI) - RES
11.50
TUMF: RESIDENTIAL
1837.44
DIF STREET MAINT.FAC-RES
116.'00
DIF TRANSPORTATION - RES
2842.00
Fee.summary Charged Paid Credited
---------------------.----------------------------------
-Due
Permit Fee Total 1066.21 .00 .00
1066.21
Plan Check'Total .00' .00 .00
.00•
:Other -Fee Total 9326.61 .00 .00
9326.61
Grand Total 10392.82 .00 .00
10392.82
LQPERMIT