13-1319 (BLCK)T
1
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
13-00001319
80043 SILVER SAGE LN
77.2-410-997-11 -32070 -
WALL/FENCE
MEDIUM HIGH DENSITY RES
2250
T d-tt 4 44*rw
Architect or Engineer:
BUILDING;,& SAFETY DEPARTMENT
BUILDING PERMIT -
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
D L -u
OCT 17 2013
CITY OF LA QUINTA
5/13
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UCENSED ONTRACTOR'S DECLARATION
-
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WORKER'S COMPENSATION DECLARATION -
VOICE (760). 777-701?.
FAX (760) 777-7011
d
INSPECTIONS (760) 777-7153
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
D L -u
OCT 17 2013
CITY OF LA QUINTA
5/13
-------------------------------------------------
UCENSED ONTRACTOR'S DECLARATION
-
----------------------------------------------—
WORKER'S COMPENSATION DECLARATION -
I hereby affirm under penalty of perjury t I am I' e e er provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Bu i ss-aia ro ion I Code, and my License is in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class:. A B / i ense No.: 690645
I/Date:. • 1� Contracto .•
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
ef OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
insurance carrier and policy number are: '
Carrier LUMBERMEN' S UND Policy Num r 429034
following reason (Sec. 7031 .5, Business'and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the ork fo which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner o as to bec to the workers' compensation laws of California;
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I uld becom s ect to a workers' compensation provisions of Section
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
3700 offhe Lab e, I shall o with co ly with those provisions.
4 77 13 ✓/
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
Date: r / Applicant:
(_ 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 Professidns Code: The
WARNING: FAILURE TO SECURE WORT RS' COMPENSATI COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds. or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000)• IN ADDITION TO THE COST OF COMPENSATION, DAMAGES ASL PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
APPLICANT ACKNOWLEDGEMENT
(_ 1- I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not -apply to an owner of
-conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_) I am exempt under Sec. , B.&P.C. for this reason - }
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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
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,ocessationork for 180 days will subject
permit to cancellation.
certify that I have.read this application and state that the ove inft. I agree to comply with all
city and county.ordinances and state laws relating to bu' i g constry authorize representatives
of this county to enterrupon the above-mentioned pr ert for inspe
Date: 'I7 `� Signature (Applicant or Agent): .
LQPERMIT
• Application Number. . . . . 13-00001319'
Permit. . . . WALL/FENCE PERMIT 2013
Additional desc .
Permit Fee 47.19 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 2250.
Expiration Date 4/13/14 r
_ Qty Unit Charge Per
Extension
1.00 47.1900 LS MISC•WALL, FIRST 100 LF
47.19
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Special Notes and Comments
45 L.F. OF 67T. BLOCK GARDEN WALLS PER
ATTACHED APPROVED ORCO DETAIL [PRECISION
CONCRETE BLOCK SHALL BE COVERED WITH
STUCCO, PAINT, OR TEXTURED COATING -WHERE
VISIBLE FROM OUTSIDE THE PROPERTY]. 2010
CALIFORNIA BUILDING CODES.
7 -----------------------------------------------------------------------------
Other Fees. . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, WALLS
60.06
Fee summary Charged Paid Credited
---- - - - - - -
Due
-- - - -- - - - - - - - - - --
Permit Fee Total 47.19 .00 .00
47.19
Plan Check Total .00 .00 .00
.00
Other Fee Total 61.06 .00 .00
61.06"
Grand Total 108.25 .00 .00
108.25
LQPERMIT
Bin #
City of La Quints
Building 8r Safety Dfvlslon
P.O. Box 1504, 78-495 Calle Tampico
Qulnta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
L/2�-La
r/?7�.2
Project Address: �().d J//V
Owner's Name: RJT Homes - Codorniz, LLC
A. P. Number:,
Address: P.O. Box 6089
Legal Description:
Contractor: RJT Investments, Inc.
City, ST, Zip: La Qu i n t a, CA 92248
Telephone: 760-564-6555
Project Description:
Address: P. 0. Box 6089
City,ST,Zip: La Quinta, CA 92248
Telephone: 760-564 -6555
StateLio.#: 690645 CityLic.#, 6089
Arch., Engr., Designer.
Sh4fGiv
Address:
City, ST, Zip:
Telephone:
��
State Lic. #:
Name of Contact Person: ��
Construction Type: e 1 Occupancy:
G p cy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: Q - -7�6
Estimated Value of Project:
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calts.
Called Contact Person
Pian Check Balance
Title 24 Coles.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S,M L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A,I,P,P,
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
I