13-0793 (SFD)P:O. BOX 1504
78495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:. .
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
13-00000793
80052 SILVER SAGE LN'
772-410-997-4 -3207.0 -
DWELLING - SINGLE'FAMILY
MEDIUM HIGH DENSITY RES
109180
VOICE (760) 777-7012
71._ �` FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Owner:
RJT HOMES CODORNIZ
1425 E UNIVERSITY
DETACHED PHOENIX, AZ 85034
Architect or Engineer:
------------
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 Professionals Code, and my License is in full force and effect..
License CI s: I A B License No.: 690645
Date: . iContractor:
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 a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
1 1 1, 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 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Seo.
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. , 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
Contractor'
D Q
D
JUL G 5 2013
CITY OF �A GIUINTA
FINANCE DEPT,
RJT INVESTMENTS INC
1425 E. UNIVERSITY DRIVE
PHOENIX, AZ 85034.
(602)257-1656
Lic. No.: 690645
7/05/13
-
---------------------------------------------—
WORKER'S COMPENSATION DECLARATION
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
1 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 subject to the workers' compensation laws of California,
and agree that, if I should, become subject to the workers' compensation provisions of Section
.13700 of the Labor Code 11 shall forth coo/9/3/ply/with those provisions.
Date Applicant:-
WAR]NG: 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 Director of Building and Safety for a permit subject to the t
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 hereby authorize representatives
of thi's ccoCty; enter upon the above-mentioned propert for,i pec ion purposes.
Date: / ,J ` Signature (Applicant or Agent):
r
i
LQPERMIT
Application -Number
13-00000793
------ Structure Information
1,692SF DWELLING/VB/RES-3/CLASS A-FR/13D-----
Other struct info
CODE EDITION
2010
# BEDROOMS
3.00
FIRE SPRINKLERS
13D
GARAGE SQ FTG
447.00
PATIO SQ FTG
25.00
NUMBER.OF UNITS
1.00
1ST FLOOR SQUARE FOOTAGE
950.00
---------------------------------------------------------
2ND FLOOR SQUARE FOOTAGE
-------------------
742.00
Permit . . .
BUILDING 2013
Additional desc .
Permit Fee . . . .
500.71 Plan Check Fee
00,
Issue Date
Valuation
. . 109180 °
Expiration Date
1/01/14
Qty Unit Charge
Per
Extension
BASE' FEE
431.86
85.00 .8100
----------------------------------------------------------------------------
THOU BLDG $25,001-$200,000
68.85'
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
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
i
LQPERMIT
LQPERMIT
Applicat7on, Number 1.3-00000793
•
.1s
LQPERMIT
Applicat7on, Number 1.3-00000793
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
r Special Notes and Comments f
1,,692SF DWELLING - PLAN SF3B, LOT 4
[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 5:05:09 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
10.92
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 1061.35 .00 .00
1061.35
Plan Check Total .00 .00 .00
.00
Other Fee Total 9326.03 .00 .00
9326.03
Grand Total 10387.38 .00 .00,
10387.38,
c