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BRES2014-1064{ e rp 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 1( Tww ^G lwQ" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BRES2014-1064 Property Address: 80092 SILVER SAGE LN APN: 777450022 Application Description: CODORNIZ TM 32070 PH 7A Property Zoning: Application Valuation: $98,772.00 Applicant: R J T INVESTMENTS INC c m � D 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. License jClas B A License No.: 690645 Date:? ► Contractor: OWNER -BUILDER DECLA ATION 1 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 fife 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, 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 Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: RJT HOMES CODORNIZ 1425 E UNIVERSITY DR PHOENIX, AZ 0 Contractor: R J T INVESTMENTS INC 1130 E MISSOURI AVE STE PHOENIX, AZ 85034 (602)257-1656 Llc. No.: 690645 Date: 7/24/2C14 s c A 0 a� O c m � D N G C � � U 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 worker' compensation, as provided for by Section 3700 of the Labor Code, for the performance o for which this permit is issued. I have and will maintain workers' compensation insurance, as required ty Sec n 3700 of the Labor Code, for the performance of the workfor which this per -nit 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, 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 3700 of the Labor Code, I shall forthw'th comppllyr with ose pr isions. Date�:�7 Applicant WARNI G: PAIL RE TO SECURE WORKERSCOMP NSATION 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 subjecu 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 6 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 cor-ect. 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: mentioned p operty/or inspection purposes. qq Date:' L ` Signature (Applicant or Agent)^ .DESCRIPTION :. :�z •R • '''`ACCOUNT QTY.. AMOUNT.' r3 ' �'PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $4.00 $0.00 PAID BY METHOD .' . ; + ` ', RECEIPT # "s 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 ` s ' •, ,• METHOD RECEIPT # CHECK # °CLTD BY DESCRIPTION: ACCOUNT` QTY " AMOUNT- + PAID' ' PAID DATE DIF - COMMUNITY CENTERS 254-0000-43200 0 $129.00 $0.00 , ` :.PAID BY •• , , METHOD f .RECEIPT#, . `f CHECK # CLTD BK'.. ' DESCRIPTION_ _ _ ACCOUNT' , QTY' AMOUNT.. ' PAID =; PAID DATE DIF - FIRE PROTECTION .257-0000-43200 0 $433.00 $0.00 ' PAID,BY _ METHOD - - . . rRECEIPT # < CHECK # „ CLTD BiY DESCRIPTION ';" Tz ACCOUNT `' e` ;.QTY -AMOUNT"` ' :; PAID 'P.AID DA -TE DIF - LIBRARIES 253-0000-43200 0 $344.00 $0.00 PAID BY 'METHOD 7.+' RECEIPT #.,' CHECK # CLTD BY DESCRIPTION .' , ' t ACCOUNT a QTY` AMOUNT, '. , ' PAID`PAID DATE DIF - PARK MAINTENANCE 256-0000-43200 0 $40.00 $0.00 " PAID BY ' " - ,METHOD RECEIPT.# ?CHECK # CLTD BY`'' DESCRIPTION :ACCOUNT QTY '..AMOUNT 1'. • .PAID = :PAID DATE DIF - PARKS/REC 251-0000-43200 0 $2,048.00 $0.00 PAID BY. ` METHOD ` s .. RECEIPT #. :" . " 'CHECK # , CLTD Elf w DESCRIPTION' ACCOUNT' ` , :QTY ; ' 'AMOUNT., . ` PAID PAID DATE DIF - STREET MAINTENANCE 255-0000-43200 0 $116.00 $0.00 PAID PAID BY ;'" METHOD .RECEIPT #':. _ .. CHECK " 9 CLTD EY, - ;; - '-: ACCOUNT QTY° �.: AMOUNT - ry PAID - PAID DATE DIF -TRANSPORTATION 250-0000-43200 0 $2,842.00 $0.00 PAID : i-° _ ° "" ' ° '' METHOD ..s - c4. `RECEIPT.# , CHECK # CLTD Elf- Total Paid forDIF - SINGLE FAMILY DWELLING, $6,894.00 $0.00 lDESCRIPTION :�i ACCOUNT ;. _ QTY =" AMOUNT PAID PAID DATE TEMP POWER SERVICE 101-0000-42403 0. 1 $23.83 $0.00 ` PAID`BY.." �" .METHOD '' '� L RECEIPT # " CHECK # :CLTD BY* Total Paid for ELECTRICAL: $23.83 $0.00 DESCRIPTION ACCOUNT - ACCOUNT- QTY •AMOUNT : I, s PAID- PAID -DA -TE RESIDENTIAL, RESIDENTIAL, EA ADDITION 1,000SF 101-0000-42403 0 $12.16 $0.00 PAID BY METHOD :° : -,RECEIPT # _ CHECK #, CLTD BY,. DESCRIPTION ' ACCOUNT 1 QTY' ` 'AMOUNT' '. r" .' PAID, = - PAID DATE. RESIDENTIAL, FIRST 1,000SF 101-0000-42403 .0 $143.00 $0.00 PAID BY a METHOD , •.'•`-` .'.:. ., �; RECEIPT # : - Vis, CHECK #:. CLTD INY Total Paid for ELECTRICAL - NEW CONSTRUCTION: $155.16 $0.00 DESCRIPTION = ; ; , • .`� , ' . -AC COUNT QTY. AMOUNT ' -a PAID PAID DATE RESIDENTIAL FINISH GRADING PC 101-0000-42600 0 $143.00 $0.00 PAID BY, ;'. - •: "i s METHOD. Y RECEIPT # . : - CHECK #.` ` „ CLTD ElY w Total Paid forGRADING: $143.00 $0.00 r �DESCRIPTION ACCOUNT, QTY; ' . 'AMOUNT ' f PAID ,PAID DATE' CONDENSER/COMPRESSOR 101-0000-42402 0 $35.75 $0.00 `5 PAID BY .x w METHOD. RECEIPT # "CHECK # CLTD E1( y .. DESCRIPTION' _ - ACCOUNT QTY .'" AMOUNT- : 'PAID . ' PAID DATE EXHAUST HOOD 101-0000-42402 0 $11.92 $0.00 PAID BY =METHOD r- RECEIPT# :CHECK # „, r'CLTD E?Y DESCRIPTION `, ;• . ACCOUNT QTY- AMOUNT r PAID » - -PAID DATE FURNACE 101-0000-42402 0 $35.75 $0.00 r, PAID.BY ,METHOD : `r : s; + ?RECEIPT# CHECK # t CLTD EY DESCRIPTION• ACCOUNT ...;' 'QTY ' •AMOUNT�- PAID PAID DATE VENT FAN 101-0000-42402 0 $47.68 $0.00 PAID BY• -'{METHOD _ .yRECEIPT # .CHECK # ' 'LT .CD EY Total Paid for MECHANICAL: $131.10 $0.00 °DESCRIPTION_;` " ;• ACCOUNT QTY AMOUNT',: `PAID *-- PAID DATE MULTI STRUCTURE PLAN CHECK - EACH 101-0000-42600 0 $47.67 $0.00 ' c ° PAID BY - . s ;' - ` #� ;+ METHOD TW.. '.. . - ;RECEIPT,# " m CHECK # ` , . CLTD EY= Total Paid forMULTI STRUCTURE PLAN CHECK - EACH: $47.67 $0.00 DESCRIPTION ` ``ACCOUNT QTY' ; '- ''AMOUNT` : 3. - PAID. o :PAID DATE MULTI -SPECIES RESIDENTIAL 8.1-14 UNITS 101-0000-20310 0 $537.00 $0.00 - :PAID BY;" 1 t METHOD " 'RECEIPT.# . `` CHECK # CLTD E•Y- I N Total Paid forMULTI-SPECIES RESIDENTIAL $537.00 $0.00 - :. :. • ;, DESCRIPTION- `s f .".ACCOUNT - QTY. ,;.r `-AMOUNT - -PAID°?;- � PAID DATE NEW CONSTRUCTION PERMIT 101-0000-42400 0 $491.80 $0.00 PAID BY ,µ METHOD i � " t'RECEIPT# '.t'CHECK.# SSL, CLTD BY Total Paid forNEW CONSTRUCTION PERMIT: $491.80 $0.00 ,:DESCRIPTION .. ' , u . `.-a7 ACCOUNT QTY .=. AMOUNT A, t PAID4'' �- , PAID DATE BUILDING SEWER 101-0000-42401 0 $11.92 $0.00 / PAID BY �� T METHOD - RECEIPT # ; j.CHECK # .'., .. CLTD BY. ' S QTY PAID br. PAIDDATEDECRI FIXTURE/TRAP 101-0000-42401 0 $119.20 $0.00 " PAID BY 7. -METHOD H RECEIPT #,q .. ;. 'CHECK # CLTD BY-. DESCRIPTION' ;', ' .` ; . ACCOUNT.{ QTY: AMOUNT, ' " PAID PAID DATE GAS SYSTEM, 1-4 OUTLETS 101-0000-42401. 0 $11.92 $0.00 PAID BY ..` _ `METHOD,'. .. PT +RECEI#; C HECK # CLTD BK DESCRIPTION , - ACCOUNT, ° , :; : -QTY AMOUNT` `. _ PAID, " PAID.DATE WATER HEATER/VENT 101-0000-42401 0 $11.92 $0.00 PAID BY; =. METHOD , - .. RECEIPT # -, `, _',_ CHECK # , CLTD BY .. .DESCRIPTION CITY:AMOUNT -PAID. PAID DATE WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $11.92 $0.00 - PAID BY "' -METHOD A RECEIPT # CHECK #CLTD BY 'Total Paid for PLUMBING FEES: $166.88 $0.00 _'. , y ACCOUNT QTc 'PAID DATE'DESCRIPTION SMI - RESIDENTIAL 101-0000-20308 0 $9.88 $0.00 PAID BY ' .,. METHOD . _ • y RECEIPT #- : ' 'z ' 3 ' • CHECK # CLTD BY - Total Paid forSTRONG MOTION INSTRUMENTATION SMt $9.88 $0.00 r DESCRIPTION 'ACCOUNT»z', .'QTY AMOUNT ` ,PAID PAID DATE SINGLE FAMILY DETACHED 224-0000-20320 0 $1,837.44 $0.00 PAID.BY '` METHOD - " t RECEIPT # ,. CHECK # CLTD BY Total Paid forTUMF - RESIDENTIAL: $1,837.44 $0.00 TOTALS:• 0• N