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04-3922 (SFD)y TAW.4y .�'axGQa BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-70.12 78-495 CALLE TAMPICO FAX (760) 777=7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 . BUILDING PERMIT Application Number . . . . . 04 00"0 -03 -92 -2 -LL- Date 5/07/04 . Proiperty:Address . . . . . 50240 VIA AMANTE- APN: 772-390-045-130 -29858 - Applicat.ion description DWELLING - SINGLE FAMILY ATTACHED Property Zoning . . . .. LOW DENSITY RESIDENTIAL Application valuation . 187754 Owner Contractor ------------------------------------------------ R.J. T HOMES r=o cam, RJT HOMES LLC 1425 E UNIVERSITY DR Cs L �. <W 1425 E. UNIVERSITY DRIVE ..PHOENIX AZ 85034 •PHOENIX AZ 85034 u. WCC: STATE FUND.... �. WC: 1583906 10/01"/04 CSLB: 690645 06/30/04 CCC': ": B -A ------ Structure Information SATT ----- Construction Type .. TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONE <=10 Flood Zone . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CBC .'GARAGE SQ FTG 457..00 PATIO SQ FTG 997:0.'0 TOT ELIGIBLE. .NO NUMBER OF UNITS.. 1.00 - FIRST -FLOOR SQ FTG 2894.00 Permit BUILDING PERMIT Additional desc Permit Fee 947.50 Plan Check Fee'. 615.88 Issue Date Valuation. 187754 Expiration -Date 5/07/05 Qty Unit Charge Per Extension BASE FEE 639.50 88.00 3.5000 THOU BLDG 100,001-500,000 308.00 Permit . . . . ELEC-NEW RESIDENTIAL. Additional desc Permit Fee 125.43 Plan Check Fee 3.77 Issue Date. :. Valuation 0 .Expiration Date 5/07/05' Qty Unit Charge Per Extension P.O. Box 1504 • .VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253. INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: L C Applicant's Mailing Address: P tom- a Xic� Date: Architect or Engineer: ik) I 64al' N5-' 2/z�r�r"f.tiE 5' Architect or Engineer' Address: dress: 60ULQ EiP, CQ Fjp C� Lic. No.: =13 60 BUILDING PERMIT DECLARATIONS 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 Licens�ee isin full force and effect. License Class (r iVERAL 65, License No. Dates— d --y Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U 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 or 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.). U 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 contractors) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. BA P.C. for this reason Date Owner WORKERS' 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. M�! workerr �mpensation insurance carrier and pglicnu Cartier S7A i� I=CI Policy Number_ J zl0.(p 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 forthwith comply with those provisions. Date C' Applicant WARNING: 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. 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.). Lenders Name N1 Lender's Address 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 the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, amend► hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. Date�d T 1/' Signature (Applicant or Agent): 1.p,61r Ph Fe r; Page 2 Application Number . . . 04-00003922 Date 5/07/04 Qty Unit Charge Per Extension BASE'FEE 15.00 2894'.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 10-.29 457.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL" 9.14 Permit . . . . . . GRADING PERMIT Additional' desc . Permit Fee .15.00 Plan Check Fee ..00 Issue'Date Valuation 0 Expiration Date 5/07/05 Qty Unit Charge 'Per Extension BASE FEE 15.00 Permit . . MECHANICAL Additional- desc . Permit Fee 79:50 Plan Check Fee 19.88 Issue Date . . . . Valuation 0 Expiration Date 5/07/04 Qty Unit•Charge Per Extension BASE FEE .15.00 1.00' 9.0000 EA MECH FURNACE <=100K 9.0.0 1.00 16.-5000 EA MECH B/C >3,-15HP/>100K-500KBTU 16.50 5.. 00 6.5000 EA MECH VENT.. FAN 32.50. 1.00 6.5000 EA. MECH EXHAUST HOOD 6.50 ----=--------------------------- Permit ------------------------------------ PLUMBING -------- Additional desc . Permit Fee 207.00 Plan Check Fee 51.75 - Issue Date • .. Valuation 0 'Expiration Date 5/07/04' Qty Unit'Charge Per Extension BASE FEE 15:00 23.00 6..0000 EA PLB FIXTURE 138.0.0.. 1.00 •15.0000 EAPLB. BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT. 7.5.0 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00. 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 6.00 .75.00 EA PLB GAS PIPE>=5 4.50 r - Page 3 e Application Number, 04-00003922. Date 5/07/04 Qty Unit Charge Per. Extension 1.00 15.0000 EA PLB GAS METER. 15.00 -----------=-----------=----------------=---------------------------- Other Fees ART IN.PUBLIC PLACES -RES. ------- .00 DIF COMMUNITY CENTERS -RES 68.00 DIF.CIVIC CENTER - RES 229.00 ENERGY REVIEW FEE 61.59 DIF FIRE.PROTECTION-RES. 78.00 GRADING PLAN CHECK FEE .00 " DIF LIBRARIES -.RES 158.00 DIF PARK MAINT FAC -.RES 3.00 DIF PARKS/REC - RES- 352.00 STRONG MOTION (SMI) - RES 18.77 DIF STREET MAINT FAC -RES "15.00 ' DIF TRANSPORTATION - RES '.1098.00 Fee summary Charged. Paid Credited .-Due Permit Fee Total "1374.,43' .00 .00 1374'.43 Plan Check Total 691.28 .00 .00 691.28 Other Fee Total .2081..36' .00 .00 2081.36" Grand Total 4147.07 .00 .00 4147..07