08-0208 (ELEC)4 P.O. BOX 1504 ^�
78-495 CALLE TAMPICO
- LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
` Application Number: 08-00000208 Owner:
Property Address: 80080 IRONBARK WY RJT HOMES - CODORNI
APN: 772-410-997-47 -32070 - P.O. BOX 810
Application description: ELECTRICAL LA QUINTA, CA 92253
Property Zoning: MEDIUM HIGH DENSSITY RES
Application valuation: :gz
Contractor:
Applicant: Architect or Engineer: RJT INVESTMENTS INC
1425 E. UNIVERSITY
� PHOENIX, AZ 85034
(602)257-1656
Lic. No.: 690645
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 Qlassif A -B nse No.: 690645
Date: Co_ntractor:.
r -
OWNER -BUILDER DECLARATION
here(y y a irm 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 ($5001: '�—
(_ 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 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—) 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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
DRIVE
1/29/08
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 worker's' compensation
insurance carrier and policy number are:
Carrier LUMBERM INS Policy Number 285868
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
700 of the Labor Code, I shall forthwith ply with those provisions.
Date: /1.011111
Applicant:
WAR ING: 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
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 isnot 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 co my dinances and state laws relating to building construction, and hereby authorize representatives
of this c ty t enter upon the above-mentioned property fo ec�tipo'nnppurposes.
Date: Signature (Applicant or Agent): W/y _2
' Application Number . . . . . 08-00000208
Permit ELEC-TEMPORARY POWER
Additional desc .
Permit Fee• 30.00 Plan Check Fee
'
'. Issue Date . . . . Valuation . . .
.00
. 0
Expiration -Date 7/27/08
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 15.0000 EA ELEC TEMPORARY POWER POLE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
200 AMP.TEMPORARY POLE PER APPROVED
PLANS.
Fee summary Charged Paid Credited
-----------------
Due
-----------------------------------------
Permit Fee Total 30.00 .00 .00
30.00
Plan Check Total .00 .00 .00
.00
Grand Total 30.00 .00 .00
30.00
LQPERMIT - -
'
C-1 .:.
Bin #
City of La Quinta
Building &–Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:
Owner's Name: RJT Homes-Codorniz, LLC
-
Address: P.O. BOX 810
Legal Description: Tract 32070
City. ST, Zip: LaQuinta-
Contractor: RJT Investments Inc.
Telephone: 760 564-6555
Address: P.O. BOX 810
Project Description: 100 iPji�l� rjjtir WF/1(
City, ST, Zip: La Quinta CA 92247
TrIL
Telephone: 760 564-6555
Ad&5
State Lie. # : 690645
City Lic. #: 4990
Arch., Etigr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft_:
# Stories:
—# units:
Telephone # of Contact Person: - \
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
flans resubmitted
Mechanical
Grading plan
2" Review, ready for correct innsrssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
flans picked up
S.M.I.
H.0,\. Approval
Plans resubmitted
Grading
IN IIOUSE:-
°n7 Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
'Total Permit Fees
TRACT N0. 32070 _
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