BWFE2016-013078-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BWFE2016-0130
Property Address: 52471 HAWTHORN CT
APN: 777460030
Application Description: RJT HOMES CODORNIE / BLOCK WALL
Property Zoning:
Application Valuation: $2,250.00
Applicant:
R YT INVESTMENTS INC
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 Class: B. A %'License No.: 690645
Date: r2t l7 Cont.o
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).:
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 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.).
(_) 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.).
( ) 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
PO BOX 6089
LA QUINTA, CA 92253
Contractor:
R 1 T INVESTMENTS INC
1130 E MISSOURI AVE STE 890
PHOENIX, AZ 85034
(602)257-1656
Llc. No.: 690645
Date: 6/15/2016
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 t4eVqrk for which this permit is issued.
� ve and will maintain workers' compensation insurance, as required by
Secti n 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: Polity 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 forthwith
comply with those provisions.
Date: IoP'—Zl App :
0.
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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official 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, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes. . /' _ _
Dat(L�?� Signature (A'pplicantror>Agen
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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 t4eVqrk for which this permit is issued.
� ve and will maintain workers' compensation insurance, as required by
Secti n 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: Polity 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 forthwith
comply with those provisions.
Date: IoP'—Zl App :
0.
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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official 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, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes. . /' _ _
Dat(L�?� Signature (A'pplicantror>Agen
DESCRIPTION,*
FINANCIALINFORMATION
ACCOUNT ., QTY AMOUNT : ' PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
$0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT''
PAID
PAID DATE
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$47.86
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNTQTY
AMOUNT
PAID
PAID DATE
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0
$60.91
$0.00
PAID BY
METHOD,
RECEIPT #
-.CHECK #
CLTD BY
Total Paid for FENCE OR FREESTANDING WALL:
TOTALS:0•
$108.77
$0.00
• 00
Description: RJT HOMES CODORNIE / BLOCK WALL
Type: WALL/FENCE Subtype: CITY STANDARD/PRE- Status: UNDER REVIEW
Applied: 6/15/2016 RSE
APPROVED
Approved:
Parcel No: 777460030 Site Address: 52471 HAWTHORN CT LA QUINTA,CA 92253
Subdivision: TR 32070 Block:. Lot: 76
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $2,250.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
APPLICANT
Details: 45LF OF 6' GARDEN WALL [CITY SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR
TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES
ADDITIONAL
CHRONOLOGY
CONDITIONS
CONTACTS
CITY STATE
ZIP
PHONE
FAX EMAIL
NAME TYPE
NAME
ADDRESSI
APPLICANT
R J T INVESTMENTS INC
1130 E MISSOURI AVE
STE 890
PHOENIX AZ
85034
(760)610-4214
CONTRACTOR
R 1 T INVESTMENTS INC
1130 E MISSOURI AVE
STE 890
PHOENIX AZ
1
85034
1
(760)610-4214
1
1 1 .
OWNER
RJT HOMES CODORNIZ
PO BOX 6089
LA QUINTA CA
1 92253
1 (760)610-4214
FINANCIAL INFORMATION
Printed: Wednesday, June 15, 2016 4:09:01 PM 1 of 2
SYSTEMS
BOND INFORMATION
ATTACHMENTS
Printed: Wednesday, June 15, 2016 4:09:01 PM 2 of 2 CJ
SYSTEMS
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS SB1413 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:.
WALL/FENCE -FIRST
101-0000-42404
0
$47.86
$0.00
100 LF
WALL/FENCE - FIRST
101-0000-42600
0
$60.91
$0.00
100 LF PC
Total Paid for FENCE OR FREESTANDING WALL: •$108.77 $0.00
TOTALS:•• 0•
BOND INFORMATION
ATTACHMENTS
Printed: Wednesday, June 15, 2016 4:09:01 PM 2 of 2 CJ
SYSTEMS
Bin #
: City of La Qufnta
• Building 8r SafetyDivision
P.O. Box 1504,78-495 Calle Tampico
U' Quinta, CA 92253 • (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
NFS 2016-6130
Project Address: &Z'
Owner's Name:. /
A. P. Number. �� �8��3�
Legal Description:
Address:
City, ST, Zip: E ��Y2_2 2Z
Contractor ��r �/%7 <UGS/!/�
Telephone _ S — %17
Address: �, �i ,� Q�' '
Project Description:
City, ST, Zip:.
Telephone:/ )
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S>F:o•f.¢:��s<l?C`.VS
State Lie.# : d
City Lie. 0.../ B�
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: `5�5%r ���� �� , a �yt�
State Lic. #: ;:
WU
Construction Occupancy:
Project type circle one Add'n Alter Repair Demo
Name of Contact Person _ ���
t.:
# Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project: Zzov, 6'D
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cala.
Plans picked up
Construction-
onstructionFlood
Floodplain plan
Plans resubmitted
Mecharitcal
Grading plan
2ud Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up .
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
INHOUSE:-
'^' 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
27
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