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04-5142 (SATT)J 00 U n �111 BUILDING & SAFETY DEPARTMENT X 1`504 (760).777-7012 OFj;I149c 41K T `ICO FAX (760) 777-7011 L� QUINCALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 C IF NANCE DEPT BUILDING PERMIT Application Number . . . . X04-00005142 Dane 6/25/04 Property Address . . . . . . 79840 DE SOL A SOL APN: 772-390-046- - - Application description . . . DWELLING - SINGLE FAMILY ATTACHED Property Zoning . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 186025 Owner Contractor R J T HOMES RJT HOMES LLC 1425 E UNIVERSITY DR 1425 E. UNIVERSITY DRIVE PHOENIX AZ 85034 PHOENIX AZ 85034 WCC: STATE FUND WC: 1583906 10/01/04 CSLB: 690645 06/30/04 CCC:. A -B ------ Structure Information SATT ----- Construction Type . . . ... TYPE.V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10 Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CBC GARAGE SQ FTG 457.00 PATIO SQ FTG 867.00 TOT ELIGIBLE NO NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 2894.00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee 944.00 Plan Check Fee 153.40 Issue Date Valuation . . . . 186025 Qty. Unit Charge Per Extension BASE FEE 639.50 87.00 3.5000 THOU BLDG 100,001-500,000 304.50 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 72.00 Plan Check Fee 4.97 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 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: D 4` SlIA Date: Applicant: --ATChitect or Engineer: Applicant's Mailing Address: IArchitect or Engineer's Address: 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 ee, and my Licen sin ful force and effect. L Q L . 'cense Class�� 'cense No. 6 I O G u 5— OWNER-BUILDER DECLARATION 1 hereby affirm under penalty of perjury that 1 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 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 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 contractor(s) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , BA P.C. for this reason Date WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of pedury one of the following declarations: _ 1 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 / ued. //MMy coo comp nsation insurance carrier al ry u�r are— er tZ!12 tzW icy Number J 4f11l) I certify that, in the performance of the work for which this permit is issu�l shall not employ 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. _ WARNING: FAILURE TO SECURE WORKERS' COMPENSATdN COVERACoE 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.). Lender's Name Lender's Address I Ar– 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 Quints, 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 conecL I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned y property for inspection purposes. Date Signature (Applicant or Agent): `/ Application Number . . 04-00005142 Page 2 Date 6/25/04 Qty Unit Charge Per Extension 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA _ MECH B/C .<=3HP/100K BTU 9.00 .00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU .00 5.00 6.5000 EA MECH VENT FAN 32.50 .1.00 6.5000 EA MECH EXHAUST HOOD 6.50 --------------------=-------------------------------------------- Permit . . . ... . ELEC-NEW RESIDENTIAL ----------- Additional desc Permit Fee 125.43 Plan Check Fee 3.76 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 2894.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 101.29 457.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.14 ------------------------------=--------------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 207.00 Plan Check Fee 12.94 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per. Extension BASE FEE 15.00 23.00 6.0000 EA PLB FIXTURE 138.00 1.00 15.000'0 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 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 .7500.EA PLB GAS PIPE >=5 .4.50 1.00 15.0000 EA PLB'GAS-METER 15.00 -----------------------------------------7---------------------------------- Permit . . . . . GRADING PERMIT Additional desc Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension 'BASE FEE 15.00 --------------- Special Notes ----------------- - - - - - and Comments - -,------------------------ ------------ SFA.- LOT 86. PLAN P1B. PERMIT DOES NOT c t i x Page 3 Application Number . . . . . 04-00005142 Date 6/25/04 ---------------------------------------------------------------------------- Special Notes and Comments INCLUDE BLOCK WALL, POOL, SPA OR DRIVEWAY APPROACH. 75% REDUCTION TO PLAN CHECK FEE DUE TO MULTIPLE ISSUANCE OF SAME PLAN TYPE -------------------- ------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 68.00 DIF CIVIC CENTER - RES 229.00 ENERGY REVIEW FEE 15.34 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 18.60 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged ---------- Paid Credited ---------- Due ----------------- Permit Fee Total 1363.43 -------------------- .00 .00 1363.43 Plan Check Total 175.07 .00 .00 175.07 Other Fee Total 2034.94 .00 .00 2034.94 Grand Total 3573.44 .00 .00 3573.44