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13-0019 (BLCK)4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT t(e Date: 1/04/13 Application Number: J3=00000019__ Owner: Property Address: 52140 DESERT SPOON CT RJT HOMES - CODORNIZ APN: 772-410-997-112 -30270 - P.O. BOX 810 Application description: WALL/FENCE LA QUINTA, CA 92253. Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 1650 Contractor: 'Applicant: Architect or Engineer: D R INVESTMENTS INC E. UNIVERSITY DRIVE q a1 P IX, AZ 85034 A!��I QOM` .1257-1656 :690645 di rr or LA QUINTA FINANCE DEPT. ------------------------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided Lic ns e C ass A B License No.: 690645 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: ontractor: 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 workers' compensation OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier LUMBERMEN' S UND Policy Number 424430 following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ 1 certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the OFAILU on in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) br 0 of the Labor Code, I s /I rtcomply with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by /i any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500): ate:!plicant: ( 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 WAR NE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,Odo). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). APPLICANT ACKNOWLEDGEMENT 1 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, I—) I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City 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: Ir LQPERMIT of La Quetta, 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 coun y ord' ances and state laws relating to building construction, and hereby authorize representatives of this court ,_ _/�t� @7rupon the above-mentioned property actio ses. L/si ature (Applicant or Agent): �� Application Number . . . . . 13-00000019 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee 39.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 1650 Expiration Date 7/03/13 Qty Unit Charge Per Extension BASE FEE 15.00 12.00 2.0000 HND BLDG 501-2,000 24.00 ---------------------------------------------------------------------------- Special Notes and Comments 66 L.F. 6' GARDEN WALL, ORCO SYSTEM. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited ---------- ---------- Due --------=-------- Permit Fee Total -------------------- 3.9.00 .00 ..00 39.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 40.00 .00 .00 40.00 LQPERMIT Bin # City of La Quwnta Building 81' Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quanta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # (� 13' Project Address: Cj� 7 �C aD� Owner's Name: RJT Home s - Codorni z , LLC 4F I A. P. Number:LAW Address: P.O. Box 6089 Legal Description: 0. Contractor: RJT Investments, Inc . Address: P.O. Box 6089 City, ST, Zip: La Qu i nt a, CA 92248 Telephone: 760-564-6555 Project Description: City,ST,Zip: L•a Quinta, CA 92248 D-rc-0 &m W-415 Telephone: 7 6 OL-544 • 7� StateLla#: 690645 CityLic.#; 6089 Arch., Engr., Designer. 1 v le 1 Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lie. #: 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 UNE # Submittal Req'd Recd TRACKNG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Pian Check Deposit Truss Cabs Called Contact Person Plan Check Balance. Title 14 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°! Review, ready for correcdonvIssue Electrical Subeontactor List Called Contact Person Plumbing Grant Deed Plans picked up SALL H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Rcylew, ready for correctlonsRssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit Issue School Fets Total Permit Fees