13-0575 (BLCK)\ P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-0 0O5"75
Property Address: 52155 DESERT SPOON CT
APN: 772-410-997-107 -_30270
Application description: WALL/FENCE
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 1650
Applicant:
Architect
or Engineer:
•_ 140"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
RJT HOMES - CODORNIZ
P.O. BOX 810
LA QUINTA, CA 92253
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury YVt I am lic sed er provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Bu e s and Pr f al Code, and my License is in full force and effect.
License Class: A B i ense No.: - 690645
Co�`
nt
oracto�__�L
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).:
1 _ 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 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.).
(_ 1 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
Contractor:
RJT INVESTMENTS INC
1425 E. UNIVERSITY DRIVE
PHOENIX, AZ 85034
(602)257-1656
Lic. No.: 690645
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: ' 5/03/13
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 workers' compensation
insurance carrier and policy number are:
Carrier LUMBERMEN'S UND Policy Number 424430
1 certify that, in the performance of the w rl for which this permit is issued, I shall not employ any
person in any manner o as to c me b'ect to the workers' compensation laws of California,
and agree that, if I s Id bec e I o the workers' compensation provisions of Section
3700 of the Labor e, I sh I f Jtwi mply with [hose provisions.
WARNING: FAILURE TO SECURE WOR69RS' 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 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 th bove infor at' i o rect. I agree to comply with all
city and county ordinances and state laws relating to bu' i g const do and eby authorize representatives
of this
/county
%to enter upon the above-mentioned pro %rt y for insp ti purpo e '
Date S.
Signature -(App icant or r AgentL: V
LQPER1111T
1
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Application Number . . . . . 13-00000575 _
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Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee 39.00 Plan Check Fee
.00
Issue Date Valuation . .
. 1650
Expiration Date 10/30/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
12.00 2.0000 HND BLDG 501-2,000
24.00
-------------------------------------------------------------------7--------
Special Notes and Comments
66 LN FT X 6 FT HT ORCO STANDARDS BLOCK
WALL PER APPROVED PLANS.
----------------------------------------------------------------------------
Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
--------------------
Due
-------------------------------------
Permit Fee Total 39.00 .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
LQPER1111T
1
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Bin #
17J
City of La Quinta
Building 8r 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: �� .' LSP,
'�"
Owner's Name: RJT Homes - Codorni z ,
Address: P.O. Box 6089
LLC
A. P. Number:
Legal Description:1r. 311
City, ST, Zip: La Quinta, CA 92248
Contractor. RJT Investments,
Address: P.O. Box 6089
Inc.
Telephone: 760-564-6555
Project Description:
City, ST, Zip: L•a Quinta, CA 92248
r
6�OL� b�'C� ZSg l7Vl
Telephone:760-564-6555:
"CiLie.#;
i
StateLic.#: 690645 6089
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
jo
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair
Demo
Name of Contact Person:
Sq. FL:
# Stories: --T-Units:
Telcphone # of Contact Person:
' %
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
q
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calm
Called Contact Person
Pian Check Balance
Tide 24 Calm
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
V Review, ready for correedons/issue
Electrical
Subeontaetor List
Called Contact Person
Plumbing
Grant Deed -
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
J
ew, ready for correctionslissue
I Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees