13-0018 (BLCK)~ P.O. BOX 1504 e�4
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA.92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:13-00000018
;
Property Address:
52160 DESERT SPOON CT
APN:.
772-410-997-114 -30270
Application description:
WALL/FENCE
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
1650
Applicant: Architect or Engineer:
-
---------------------------------- - - - - -- ;,(% -1r,
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.
Lic nse C ss: B license No.: 690645
Date: iContractor•. �'
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)l 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 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 _ 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
Owner:
RJT HOMES - CODORNIZ
P.O. BOX 810
LA QUINTA, CA 92253
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: 1/04/13
WORKER'S COMPENSATION DECLARATION
i ;
p
under penalty of perjury one of the following declarations:
ave 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
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,
*.FAILURE
agree that, if I should become subject to the workers' compensation provisions of Section
0 of the Labor Code, I h rthwith comply with those provisions.
i
Date:ittpplicant:
WAR 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 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 cou y ord' ances and state laws relating to building construction, and hereby authorize representatives
of this?PC'
he above-mentioned property ar '' ec ' poses.
ate: re (Applicant or Ageml:
Application Number . . . . . 13-00000018
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
--------------------
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
LQPERMIT
Bin #
City Of %a Qulnta
Building 8E Safety Division
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Petmlt #P.O.
Project Address:
Owner's Name: RJT Homes - Codorniz,
LLC
A. P. Number:
Address: P.O. Box 6089
Legal Description: ij ` 7-19V .
Contractor: RJT Investments, Inc.
Address: P.O. Box 6089
City, ST, Zip: La Quinta, CA 92248
Telephone: 760-564-6555
Project Description:
City, ST, Zip: L•a Quinta, CA
92248
Telephone: 7 6 0 -V
StateLIa#: 690645
Arch., Engr•, Designer.
CityLic.#; 6089
1
� e
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair
Sq. Ft.: # Stories: # Units:
Demo
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cala.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance •
Tide 24 Calm
Plans picked up
Construction
Flood plain plan
Plana resubmitted
Mechanical
Grading plan
2°' Review, ready for correctionallasue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plana picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for correctton0mue
Developer Impact Fee
Planning Approval
Called Contact Person
AJ.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees